WorldWideScience

Sample records for cataract surgery review

  1. Impact of cataract surgery in reducing visual impairment: A review

    Rajiv Khandekar

    2015-01-01

    Full Text Available Purpose: The aim was to assess the impact of cataract surgeries in reducing visual disabilities and factors influencing it at three institutes of India. Materials and Methods: A retrospective chart review was performed in 2013. Data of 4 years were collected on gender, age, residence, presenting a vision in each eye, eye that underwent surgery, type of surgery and the amount the patient paid out of pocket for surgery. Visual impairment was categorized as; absolute blindness (no perception of light; blind (<3/60; severe visual impairment (SVI (<6/60-3/60; moderate visual impairment (6/18-6/60 and; normal vision (≥6/12. Statistically analysis was performed to evaluate the association between visual disabilities and demographics or other possible barriers. The trend of visual impairment over time was also evaluated. We compared the data of 2011 to data available about cataract cases from institutions between 2002 and 2009. Results: There were 108,238 cataract cases (50.6% were female that underwent cataract surgery at the three institutions. In 2011, 71,615 (66.2% cases underwent surgery. There were 45,336 (41.9% with presenting vision < 3/60 and 75,393 (69.7% had SVI in the fellow eye. Blindness at presentation for cataract surgery was associated to, male patients, Institution 3 (Dristi Netralaya, Dahod surgeries after 2009, cataract surgeries without Intra ocular lens implant implantation, and patients paying <25 US $ for surgery. Predictors of SVI at time of cataract surgery were, male, Institution 3 (OM, phaco surgeries, those opting to pay 250 US $ for cataract surgeries. Conclusion: Patients with cataract seek eye care in late stages of visual disability. The goal of improving vision related quality of life for cataract patients during the early stages of visual impairment that is common in industrialized countries seems to be non-attainable in the rural India.

  2. Barriers to cataract surgery in Africa: A systematic review

    Shaheer Aboobaker

    2016-01-01

    Full Text Available Cataract remains the leading cause of blindness in Africa. We performed a systematic literature search of articles reporting barriers to cataract surgery in Africa. PubMed and Google Scholar databases were searched with the terms "barriers, cataract, Africa, cataract surgery, cataract surgical coverage (CSC, and rapid assessment of avoidable blindness (RAAB." The review covered from 1999 to 2014. In RAAB studies, barriers related to awareness and access were more commonly reported than acceptance. Other type of studies reported cost as the most common barrier. Some qualitative studies tended to report community and family dynamics as barriers to cataract surgery. CSC was lower in females in 88.2% of the studies. The variability in outcomes of studies of barriers to cataract surgery could be due to context and the type of data collection. It is likely that qualitative data will provide a deeper understanding of the complex social, family, community, financial and gender issues relating to barriers to uptake of cataract surgery in Africa.

  3. Femtosecond laser-assisted cataract surgery: A current review

    Majid Moshirfar

    2011-01-01

    Full Text Available 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.

  4. Impact of cataract surgery in reducing visual impairment: A review

    Rajiv Khandekar; Anand Sudhan; B K Jain; Madan Deshpande; Kuldeep Dole; Mahul Shah; Shreya Shah

    2015-01-01

    Purpose: The aim was to assess the impact of cataract surgeries in reducing visual disabilities and factors influencing it at three institutes of India. Materials and Methods: A retrospective chart review was performed in 2013. Data of 4 years were collected on gender, age, residence, presenting a vision in each eye, eye that underwent surgery, type of surgery and the amount the patient paid out of pocket for surgery. Visual impairment was categorized as; absolute blindness (no perception...

  5. Cataract Surgery

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  6. Cataract Surgery in Uveitis

    Rupesh Agrawal; Somashiela Murthy; Sudha K. Ganesh; Chee Soon Phaik; Virender Sangwan; Jyotimai Biswas

    2012-01-01

    Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, ...

  7. A Review of Femtosecond Laser Assisted Cataract Surgery for Hawai‘i

    Chen, Ming

    2013-01-01

    Hawai‘i has had the first US Food and Drug Administration approved femtosecond laser (LenSx as shown in figure) for cataract surgery since early 2012, a brand new laser technology for modern cataract surgery in Hawai‘i. This article intends to evaluate the cost, safety, efficacy, advantages, and limitations of femtosecond laser-assisted cataract surgery through a review of the literature for the public of Hawai‘i. A search was conducted using keywords to screen and select articles from PubMed...

  8. Recovery after cataract surgery.

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

    2016-04-01

    Cataract surgery is the most common ophthalmological surgical procedure, and it is predicted that the number of surgeries will increase significantly in the future. However, little is known about the recovery after surgery. The first aim of this study was to evaluate the prevalence, severity and duration of pain and other ocular discomfort symptoms experienced after cataract surgery. The other objectives were to identify the factors associated with lower postoperative patient satisfaction and to measure the effect of cataract surgery on patients' health-related quality of life (HRQoL) and visual function in everyday life. The study design was a prospective follow-up study. The course of the recovery and the presence of ocular symptoms were evaluated by interviewing the patients via a questionnaire at 1 day, 1 week, 6 weeks and one year after surgery The visual functioning in everyday life was measured with Visual Functioning Index VF-7 and Catquest-9SF-questionnaires and furthermore the HRQoL was measured with the 15D-instrument before surgery and at 12 months after surgery. The patients returned the questionnaires by mail and were interviewed in the hospital on the day of the surgery. The same patients filled-in all the questionnaires. The patient reports were used to collect the data on medical history. A total of 303 patients were approached at Kuopio University Hospital in 2010-2011 and of these 196 patients were eligible and willing to participate, with postoperative data being available from 186 (95%) patients. A systematic review article was included in the study procedure and it revealed the wide range in the reported incidence of postoperative ocular pain. Some of the identified randomized controlled studies reported no or only minor pain whereas in some studies significant pain or pain lasting for several weeks has been described in more than 50% of the study patients. In the present study setting, pain was reported by 34% during the first postoperative hours and by approximately 10% of patients during the first six weeks after surgery. During the early recovery in the hospital, only a minority of the patients reporting pain were provided with pain medication. The ocular discomfort symptoms such as itchiness, burning, foreign-body sensation and tearing were common both before (54%) and after surgery (38-52%). These symptoms can also be described as painful symptoms and are often difficult to distinguish from ocular pain. The symptoms are also typical of ocular surface disease, and some patients may benefit from the postoperative administration of tear substitutes. The patients reporting postoperative ocular symptoms were less satisfied with the treatment outcome at 12 months after surgery (p = 0.001) compared to the patients who experienced no symptoms. Those patients reporting less disability in visual functioning before surgery were more satisfied than patients with more reported disability. The HRQoL improved significantly after cataract surgery (p = 0.002). However, when compared to an age-and gender-standardized control population, in cataract subjects the HRQoL remained slightly worse both before and at 12 months after surgery. PMID:27111408

  9. Advances in hard nucleus cataract surgery

    Wei Cui

    2013-11-01

    Full Text Available Security and perfect vision and fewer complications are our goals in cataract surgery, and hard-nucleus cataract surgery is always a difficulty one. Many new studies indicate that micro-incision phacoemulsification in treating hard nucleus cataract is obviously effective. This article reviews the evolution process of hard nuclear cataract surgery, the new progress in the research of artificial intraocular lens for microincision, and analyse advantages and disadvantages of various surgical methods.

  10. Femtosecond laser cataract surgery.

    Nagy, Zoltan Z; McAlinden, Colm

    2015-01-01

    Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages have resulted in improved visual and refractive outcomes in the short term. Complication rates are low which reduce with surgeon experience. This review article focuses on the Alcon LenSx system. PMID:26605364

  11. Immediate Sequential Bilateral Cataract Surgery

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...... performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery...

  12. Viscoless microincision cataract surgery

    Guy Sallet

    2008-06-01

    Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision

  13. Cataract Surgery Tool

    1977-01-01

    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.

  14. Cataract surgery in juvenile xanthogranuloma: Case report and a brief review of literature

    R Muralidhar

    2013-01-01

    Full Text Available There is limited literature on the management of cataracts in juvenile xanthogranuloma (JXG. A 2-month-old girl presented to us with hyphema, secondary glaucoma OU and skin nodules suggestive of JXG. She developed bilateral cataracts during her follow-up and was treated successfully with cataract surgery and aphakic rehabilitation.

  15. Pediatric Cataract Surgery

    Farid Karimian

    2008-12-01

    Full Text Available

    Several aspects of cataract surgery in children differ from adults. Ocular anatomy, cataract morphology, exaggerated response to surgical trauma, and the need for amblyopia therapy are major concerns in pediatric cataract surgery. Moreover, intraoperative differences such as location and type of incisions, management of anterior and posterior capsules and need for anterior vitrectomy are other important issues to be considered. Achieving a successful result depends on adhering to all the pre-, intra- and post-operative considerations and their proper management.

  16. Recent advances in congenital cataract surgery

    Zhou Zhou

    2014-11-01

    Full Text Available Congenital cataract is a common eye disease which leads to children low vision. Surgery is the main treatment. Because of children's preoperative evaluation, operation, postoperative management is more difficult than adult, the outcome of surgery is not so well. Therefore, we review the relevant congenital cataract surgery researches in recent years in order to discuss the problems and further developments in this area.

  17. Cataract Surgery in Eyes with Shallow Anterior Chamber

    Hüseyin Bayramlar; Remzi Karadağ; Ünsal Sarı

    2014-01-01

    Shallow anterior chamber may be encountered in an eye planned for cataract surgery as well as during phacoemulsification. In both situations, cataract surgery is a challenging case. In this article, we tried to review the situations and management of shallow anterior chamber in cataract surgery. (Turk J Ophthalmol 2014; 44: 388-91

  18. Changing indications for cataract surgery.

    Cairns, L; Sommer, A.

    1984-01-01

    Despite the fact that two community-based surgeons switched from routine intracapsular cataract extraction to planned extracapsular cataract surgery and routine implantation of posterior chamber lenses, they did not materially increase the size of their surgical load or change their indications for cataract surgery. In contrast a similar change in surgical technique by two high-referral hospital-based surgeons was associated with a marked increase in operative rates and increased preoperative...

  19. [Keratoplasty combined with cataract surgery].

    Muraine, M; Gueudry, J; Retout, A; Genevois, O

    2012-09-01

    Corneal pathologies leading to keratoplasty are often associated with cataract and combined surgery is therefore mandatory. Triple procedure with penetrating keratoplasty and concurrent cataract extraction followed by intra ocular lens (IOL) implantation is usually the preferential choice because visual rehabilitation is theoretically more rapid. Surgeons have to be aware of surgical conditions during open-sky surgery because vitreous pressure is not counterbalanced by anterior chamber pressure. Today, many surgeons prefer non-simultaneous procedures with cataract surgery performed months after grafting because of the improvement in spherical refractive error. More recently, new triple procedures, Descemet's stripping automated keratoplasty and concurrent cataract surgery have gained popularity, especially in patients with Fuchs dystrophy associated with cataract. Surgery starts with phacoemulsification, followed by endothelium exchange through a 3 to 5 mm incision. Advantages against classic triple procedure are quick visual rehabilitation, fewer induced refractive errors, minimal postoperative discomfort and corneal integrity. Surgeons have to consider an eventual postoperative hyperopic shift secondary to corneal lenticule shape when choosing adequate intraocular lens. PMID:22921023

  20. Risk of Retinal Detachment After Pediatric Cataract Surgery

    Haargaard, Birgitte; Andersen, Elisabeth W; Oudin, Anna; Poulsen, Gry; Wohlfahrt, Jan; la Cour, Morten; Melbye, Mads

    2014-01-01

    PURPOSE: To determine the long-term risk of retinal detachment following pediatric cataract surgery and to identify risk factors for retinal detachment. METHODS: We included all children (aged 0 to 17 years) who during the time period of 1977 to 2005 underwent pediatric cataract surgery in Denmark...... was based on medical chart review. RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3...... (16% [95% CI: 6%-24%]). CONCLUSIONS: The estimated overall risk of retinal detachment 20 years after pediatric cataract surgery was 7%, but only 3% for isolated cataract. Particularly high risks of retinal detachment after cataract surgery were associated with mental retardation and having other...

  1. Femtosecond laser in refractive and cataract surgeries

    Han-Han Liu; Ying Hu; Hong-Ping Cui

    2015-01-01

    In the past few years, 9 unique laser platforms have been brought to the market. As femtosecond (FS) laser-assisted ophthalmic surgery potentially improves patient safety and visual outcomes, this new technology indeed provides ophthalmologists a reliable new option. But this new technology also poses a range of new clinical and financial challenges for surgeons. We provide an overview of the evolution of FS laser technology for use in refractive and cataract surgeries. This review describes ...

  2. Simulation-based certification for cataract surgery

    Thomsen, Ann Sofia Skou; Kiilgaard, Jens Folke; Kjaerbo, Hadi; la Cour, Morten; Konge, Lars

    2015-01-01

    PURPOSE: To evaluate the EyeSi() simulator in regard to assessing competence in cataract surgery. The primary objective was to explore all simulator metrics to establish a proficiency-based test with solid evidence. The secondary objective was to evaluate whether the skill assessment was specific...... to cataract surgery. METHODS: We included 26 ophthalmic trainees (no cataract surgery experience), 11 experienced cataract surgeons (>4000 cataract procedures) and five vitreoretinal surgeons. All subjects completed 13 different modules twice. Simulator metrics were used for the assessments. RESULTS...

  3. Femtosecond laser in refractive and cataract surgeries

    Han-Han Liu

    2015-04-01

    Full Text Available In the past few years, 9 unique laser platforms have been brought to the market. As femtosecond (FS laser-assisted ophthalmic surgery potentially improves patient safety and visual outcomes, this new technology indeed provides ophthalmologists a reliable new option. But this new technology also poses a range of new clinical and financial challenges for surgeons. We provide an overview of the evolution of FS laser technology for use in refractive and cataract surgeries. This review describes the available laser platforms and mainly focuses on discussing the development of ophthalmic surgery technologies.

  4. Femtosecond laser in refractive and cataract surgeries.

    Liu, Han-Han; Hu, Ying; Cui, Hong-Ping

    2015-01-01

    In the past few years, 9 unique laser platforms have been brought to the market. As femtosecond (FS) laser-assisted ophthalmic surgery potentially improves patient safety and visual outcomes, this new technology indeed provides ophthalmologists a reliable new option. But this new technology also poses a range of new clinical and financial challenges for surgeons. We provide an overview of the evolution of FS laser technology for use in refractive and cataract surgeries. This review describes the available laser platforms and mainly focuses on discussing the development of ophthalmic surgery technologies. PMID:25938066

  5. Indication for cataract surgery. Do we have evidence of who will benefit from surgery? A systematic review and meta-analysis.

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2016-02-01

    The need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence-based recommendation for the indication of cataract surgery based on which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluating the outcome after cataract surgery according to preoperative visual acuity and visual complaints were included in a meta-analysis. We identified eight observational studies comparing outcome after cataract surgery in patients with poor (20/40) preoperative visual acuity. We could not find any studies that compared outcome after cataract surgery in patients with few or many preoperative visual complaints. A meta-analysis showed that the outcome of cataract surgery, evaluated as objective and subjective visual improvement, was independent on preoperative visual acuity. There is a lack of scientific evidence to guide the clinician in deciding which patients are most likely to benefit from surgery. To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of a patient has been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery. PMID:26036605

  6. Indication for cataract surgery. Do we have evidence of who will benefit from surgery? A systematic review and meta‐analysis

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    Abstract The need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence‐based recommendation for the indication of cataract surgery based on which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluat...

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

    Grob SR

    2014-07-01

    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

  8. Cataract surgery after Descemet stripping endothelial keratoplasty

    Sunita Chaurasia

    2012-01-01

    Full Text Available Management of endothelial dysfunction in phakic patients is sometimes a dilemma for corneal surgeons. Phakic patients with visually significant cataract and endothelial dysfunction are preferably managed by performing combined cataract surgery with endothelial keratoplasty. However, combined surgery may be deferred in eyes with early incipient cataract, younger age and where anterior chamber is poorly visualized. As cataract formation may be accelerated after endothelial keratoplasty, these eyes may need cataract surgery subsequently. Surgical intervention in eyes with endothelial keratoplasty is of concern as this may affect the graft adversely and threaten graft survival. In this report, we describe the intraoperative surgical details and postoperative clinical course of a patient who underwent phacoemulsification with intraocular lens implantation after Descemet stripping automated endothelial keratoplasty (DSAEK.

  9. Cost-utility of routine cataract surgery

    Ryynänen Olli-Pekka; Koivisto Anna-Maija; Leivo Tiina; Sintonen Harri; Krootila Kari; Räsänen Pirjo; Blom Marja; Roine Risto P

    2006-01-01

    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 bo...

  10. Simultaneous pterygium and cataract surgery.

    Gulani A; Dastur Y

    1995-01-01

    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. ...

  11. Cataract

    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 ...

  12. Evaluation of Changes of Macular Thickness in Diabetic Retinopathy after Cataract Surgery

    Kwon, Soon Il; Hwang, Duck Jin; Seo, Ji Young; Park, In Won

    2011-01-01

    Purpose To assess the macular thickness changes after cataract surgery in diabetic patients using optical coherence tomography (OCT). Methods We retrospectively reviewed the records of 104 diabetic patients who underwent cataract surgery. We examined the changes of macular thickness using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery. The central subfield mean thickness (CSMT) was used to evaluate macular edema which was defined as an increase of CSMT (ΔCSMT) > 30%...

  13. Intraocular lens employed for cataract surgery

    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.

  14. Intraocular lens employed for cataract surgery

    Roszkowska, A. M.; Torrisi, L.

    2014-04-01

    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.

  15. Simultaneous pterygium and cataract surgery.

    Gulani A

    1995-01-01

    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.

  16. Acute Endophthalmitis Following Cataract Surgery via Contaminated Phaco Needle

    Bozkurt, İlkay

    2014-01-01

    Cataract is one of the most common causes of visual impairment [1]. It is estimated that there are approximately 30 million blind people in the world and 50 percent of them are blind due to cataracts [2]. The only treatment for cataract is surgery and modern surgical techniques are extremely safe with few major complications [3]. Endophthalmitis is a severe intraocular inflammation which may occur as a serious complication of cataract surgery [4].In our hospital cataract surgery has been perf...

  17. Evaluation of povidone-iodine applications in cataract surgery

    Xi Zhang

    2013-09-01

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

  18. Surgical options for correction of refractive error following cataract surgery

    Ahmed A. Abdelghany; Alio, Jorge L

    2014-01-01

    Summary Refractive errors are frequently found following cataract surgery and refractive lens exchange. Accurate biometric analysis, selection and calculation of the adequate intraocular lens (IOL) and modern techniques for cataract surgery all contribute to achieving the goal of cataract surgery as a refractive procedure with no refractive error. However, in spite of all these advances, residual refractive error still occasionally occurs after cataract surgery and laser in situ keratomileusi...

  19. Outsourced cataract surgery and postoperative endophthalmitis

    Solborg Bjerrum, Sren; Kiilgaard, Jens F; Mikkelsen, Kim Lyngby; la Cour, Morten

    2013-01-01

    To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk.......To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk....

  20. New technology update: femtosecond laser in cataract surgery

    Nagy ZZ

    2014-06-01

    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 in2008, 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

  1. Cost-utility of routine cataract surgery

    Ryynänen Olli-Pekka

    2006-09-01

    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.

  2. Spontaneous corneal perforation post cataract surgery

    Chaudhary, Rishika; Mushtaq, Bushra

    2011-01-01

    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. T...

  3. Safety of deferring review after uneventful cataract surgery until 2weeks postoperatively

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    UNLABELLED: We conducted a systematic review and metaanalysis to provide evidence-based recommendations on the value of early postoperative review. We identified 3 randomized controlled trials (RCTs) that compared patients seen on the first postoperative day with those reviewed at 2 weeks; the 3 ...

  4. Cataract surgery following KAMRA presbyopic implant

    Tan TE

    2013-09-01

    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

  5. Tools to fight the cataract epidemic: A review of experimental animal models that mimic age related nuclear cataract.

    Lim, Julie C; Umapathy, Ankita; Donaldson, Paul J

    2016-04-01

    Cataract is the leading cause of blindness worldwide and accounts for approximately half of all forms of vision loss. Currently, the only way to treat cataracts is by surgery. However, with an ageing population, the demand for surgery and the need for cost effective alternative solutions grows exponentially. To reduce the need for cataract surgery, alternative medical therapies to delay cataracts are urgently required. However, given the difficulty in accessing human cataract lenses, investigating the process of cataract formation and testing the efficacy of potential therapies in humans is problematic. Therefore, researchers have looked to create suitable animal models of cataractogenesis to identify therapeutic options. This review will provide an overview of the cataract specific changes previously reported in human cataract lenses, before focussing on the specific changes that occur in age related nuclear (ARN) cataract, the most common form of cataract in humans. This will be followed by a discussion of a range of existing animal cataract models and their respective suitability for mimicking the processes associated with the development of ARN cataract, and therefore their utility as models to test anti-cataract therapies for future use in humans. PMID:26391448

  6. Axial length variability in cataract surgery

    To determine the mean axial length and biometric measures in patients undergoing cataract surgery and further compare the variability of axial length between the gender and with age. Study Design: Cross-sectional observational study. Place and Duration of Study: Eye Unit I, Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan from January 2010 to December 2012. Methodology: All patients referred for cataract surgery were assessed. The study included 886 eyes which were straightforward cataract cases with no other ocular problem. The data was collected for axial length, keratometric values and Intra-Ocular Lens (IOL) power prior to cataract surgery. The collected data was then analyzed using SPSS version 19 for windows software. Results: Gender based comparison showed significant difference in age, axial length, keratometric values and IOL power between the two groups (p=0.000). 86% of the eyes had an axial length between 21.00 mm and 23.99 mm. In univariate analysis there was significant (p=0.000) relation between overall age and axial length. The keratometric values ranged between 36.75 D and 52.50 D. Majority of the IOL powers ranged between 20.00 D and 23.00 D. Conclusion: The mean axial length of patients undergoing cataract surgery was 22.96 +- 1.04 mm, was comparable to Indian and Chinese population but shorter than the Western population. Females had shorter axial lengths, similar to other studies. Axial length was positively associated with age among the females, the cause of which is yet to be determined. (author)

  7. The clinical utility of new combination phenylephrine/ketorolac injection in cataract surgery

    Lawuyi LE

    2015-07-01

    Full Text Available Lola Elizabeth Lawuyi, Avinash Gurbaxani Moorfields Eye Hospital Dubai, Dubai, UAE Abstract: The maintenance of mydriasis throughout cataract extraction surgery and the control of ocular inflammation are crucial for successful surgical outcomes. The development of miosis during cataract surgery compromises the visualization of the surgical field and working space for surgeons. This may lead to complications that include posterior capsular tear and associated vitreous loss, longer surgical time, and postoperative inflammation. Postoperative inflammation is often uncomfortable and frustrating for patients. It causes pain, redness, and photophobia. This compromises the best-uncorrected vision following surgery and often leads to multiple clinic visits. This article examines the literature published on the current treatments used to manage mydriasis, pain, and inflammation in cataract extraction surgery. Combination phenylephrine/ketorolac injection offers an exciting new class of medication for use in cataract surgery. With the recent approval of Omidria™ (combination of phenylephrine 1% and ketorolac 0.3% by the US Food and Drug Administration (FDA for intraocular use, we review the clinical utility of this new combination injection in cataract surgery. PubMed, MEDLINE, and conference proceedings were searched for the relevant literature using a combination of the following search terms: cataract extraction surgery, pupil dilation (mydriasis, miosis, phenylephrine, ketorolac, Omidria™, intracameral mydriatic. Relevant articles were reviewed and their references checked for further relevant literature. All abstracts were reviewed and full texts retrieved where available. Keywords: cataract extraction surgery, ketorolac, mydriasis, miosis, Omidria™, phenylephrine

  8. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

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

    2007-01-01

    Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantagesand advantages, and the visual outcomes for simultaneous bilateralcataract surgery (SBCS) under general anesthesia.Methods: This retrospective case review pertained to a period spanning from June1998 through June 2005 inclusively, and comprised of 27 consecutivepatients (54 eyes) that underwent simultaneous bilateral cataract surgeryunder general anesthesia at the Kaohsiung Chang Gung Memorial Ho...

  9. Outcomes of Cataract Surgery in Vitrectomized Eyes

    Nilfer Koak

    2013-01-01

    Full Text Available Pur po se: To evaluate the intraoperative complications and postoperative visual outcomes of phacoemulsification surgery for the secondary cataract in vitrectomized eyes. Ma te ri al and Met hod: We retrospectively evaluated 51 previously vitrectomized eyes of 51 patients who had undergone phacoemulsification and intraocular lens (PHACO+IOL implantation surgery. PHACO+IOL surgery was performed in our clinic between October 2008 and May 2011. Intraoperative complications and postoperative best-corrected visual acuity (BCVA outcomes were analyzed. Re sults: In this study, 31 out of 51 eyes had posterior subcapsular cataract. Cataract surgery was performed after a mean of 21.3926.4 (6- 120, median 10.75 months following PPV. Mean preoperative and postoperative BCVA was measured to be 1.520.88 logMAR and 0.740.73 logMAR, respectively. In 25 eyes which had been filled with silicon oil, mean BCVA was 1.950.91 logMAR preoperatively and 1.150.84 logMAR postoperatively. In 18 (35.3% eyes which had been filled with sulfur hexafluoride tamponade, mean BCVA was 1.170.47 logMAR preoperatively and 0.383.6 logMAR postoperatively. Peroperative zonular dialysis with instable deep anterior chamber occurred in two eyes, and posterior capsular tear occurred in one eye. Four eyes had Nd:YAG capsulotomy due to the posterior capsular opacity during the follow-up period. Dis cus si on: Despite the well-known difficulties encountered in vitrectomized eyes such as zonular weakness, increased mobility of the lens-iris diaphragm, posterior capsular instability and posterior capsular plaques, phacoemulsification in vitrectomized eyes proved to be a safe surgery, and increase in visual acuity can be achieved. (Turk J Ophthalmol 2013; 43: 23-6

  10. Usefulness of Surgical Media Center as a Cataract Surgery Educational Tool

    Ogawa, Tomoichiro; Shiba, Takuya; Tsuneoka, Hiroshi

    2016-01-01

    Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications. Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators. Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery.

  11. Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

    Jan Teper, Slawomir; Dobrowolski, Dariusz; Wylegala, Edward

    2011-01-01

    The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature publi...

  12. [Cataract surgery: or why are there some patients excluded].

    Kara-José, N; Temporini, E R

    1999-10-01

    Cataracts are the main cause of blindness in the world, although they can be treated with relatively simple and inexpensive surgery. This study was carried out in 1997 and 1998 in five cities in the state of São Paulo, Brazil, to identify the reasons for persons not having cataract surgery. The population studied were patients seen at a community project for the rehabilitation of cataract-caused blindness, Projeto Zona Livre de Catarata (the Cataract-free-Zone Project). A questionnaire was used to interview 776 individuals with cataracts who sought assistance at the project and who had a visual acuity of 20/100 or less in the better eye. Six hundred and eighty-three patients had previously sought ophthalmic care, most frequently (27%) at public health services. The main reasons for subjects not having had cataract surgery were financial (69% of respondents) and the feeling of "still having good eyesight" (69% of respondents). Among patients who said they were afraid of surgery, the main reason was concern about being left blind. All the subjects whom the project deemed suitable for surgery agreed to undergo the procedure. Apparently, there is a gap between searching for ophthalmic services and the surgical resolution of cataracts. The predominant reasons for not having surgery were financial and logistical. There is a need to facilitate access to cataract surgery by decentralizing social services and by developing community projects to prevent cataract-caused blindness. PMID:10572474

  13. VISUAL OUTCOME FOLLOWING SURGERY OF TRAUMATIC CATARACT

    Prasad Rao

    2015-04-01

    Full Text Available AIM: To assess the visual outcome following traumatic cataract surgery and to assess the predictors of better visual outcome STUDY SETUP AND DESIGN: This is a prospective case study made on consecutive series of patients with traumatic cataract who underwent surgery between November 2012 to July 2013 at Government Regional eye hospital, Andhra medical college, Visakhapatnam . METHODS: Study was made on 100 eyes of 100 patients. Patient’s detailed history, clinical features, pre - operative examination, surgical intervention, post - operative visual acuity and follow up refraction changes record. RESULTS: In total , 100 eyes of 100 patients were included . Out of 100 cases, 78 cases (78% were males and 22 cases (22% were females. Good visual acuity of 6/6 – 6/18 was achieved by 70 cases, (70% out of which 58 cases (58% are closed globe type and 12 cases ( 12% are open globe type. 4 cases ( 4% achieved visual acuity of 6/24 to 6/609 . ( 1 26 cases ( 26% achieved a poor visual outcome of < 6/60 out of which 22 cases (22% are open globe type and 4 cases 4% are closed globe type . ( 2 CONCLUSIONS: Closed globe injury has a favorable prognosis for a satisfactory better that 6/18 visual recovery after surgical management of traumatic cataract , compared to open globe type. In case of open globe injury . (3 prompt wound repair , proper use of drugs to reduce infection , inflammation followed by timely surgery may improve the visual prognosis if there is no other sight threatening injury.

  14. Early Experience in Femtosecond Laser-Assisted Cataract Surgery

    Bilgehan Sezgin Asena

    2015-05-01

    Full Text Available Objectives: To analyze the early experience and intraoperative complications of femtosecond laser-assisted cataract and refractive lens exchange (RLE surgery. Materials and Methods: The initial 50 eyes of 29 patients who underwent cataract or RLE surgery between March 2013 and May 2013 were included in this study. All patients underwent anterior capsulotomy, lens fragmentation, and corneal incisions with the femtosecond laser (LenSx®, Alcon Inc.. The operation was completed by phacoemulsification and implantation of an intraocular lens. Intraoperative complications were evaluated from patient charts and video reviews retrospectively. Results: The mean age of the patients included was 63.8±11.7 years. No suction break or anterior capsule tear occurred in any case. Small anterior capsular tags occurred in 11 eyes (22%. The capsulotomy buttons were free-floating in 7 eyes (14%, while capsulorrhexis was partially completed with microadhesions in 40 eyes (60% and uncompleted in 3 eyes (6%. One eye (2% had a posterior capsule rupture secondary to increase in the intracapsular pressure. Corneal incisions either were not preferred to be used in 8 eyes (16% or could not be completed in 4 eyes (8%. Miosis occurred in 20 eyes (40%. No vision lost or dropped nuclei were observed. Conclusion: The use of femtosecond lasers in cataract and RLE surgery is safe. There had been no vision lost secondary to complications. (Turk J Ophthalmol 2015; 45: 97-101

  15. Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results

    Chang JS

    2013-04-01

    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

  16. The clinical utility of new combination phenylephrine/ketorolac injection in cataract surgery.

    Lawuyi, Lola Elizabeth; Gurbaxani, Avinash

    2015-01-01

    The maintenance of mydriasis throughout cataract extraction surgery and the control of ocular inflammation are crucial for successful surgical outcomes. The development of miosis during cataract surgery compromises the visualization of the surgical field and working space for surgeons. This may lead to complications that include posterior capsular tear and associated vitreous loss, longer surgical time, and postoperative inflammation. Postoperative inflammation is often uncomfortable and frustrating for patients. It causes pain, redness, and photophobia. This compromises the best-uncorrected vision following surgery and often leads to multiple clinic visits. This article examines the literature published on the current treatments used to manage mydriasis, pain, and inflammation in cataract extraction surgery. Combination phenylephrine/ketorolac injection offers an exciting new class of medication for use in cataract surgery. With the recent approval of Omidria™ (combination of phenylephrine 1% and ketorolac 0.3%) by the US Food and Drug Administration (FDA) for intraocular use, we review the clinical utility of this new combination injection in cataract surgery. PubMed, MEDLINE, and conference proceedings were searched for the relevant literature using a combination of the following search terms: cataract extraction surgery, pupil dilation (mydriasis), miosis, phenylephrine, ketorolac, Omidria™, intracameral mydriatic. Relevant articles were reviewed and their references checked for further relevant literature. All abstracts were reviewed and full texts retrieved where available. PMID:26203214

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

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

    2013-01-01

    Femtosecond laser-assisted cataract surgery (FLACS) represents a potential paradigm shift in cataract surgery, but it is not without controversy. Advocates of the technology herald FLACS as a revolution that promises superior outcomes and an improved safety profile for patients. Conversely, detractors point to the large financial costs involved and claim that similar results are achievable with conventional small-incision phacoemulsification. This review provides a balanced and comprehensive ...

  18. The effect of cataract surgery on ocular dominance

    Schwartz R; Yatziv Y

    2015-01-01

    Roy Schwartz, Yossi Yatziv Ophthalmology Department, Tel Aviv Sourasky Medical Center and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Purpose: The aim of this study is to assess whether eye dominance may change after cataract surgery. Methods: This is a prospective case series. Cataract surgery candidates were examined prior to surgery for best-corrected visual acuity, eye dominance, and handedness. Patients with ocular conditions that may affect visual ...

  19. Cataract Surgery Audit at a Private Hospital in Saudi Arabia

    Tariq Alasbali; Nancy Maher Lofty; Saeed Al-Gehaban; Alkuraya, Hisham S.; Abdulrahman M Alsharif; Rajiv Khandekar

    2015-01-01

    Background: To assess the visual outcomes following cataract surgeries at a Private Eye Hospital in Riyadh, Saudi Arabia. Methods: This was a cohort study of cataract surgeries performed from January to June 2014. Preoperative data were collected on patient demographics presenting and best corrected distance visual acuity (BCVA) and ocular comorbidity. Data were also collected on the type of surgery, type of intraocular lens (IOLs) implanted, and complications. BCVA and refractive status a...

  20. Determinants of Visual Outcomes in Femtosecond Laser Assisted Cataract Surgery and Phacoemulsification: A Nested Case Control Study

    Rajiv Khandekar; Ashley Behrens; Abdul Elah Al. Towerki; William May; Saeed Motowa; Komal Tailor; Ches Souru

    2015-01-01

    Purpose: We present the visual outcomes 6 weeks following Femtosecond laser assisted cataract surgery (FLACS) and conventional phacoemulsification cataract extraction (CE) cataract surgeries in 2013. Materials and Methods: This was a review of health record type of study. Eyes operated by FLACS and an equal number of conventional phacoemulsification (CE) on the same day by same surgeon were included in the study. Demographics, preoperative status, operative details and the best-corrected ...

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

    Bunce Catey

    2007-09-01

    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.

  2. Ocular safety limits for 1030nm femtosecond laser cataract surgery

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

    2013-03-01

    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.

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

    Khandekar Rajiv

    2007-01-01

    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.

  4. A review of the use of ketorolac tromethamine 0.4% in the treatment of post-surgical inflammation following cataract and refractive surgery

    Sandoval, Helga P; Fernández de Castro, Luis E; Vroman, David T; Solomon, Kerry D

    2007-01-01

    The non-steroidal anti-inflammatory drug (NSAID) ketorolac tromethamine 0.4% ophthalmic solution, a recent reformulation containing 20% less active ingredient that the original formulation, is indicated for the reduction of ocular pain and burning/stinging following corneal refractive surgery. Clinical studies have shown ketorolac tromethamine 0.4% to be as effective as ketorolac tromethamine 0.5% to control inflammation after cataract surgery including prevention of cystoid macular edema (CM...

  5. Cataract surgery and age-related macular degeneration. An evidence-based update

    Kessel, Line; Erngaard, Ditte; Flesner, Per; Andresen, Jens; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    PURPOSE: Age-related macular degeneration (AMD) and cataract often coexist in patients and concerns that cataract surgery is associated with an increased risk of incidence or progression of existing AMD has been raised. This systematic review and meta-analysis is focused on presenting the evidence...... concerning progression of AMD in patients undergoing cataract surgery. METHODS: We performed a systematic literature search in the PubMed, Medline, Cochrane Library and CINAHL databases. Two randomized trials and two case-control trials were identified. Quality of the studies was assessed using the Cochrane...... unoperated eyes, but the included number of subjects was small, and hence, the quality of evidence was downgraded to moderate. We did not find an increased risk of progression to exudative AMD 6-12 months after cataract surgery [RR 3.21 (0.14-75.68)], but the included number of subjects was small, and thus...

  6. Cataract surgery in a case of carotid cavernous fistula

    Akshay Gopinathan Nair

    2014-01-01

    Full Text Available A carotid-cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF.

  7. Cataract surgery outcomes in a Tertiary Hospital, Riyadh

    Bader Al-Qahtani

    2016-01-01

    Conclusion: Cataract removal is a safe and effective surgery which can improve the quality of life. It has some complications that can be minimised with good pre-operative evaluation and post-operative rehabilitation.

  8. Glaucoma in aphakia and pseudophakia after congenital cataract surgery.

    Mandal Anil; Netland Peter

    2004-01-01

    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 iden...

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

    Thevi Thanigasalam

    2014-08-01

    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.

  10. Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy

    Ostri, Christoffer; Lux, Anja; Lund-Andersen, Henrik; la Cour, Morten

    2014-01-01

    PURPOSE: To report long-term results, prognostic factors and cataract surgery after diabetic vitrectomy. METHODS: Retrospective review of patient files from a large diabetes centre between 1996 and 2010. Surgical history was obtained from the Danish National Patient Register. Follow-up intervals...... after 5 and 10 years, respectively. Use of silicone oil increased the risk of cataract surgery (p = 0.009, log-rank test). CONCLUSIONS: Most diabetic vitrectomy patients stand to gain visual acuity ?0.3 after surgery and a stable long-term visual acuity after 1 year. The only consistent long......-term predictor of low vision after surgery is use of silicone oil for endotamponade. About 2/3 of phakic patients will subsequently have cataract surgery the first 10 years after diabetic vitrectomy....

  11. Role of cataract surgery in lowering intraocular pressure

    To study the effects of cataract surgery in lowering of intraocular pressure (IOP). Study Design: Retrospective study. Place and Duration of Study: The Department of Ophthalmology, Combined Military Hospital, Rawalpindi from January 2011 to December 2013. Patients and Methods: The study included a total of 250 patients; of which 100 cases had simple cataract with no coexisting disease, 100 cases had cataract with primary open angle glaucoma and 50 cases of cataract had accompanying pseudoexfoliation glaucoma. All patients were assessed and recorded preoperatively for their IOP, vision, depth of anterior chamber (ACD), angle of anterior chamber by gonioscopy and glaucoma medications being used. Cataract surgery was performed by phacoemulsification and IOL implantations in all cases. These patients were followed up for a period of six months. Results: The intraocular ressure of all these patients was recorded at monthly interval for six months. The IOP showed a significant decrease in all cases and remained constant till the end of the study. A marked improvement of vision was noted in all cases. The depth of the anterior chamber increased and the angle also widened in all cases. Discussion: Cataract surgery has been found to reduce IOP along with improvement in vision. Patients with glaucoma have a dual benefit of reduced IOP and visual improvement after cataract surgery. (author)

  12. The Effect of Cataract Surgery on Circadian Photoentrainment

    Brøndsted, Adam Elias; Sander, Birgit; Haargaard, Birgitte; Lund-Andersen, Henrik; Jennum, Poul; Gammeltoft, Steen; Kessel, Line

    2015-01-01

    of cataract surgery on circadian photoentrainment and to determine any difference between blue-blocking and neutral intraocular lenses (IOLs). DESIGN: The study was a single-center, investigator-driven, double-masked, block-randomized clinical trial. PARTICIPANTS: One eye in 76 patients with...... conclude that cataract surgery does not adversely affect the circadian rhythm or sleep. Longer follow-up time and fellow eye surgery may reveal the significance of the subtle changes observed. We found no difference between blue-blocking and neutral IOLs, and, because of the minor effect of surgery in...

  13. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    Tien-En Huang

    2007-04-01

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

  14. Oxidative stress as a predictor of cataract surgery outcomes

    M. A. Kovalevskaya

    2015-03-01

    Full Text Available Exhaustion of anti-oxidative potential and oxidative stress are considered as trigger mechanisms of cataract development. Products of free radical oxidation are accumulated in lens. Decrease in water solubility of proteins results in the sorption of uncharged proteins on cellular membranes. This affects regular lenticular membrane folding. Light scattering on folded membranes of lenticular fibers is considered as a primary cause of lens opacities in cataract. Most problems occur in complicated cataract surgery as its development is associated with background diseases, ocular pathology, and external factor exposure. Aim. To increase the efficacy of cataract treatment in metabolic syndrome patients. Materials and methods. 115 cataract patients (230 eyes were examined. All patients have undergone detailed clinical and complex eye examination and were divided into 2 groups depending on cataract genesis. In group 1 (age-related cataracts, somatic disorders were diagnosed in 4.5% of cases, in group 2 (complicated cataracts, somatic disorders were diagnosed in 100% of cases. Tear and blood tests were performed. Tear level of active peroxiredoxin 6 (PRDX6 and/or its breakdown fragments in fluid and blood level of metabolic syndrome markers were studied. Results. The expression of oxidative stress protective enzymes in tear fluid was investigated. Comparative assessment of tear antioxidant enzyme activity under oxidative stress in therapeutic and surgical procedures (phaco and ECCE was performed. Post-operatively, PRDX6 increase was revealed in age-related cataract patients. This is confirmed by the absence of phaco complications. In complicated cataract, PRDX6 level was 6 times lower than in age-related cataract patients. Conclusions. Dynamic analysis of laboratory tests in complicated cataract patients confirmed or disproved the presence of general metabolic disorders and oxidative stress development. Tear proteomic profile and blood metabolic disorder parameters served as a basis for selective choice of topical and systemic antioxidant agents to prevent and stabilize lens opacities. 

  15. Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

    Dobrowolski, Dariusz; Wylegala, Edward

    2011-01-01

    The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature published on this topic and provides recommendations on how to reduce incidence of iatrogenic IFIS or its severity and outcomes in patients with BPH. PMID:24578865

  16. Cataract surgery in Knobloch syndrome: a case report

    Bongiovanni CS

    2011-06-01

    Full Text Available Carmen Slvia Bongiovanni1, Carla Cristina Serra Ferreira1, Ana Paula Silvrio Rodrigues1, Joo Borges Fortes Filho2, Mrcia Beatriz Tartarella11Department of Ophthalmology, Congenital Cataract Section, Medical School, Federal University of So Paulo, So 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

  17. EVALUATION OF VISUAL ACUITY AND QUALITY OF LIFE AFTER CATARACT SURGERY IN KOLAR DISTRICT

    Kanthamani; Narendra P.; Prashanth; Deepankar; Nagesha

    2014-01-01

    INTRODUCTION: Cataract is a highly treatable condition due to advances in cataract surgery procedures. The aim of cataract surgery is to improve visual function which in turn will improve overall quality of life. OBJECTIVE : To evaluate visual acuity and qu ality of life after cataract surgery. MATERIALS & METHODS : Five hundred patients having senile cataract attending the outpatient department of ophthalmology at R.L.JALAPPA Hospital between January 2011 to ...

  18. Effect of cataract surgery on regulation of circadian rhythms

    Erichsen, Jesper Høiberg; Brøndsted, Adam E; Kessel, Line

    2015-01-01

    Trials web site. Trials that reported the effect of cataract surgery on circadian rhythms were included. Outcomes were the Pittsburgh Sleep Quality Index (PSQI) global score, number of poor sleepers, Epworth Sleepiness Score, sleep efficiency, and mean concentration of melatonin. Cataract surgery......UNLABELLED: This review looked at the effect of cataract surgery on the regulation of circadian rhythms and compared the effect of blue light-filtering and clear intraocular lenses (IOLs) on circadian rhythms. A systematic review and metaanalysis were performed, and the level of evidence was...... improved regulation of circadian rhythms measured by the PSQI questionnaire, but the clinical relevance is uncertain. There was no difference between the effect of the 2 IOL types. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned....

  19. Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification

    Ming Chen

    2015-02-01

    Full Text Available AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery (FLACS and traditional phacoemulsification for the first 18mo of FLACS use at a private surgical center in Hawaii. METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined. All surgeries were performed at a single surgical center in Hawaii. The presence of intraoperative complications was used as the main outcome measure. Approval was obtained from the institutional review board of the University of Hawaii. RESULTS: The overall complication rate for FLACS was 1.8%, while that of the traditional procedure was 5.8% (PCONCLUSION: FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients.

  20. Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

    Kang, Kui Dong; Yim, Hye Bin; Biglan, Albert W

    2006-01-01

    Purpose To investigate the causes and characteristics of glaucoma in children following cataract surgery. Methods Twenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in ...

  1. Outcomes of Surgery for Posterior Polar Cataract Using Torsional Ultrasound

    Selçuk Sızmaz

    2013-10-01

    Full Text Available Purpose: The aim of this study is to report outcomes of surgery for posterior polar cataract using torsional ultrasound. Material and Method: Medical records of 26 eyes of 21 consecutive patients with posterior polar cataract who had cataract surgery using the torsional phacoemulsification were evaluated retrospectively. The surgical procedure used, phacoemulsification parameters, intraoperative complications, and postoperative visual outcome were recorded. Results: Of the 26 eyes, 24 (92.3% had small to medium posterior polar opacity. Two eyes had large opacity. All surgeries were performed using the torsional handpiece. Posterior capsule rupture occurred in 4 (15.3% eyes. The mean visual acuity improved significantly after surgery (p<0.001. The postoperative visual acuity was worse than 20/20 in 5 eyes. The cause of the low acuity was amblyopia. Discussion: Successful surgical results and good visual outcome can be achieved with phacoemulsification using the torsional handpiece. (Turk J Ophthalmol 2013; 43: 345-7

  2. Sutureless Cataract Surgery: Principles and Steps

    John Sandford-Smith

    2003-01-01

    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.

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

    Aasuri Murali

    1999-01-01

    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.

  4. CORTICAL CLEANUP WITHOUT SIDE PORT IN SMALL INCISION CATARACT SURGERY

    Udaya Kumar; Satyavathi; Khadari

    2015-01-01

    The aim of study was to achieve complete cortical cleanup and avoid problems related with sideport during Small Incision Cataract Surgery (SICS) so as to have a good visual out come with minimal recovery period, and a better quality of life. After nucleus delivery, cortical cleanup is an important step in any cataract surgical procedure. Cortex especially subincisional area (11 to 1 o’clock) is difficult to manage intraoperatively. Bimanual irrigation aspiration through two side p...

  5. Orbital cellulits following cataract surgery under peribulbar anaesthesia

    Mukherjee, C; Mitra, A.; Mushtaq, B

    2015-01-01

    Introduction: Orbital cellulits following cataract surgery is extremely rare. We describe a case of orbital and facial cellulitis that occurred after routine cataract operation with peribulbar anaesthesia. There were no preoperative systemic or ocular risk factors for postoperative infection. Case description: An 89-year-old man presented to eye casualty, the day after he underwent an uneventful phacoemulsification and posterior chamber lens implantation in the left eye under peribulabr ana...

  6. Safety of warfarin therapy during cataract surgery under topical anesthesia

    Newton Kara-Junior

    2015-06-01

    Full Text Available ABSTRACT Purpose: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. Methods: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30 and a control (n=30 group. Results: There were no records of intraoperative or postoperative intracameral bleeding complications in both the groups. At 1-month postoperative follow-up, 90.0% of patients presented spectacle-corrected visual acuity of at least 20/40. Conclusion: Cataract surgery by phacoemulsification with topical anesthesia can be successfully conducted without discontinuing warfarin.

  7. Evolving trends in cataract surgery techniques and timing.

    Koch, P S

    1997-02-01

    Evolution in cataract surgery developed along two fronts: technique and timing. New cannulae with very wide aspiration ports permit nucleosuction; a manual small incision method that fractionates and aspirates the nucleus. Phacoemulsification is made easier and safer with phaco sweep. Posterior capsule polishing is gentle if the only vacuum is generated by the infusion passing through the system and the aspiration tubing is not used. Fibrin glue may make long corneal incisions as stable as short ones. Several studies challenge our conventional thoughts simultaneous bilateral cataract surgery and whether patients need to be examined on the first postoperative day. PMID:10168267

  8. The effect of cataract surgery on ocular dominance

    Schwartz, Roy; Yatziv, Yossi

    2015-01-01

    Purpose The aim of this study is to assess whether eye dominance may change after cataract surgery. Methods This is a prospective case series. Cataract surgery candidates were examined prior to surgery for best-corrected visual acuity, eye dominance, and handedness. Patients with ocular conditions that may affect visual acuity were excluded from the study. A month following surgery, best-corrected visual acuity and eye dominance examinations were repeated. Results The study included 33 patients with a mean age of 70.59.4 years. Eighteen patients (54.5%) had right eye dominance. Following surgery, seven patients (21.2%) had a change in eye dominance. The change in dominance was linked to improved visual acuity in the operated eye and to a younger age, although with no statistical significance. Conclusion This is the first study reported in the literature to show that ocular dominance is a plastic characteristic following cataract surgeries. The results may change the importance given to eye dominance measurement prior to surgeries that rely on this examination, such as monovision surgeries. PMID:26715837

  9. Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery

    Lav Kochgaway

    2013-01-01

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

  10. Cataract Vision Simulator

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... What Are Cataracts? Cataract Symptoms Who Is at Risk for Cataracts? Cataract Causes Cataract Diagnosis Cataract Treatment ...

  11. A prospective study on postoperative pain after cataract surgery

    Porela-Tiihonen S

    2013-07-01

    Full Text Available Susanna Porela-Tiihonen,1 Kai Kaarniranta,2 Merja Kokki,1 Sinikka Purhonen,1 Hannu Kokki1 1Department of Anesthesia and Operative Services, Kuopio University Hospital, School of Medicine, University of Eastern Finland, Kuopio, Finland; 2Department of Ophthalmology, Kuopio University Hospital, School of Medicine, University of Eastern Finland, Kuopio, Finland Purpose: To evaluate postoperative pain and early recovery in cataract patients. Patients and methods: A total of 201 patients who underwent elective first eye cataract extraction surgery were enrolled, and 196 were included in the final analysis. The study design was a single-center, prospective, follow-up study in a tertiary hospital in eastern Finland. Postoperative pain was evaluated with the Brief Pain Inventory at four time points: at baseline, and at 24 hours, 1 week, and 6 weeks postsurgery. Results: Postoperative pain was relatively common during the first hours after surgery, as it was reported by 67 (34% patients. After hospital discharge, the prevalence decreased; at 24 hours, 1 week, and 6 weeks, 18 (10%, 15 (9% and 12 (7% patients reported having ocular pain, respectively. Most patients with eye pain reported significant pain, with a score of ≥4 on a pain scale of 0–10, but few had taken analgesics for eye pain. Those who had used analgesics rated the analgesic efficacy of paracetamol and ibuprofen as good or excellent. Other ocular irritation symptoms were common after surgery; as a new postoperative symptom, foreign-body sensation was reported by 40 patients (22%, light sensitivity by 29 (16%, burning by 15 (8%, and itching by 15 (8%. Conclusion: Moderate or severe postoperative pain was relatively common after cataract surgery. Thus, all patients undergoing cataract surgery should be provided appropriate counseling on pain and pain management after surgery. Keywords: eye, cataract extraction, phacoemulsification, refractive surgical procedures, follow-up study, recovery, aged

  12. Cataract surgery audit at a private hospital in Saudi Arabia

    Tariq Alasbali

    2015-01-01

    Conclusion: The recent trend of intentional overcorrection in one eye following modern cataract surgery in order to provide some functional near vision indicates that benchmark for success in getting “good visual outcomes” postoperatively (vision of ≥6/18 may need to be revised.

  13. Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification

    Ming Chen; Christian Swinney; Mindy Chen

    2015-01-01

    AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery (FLACS) and traditional phacoemulsification for the first 18mo of FLACS use at a private surgical center in Hawaii. METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined. All surgeries were performed at a single surgical center in Hawaii. The presence of intraope...

  14. A Comparison of Different Operating Systems for Femtosecond Lasers in Cataract Surgery.

    Wu, B M; Williams, G P; Tan, A; Mehta, J S

    2015-01-01

    The introduction of femtosecond lasers is potentially a major shift in the way we approach cataract surgery. The development of increasingly sophisticated intraocular lenses (IOLs), coupled with heightened patient expectation of high quality postsurgical visual outcomes, has generated the need for a more precise, highly reproducible and standardized method to carry out cataract operations. As femtosecond laser-assisted cataract surgery (FLACS) becomes more commonplace in surgical centers, further evaluation of the potential risks and benefits needs to be established, particularly in the medium/long term effects. Healthcare administrators will also have to weigh and balance out the financial costs of these lasers relative to the advantages they put forth. In this review, we provide an operational overview of three of five femtosecond laser platforms that are currently commercially available: the Catalys (USA), the Victus (USA), and the LDV Z8 (Switzerland). PMID:26483973

  15. Topical use of indomethacin on the day of cataract surgery.

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

    1990-01-01

    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...

  16. Conjunctival inclusion cysts following small incision cataract surgery

    Narayanappa Shylaja

    2010-01-01

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

  17. Cataract surgery: ensuring equal access for boys and girls

    Sylvia Shirima

    2009-06-01

    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.

  18. Ocular wavefront analysis of aspheric compared with spherical monofocal intraocular lenses in cataract surgery: Systematic review with metaanalysis.

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

    2015-05-01

    This review was conducted to compare the physical effect of aspheric IOL implantation on wavefront properties with that of spherical IOL implantation. The peer-reviewed literature was systematically searched in Medline, Embase, Web of Science, Biosis, and the Cochrane Library according to the Cochrane Collaboration method. Inclusion criteria were randomized controlled trials comparing the use of aspheric versus spherical monofocal IOL implantation that assessed visual acuity, contrast sensitivity, or quality of vision. A secondary outcome was ocular wavefront analysis; spherical aberration, higher-order aberrations (HOAs), coma, and trefoil were evaluated. Effects were calculated as standardized mean differences (Hedges g) and were pooled using random-effect models. Thirty-four of 43 studies provided data for wavefront analysis. Aspheric monofocal IOL implantation resulted in less ocular spherical aberration and fewer ocular HOAs than spherical IOLs. This might explain the better contrast sensitivity in patients with aspheric IOLs. PMID:25956711

  19. Prevalence of myopic shifts among patients seeking cataract surgery

    Rafael Iribarren

    2013-06-01

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

  20. DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY

    Ibrahim SAHBAZ

    2014-04-01

    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.

  1. Comparison of small-incision cataract surgery and phacoemulsification

    Bing-Cheng Wu*

    2015-05-01

    Full Text Available AIM: To compare the clinical effect between small-incision cataract surgery and phacoemulsification.METHODS: Totally 93 patients(124 eyeswith age-related cataract who received treatment in Mar 2010 and Feb 2013 were dicided into 2 groups randomly. Forty-two patients(59 eyesin group small-incision cataract surgery(SICSwere treated by SICS, while other 51 patients(65 eyesin group Phaco were treated by phacoemulsification. And then, postoperative visual acuity, corneal astigmatism, surgically induced astigmatism(SIAand intraoperative and postoperative complications were contrasted between groups.RESULTS: After 1d and 1wk of postoperation, there were 38 eyes(64.4%and 41 eyes(69.5%having a better visual acuity of 0.5 in the SICS group, while there were 29 eyes(44.6%and 32 eyes(49.2%in the Phaco group. The vision of SICS group was better than that of Phcao group(χ2=4.877, 5.242, Pχ2=0.005, 0.085, P>0.05. The average corneal astigmatism used analysis of repeatedly measuring designing variance: Comparing the corneal astigmatism in intra-groups at different times, it was statistically significant(F=25.624, PF=0.986, P>0.05. The coneal astigmatism of each group was higher at 1wk after the surgery than that of preoperation, and the contrast had statistical sigenficence(t=2.906, 2.427, Pt=-4.628, 2.770, Pt=0.754, P>0.05. There were statistical differences in SIA at different time both by intra-group comparison and group comparison(F=26.37, PF=14.29, PCONCLUSION: Our research shows that small-incision cataract surgery and phacoemulsification had similar effect in the treatment of cataract. Phacoemulsification is not the only surgery option for the best treatment effect. Small-incision cataract surgery can be popularized in basic-level hospitals, achieving the effect similar to phacoemulsification.

  2. CORTICAL CLEANUP WITHOUT SIDE PORT IN SMALL INCISION CATARACT SURGERY

    Udaya Kumar

    2015-11-01

    Full Text Available The aim of study was to achieve complete cortical cleanup and avoid problems related with sideport during Small Incision Cataract Surgery (SICS so as to have a good visual out come with minimal recovery period, and a better quality of life. After nucleus delivery, cortical cleanup is an important step in any cataract surgical procedure. Cortex especially subincisional area (11 to 1 o’clock is difficult to manage intraoperatively. Bimanual irrigation aspiration through two side ports, aspiration by J cannula, iris massage manoeuver, ice cream scoop manoeuver are various techniques of cortical matter aspiration. We acquired the technique of aspiration of subincisional cortex without using side port in all cases by paying attention on type of cataract, status of pupil, use of Adrenalin mixed BSS intraoperatively, Tunnel construction, Capsulorhexis size and capsular rim size at 12 o’clock. MATERIAL AND METHODS In this retrospective study of 1 year from 2013 to 2014, 60 patients (60 eyes aged 40 years or older attending the General Ophthalmic Department were included in the study group with another group of 60 patients (60 eyes as controls. The study was on age related cataracts which are basically. 1 Cortical cataract 2 Nuclear cataract 3 Subcapsular cataract. Proper assessment of cortical cataract based on its maturity such as a Immature b Mature c Hyper mature and d Morgagnian cataract, nucleus for its opalescence and color, size of posterior subcapsular opacity and pupillary status (Dilating well or not with mydriatics were taken into consideration. Eyes with pseudoexfoliation having poor pupillary dilation were also included. Eyes with congenital anomalies, congenital cataract, gross corneal and retinal pathologies, and glaucoma were excluded. RESULTS Among 60 study eyes in the study group 35 presented with cortical, 20 with nuclear cataract and 5 with posterior subcapsular cataracts. In 58(96.6% cases, sideport was not required; 3(5% eyes had difficulty in aspiration of cortical matter at subincisional area of which 2 eyes (3.3% required side port. Intraoperative miosis was prevented (100% by Adrenalin mixed BSS in study group, but it was in 8(13% eyes of controls. Postoperatively, minimal lens matter was seen in 1(1.6% eye with no post-operative reaction or Posterior Capsular Opacification (PCO at 6 months followup. Descemet’s membrane separation was nil (100% in study group, which was seen in 8(13% cases of controls at final followup of 6 months, which might be the cause for some postoperative discomfort in some patients in an otherwise normal eye. CONCLUSION Without side port cortical clean up in 360 degrees is possible in small incision cataract surgery by taking adequate measures. Use of side port may be limited to some selective cases of small pupil especially in those having exfoliation.

  3. Retinal safety of near-infrared lasers in cataract surgery

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

    2012-09-01

    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.

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

    Yeniad Baris

    2010-01-01

    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.

  5. Anaesthetic Management for Cataract Surgery in VACTERL Syndrome Case Report

    Sonal S Khatavkar

    2009-01-01

    Full Text Available Eight year old girl, weighing 14 kg with VACTERL syndrome V: Vertebral anomalies, A: Anal malformation, C: Cardiovascular defect, TE: Tracheal and esophageal malformation, R:Renal agenesis, L: Limb anomalies., underwent cataract surgery under general anaesthesia. She had multiple congenital anomalies like esophageal atresia, imperfo-rate anus (corrected, single kidney& radial aplasia. Anticipating problems of gastro-esophageal reflux& chronic renal failure, successful management was done.

  6. Bilateral Pseudomonas aeruginosa endophthalmitis following bilateral simultaneous cataract surgery

    Kashkouli Mohsen

    2007-01-01

    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.

  7. DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY

    Ibrahim SAHBAZ; Mehmet Tolga TANER; Gamze KAGAN; Hüseyin SANISOGLU; Engin ERBAS; Ebubekir DURMUS; Meltem TUNCA; Hazar ENGINYURT

    2014-01-01

    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 ...

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

    Qing-Cheng Shi

    2013-05-01

    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(Ⅳ 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.

  9. Visual acuity improvements after implantation of toric intraocular lenses in cataract patients with astigmatism: a systematic review

    Agresta Blaise; Knorz Michael C; Donatti Christina; Jackson Daniel

    2012-01-01

    Abstract Background Cataracts are a common and significant cause of visual impairment globally. We aimed to evaluate uncorrected distance visual acuity (UDVA) as an outcome in treating astigmatic cataract patients to assist clinicians or ophthalmologists in their decision making process regarding available interventions. Methods Medline, Embase and Evidence Based Reviews were systematically reviewed to identify relevant studies reporting changes in UDVA, UIVA and UNVA after cataract surgery i...

  10. Influence of cataract surgery in biopsychosocial adaptation in the elderly

    Leonor Rosario Diaz Alfonso

    2010-11-01

    Full Text Available Background: The twenty-first century is characterized by a progressive aging in the population, with the subsequent demand of medical care it implies due to the polimorbility rates typical of this stage of life. Objective: to prove the positive influence of cataract surgery in biopsychosocial adaptation of elderlies. Methods: a descriptive study conducted from January to June 2008 in the General University Hospital "Dr. Aldereguía Gustavo Lima’’ in Cienfuegos. The 60 elder patients who underwent surgery cataract in that period were included. Geriatric evaluation was used as assessment instrument. It was applied before and 3 months after cataract surgery and included the Yesavage Geriatric Depression Rating Scale to measure emotional function and the Katz index for functional evaluation. The variables used are part of the preoperative geriatric assessment. Among them we can find biomedical, social, functional and psychological aspects as well as-risk benefit and anesthetic risks analysis. Results: the largest amount of patients was between 70 and 74 years old, predominantly males and white skinned. Most frequent personal pathological records were arthropathies, diabetes mellitus and hypertension. A significant relationship between initial visual acuity levels and depression rates was found; as well as limitations in performing basic daily life activities. Conclusions: with surgical intervention an improved visual acuity was achieved and a number of functional capacities were reestablished to allow a better biopsychosocial adaptation in elderlies.

  11. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II

    Parikshit Gogate; Shailbala Patil; Anil Kulkarni; Ashok Mahadik; Rahin Tamboli; Rekha Mane; Rishiraj Borah; Rao, G V

    2014-01-01

    Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery. Aim: To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts) who underwent cataract surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and a "barriers to follow-up" questionnaire completed. Demographic data collected,...

  12. Application of intracameral moxifloxacin to prevent endophthalmitis in cataract surgery

    Servet Cetinkaya

    2015-10-01

    Full Text Available AIM: To evaluate the safety and efficacy of intracameral moxifloxacin in preventing endophthalmitis after cataract surgery.METHODS:Sixty-five eyes of 65 patients underwent cataract surgery between January and June 2012. Some patients received intracameral moxifloxacin at the end of surgery, while others did not(controls. Pre- and postperative logarithm of the minimum angle of resolution(logMARbest corrected visual acuity(BCVA, intraocular pressure(IOP, corneal edema, and anterior chamber(ACstatus were examined.RESULTS: Thirty-three patients(19 males, 14 females; average age, 64.81±11.61y(range: 41-82yreceived moxifloxacin and 32 patients(15 males, 17 females; average age, 65.43±11.10y(range: 42-81ydid not. The differences in patient age(P=0.827and sex(P=0.396were insignificant. Preoperative BCVA was approximately 20/130 in both groups. After surgery, moxifloxacin and control patients had a BCVA of 20/25 and 20/23, respectively(P=0.160. Preoperative IOP was 14.93±2.77mmHg(range: 11-21mmHgin moxifloxacin patients and 15.06±2.42mm Hg(range: 12-21mmHgin controls(P=0.850. After surgery, IOP was not statistically different between two groups(moxifloxacin: 14.06±2.31(range: 10-19mmHg, controls: 14.03±2.36mmHg(range: 10-19mmHg, P=0.960. Slight differences in corneal edema(P=0.623and anterior chamber cell(P=0.726incidences between two groups were not statistically significant. CONCLUSION: Intracameral moxifloxacin is safe and effective in preventing endophtalmitis after cataract surgery.

  13. Indication for cataract surgery. Do we have evidence of who will benefit from surgery?

    Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper

    2015-01-01

    visual complaints. A meta-analysis showed that the outcome of cataract surgery, evaluated as objective and subjective visualimprovement, was independent on preoperative visual acuity. There is a lack of scientific evidence to guide the clinician in deciding which patients are most likely to benefit from...... which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluating the outcome after cataract surgery according to preoperative visual acuity and visual complaints were included...

  14. Bilateral photic maculopathy after extracapsular cataract surgery: a case report

    Chalfin, Steven

    1997-05-01

    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.

  15. Femtosecond laser-assisted cataract surgery-current status and future directions.

    Grewal, Dilraj S; Schultz, Tim; Basti, Surendra; Dick, H Burkhard

    2016-01-01

    Femtosecond laser-assisted cataract surgery (FLACS) putatively offers several advantages over conventional phacoemulsification. We review the current status of FLACS and discuss the evolution of femtosecond lasers in cataract surgery and the currently available femtosecond laser platforms. We summarize the outcomes of FLACS for corneal wound creation, limbal relaxing incisions, capsulotomy, and lens fragmentation. We discuss surgical planning, preoperative considerations, clinical experiences including the learning curve and postoperative outcomes with FLACS, and also the cost effectiveness of FLACS. We present the intraoperative complications and management of challenging cases where FLACS offers an advantage and also speculate on the future directions with FLACS. Further advancements in laser technology to refine its efficacy, advancement in intraocular lens design to harness the potential benefits of FLACS, and a reduction in cost are needed to establish a clear superiority over conventional phacoemulsification. PMID:26409902

  16. The combination of intravitreal triamcinolone and phacoemulsification surgery in patients with diabeticfoveal oedema and cataract

    Cannon Paul S

    2005-06-01

    Full Text Available Abstract Background The management of diabetic patients with refractory macular oedema or patients with no adequate pre-operative view to administer laser treatment provide a challenge to the ophthalmologist. We wished to assess the use, safety and effect of intravitreal triamcinolone injection at the time of cataract surgery in patients with diabetic foveal oedema and sight limiting lens opacities. Method This was a longitudinal non-randomised prospective pilot study in 18 eyes (12 patients. All patients had visually significant lens opacities and either persistent diabetic foveal oedema unresponsive to laser treatment-group A, or foveal oedema with no adequate pre-operative view for laser treatment- group B. The cataract surgery was carried out under full aseptic technique using a self-sealing temporal incision and a foldable acrylic lens. Intravitreal triamcinolone was given infratemporally pars plana at the completion of the cataract surgery. The patients were reviewed at day 5, 2 weeks, 2 months and then every 3 months as required. The Wilcoxin matched-pairs test was used to assess the significance of the improvement in visual acuity at 2 months. Results Twelve patients with a total of 18 eyes were included in the study. There were 10 patients (15 eyes in group A and 3 patients (3 eyes in group B. Preoperatively 16 of the 18 eyes had a visual acuity of 6/24 or worse. Postoperatively 83% of patients had completely dry foveae at 2 weeks. Best-corrected visual acuities at two months review ranged from 6/6 to CF with 9 eyes (50% achieving 6/12 or better (7 eyes (47% in group A and 2 eyes (67% in group B. Three eyes had no recorded improvement in visual acuity, but no eyes had deterioration in acuity. The improvement in visual acuity was significant at p = 0.001. There were no significant sight threatening complications. Conclusion Intravitreal triamcinolone has been shown to lead to an improvement in macular oedema and visual improvement in diabetic patients not undergoing cataract surgery but has not, to our knowledge, been previously used in a study like this one. We suggest that intravitreal injection at the time of cataract surgery could be carried out safely with encouraging visual outcomes in patients with diabetic foveal oedema and cataract.

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

    Bellucci R

    2012-02-01

    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

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

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

    2013-04-01

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

  19. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery.

    Wong, Margaret; Baumrind, Benjamin R; Frank, James H; Halpern, Robert L

    2015-01-01

    A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventually yielded culture results positive for Staphylococcus haemolyticus, which was sensitive to vancomycin. We report a case of endophthalmitis that occurred on postoperative day 1 following complicated cataract surgery. This is an uncommon bacterium that is not widely reported in the literature as a cause of endophthalmitis in the postoperative period. We urge clinicians to consider S. haemolyticus as an offending agent, especially when the infection presents very early and aggressively in the postoperative period. PMID:26951642

  20. Cataracts in Diabetic Patients: A Review Article

    Mohammad-Ali Javadi

    2008-11-01

    Full Text Available

    The number of people with diabetes mellitus is increasing and cataracts are one of the most common causes of visual impairment in these subjects. Advances in cataract surgical techniques and instrumentation have generally improved the outcomes; however, surgery may not be safe and effective in certain individuals with pre-existing retinal pathology or limited visual potential. This review article aims to address different aspects surrounding cataracts in diabetic patients. In a computerized MEDLINE search, relevant studies were selected by two authors using the keywords "diabetes mellitus", "cataract", "diabetic retinopathy" and "diabetic maculopathy".

  1. Strabismus and Nystagmus Following Cataract Surgeries in Childhood

    Ayşe Yeşim Oral

    2012-03-01

    Full Text Available Pur po se: To evaluate the incidence of strabismus in pediatric cataracts and the effects of strabismus and nystagmus accompanied by cataract on postoperative visual acuity. Ma te ri als and Met hod: Seventy-four eyes of 45 patients under 15 years old who had undergone cataract operation were included in this study. The mean postoperative follow-up period was 1.57±2.25 years (ranged between 3 months and 9 years. Twenty-nine of the patients (64% had bilateral and 16 of the patients (36% had unilateral cataract. Preoperative and postoperative visual acuities, as well as the presence of nystagmus and strabismus were recorded. Re sults: Seventeen of the patients (38% had strabismus: 9 of them (53% had esotropia (ET, and 8 of them had (47% exotropia (XT. Fourteen (19% of the total number of cases had nystagmus. The mean age was 5.8±4.4 years for the total group of patients, 4.6±3.0 years for patients with strabismus and 5.1±3.7 years for patients with nystagmus. Visual acuity measurements were not possible in 26 uncooperative patients. The visual acuity was 0.3 logMAR and over in 15 (31% and 1.0 logMAR and under in 12 (25% of the remaining of 48 eyes. Of a total of 28 eyes with strabismus, we were unable to measure visual acuity in 10 patients, and the visual acuities were 0.3 logMAR and over in 7 (39% and 1.0 logMAR and under in 5 (28% of the rest of the 18 patients. The mean visual acuity was significantly lower in the 8 of 14 patients with nystagmus whose visual acuity could be measured (1.25±0.45 logMAR than in both the patients without strabismus (0.44±0.59 logMAR and the patients with strabismus (0.66±0.56 logMAR (p=0.019 and p=0.015, respectively. Dis cus si on: Although strabismus is seen more often in childhood cataracts compared to general population, the presence of strabismus has no negative effect on visual acuity after cataract surgery, while nystagmus is the main factor limiting the visual outcome. (Turk J Ophthalmol 2012; 42: 111-5

  2. Telephone follow-up for cataract surgery: feasibility and patient satisfaction study.

    Hoffman, Jeremy J S L; Pelosini, Lucia

    2016-05-01

    Purpose - The purpose of this paper is to investigate the feasibility of telephone follow-up (TFU) after uncomplicated cataract surgery in low-risk patients and patient satisfaction with this alternative clinical pathway. Design/methodology/approach - Prospective, non-randomised cohort study. A ten-point subjective ophthalmic assessment questionnaire and a six-point patient satisfaction questionnaire were administered to patients following routine cataract surgery at two to three weeks post-procedure. All patients were offered a further clinic review if required. Exclusion criteria comprised ophthalmic co-morbidities, hearing/language impairment and high risk of post-operative complications. Patient notes were retrospectively reviewed over the study period to ensure no additional emergency attendances took place. Findings - Over three months, 50 eyes of 50 patients (mean age: 80; age range 60-91; 66 per cent second eye surgery) underwent uncomplicated phacoemulsification surgery received a TFU at 12-24 days (mean: 16 days) post-operatively. Subjective visual acuity was graded as good by 92 per cent of patients; 72 per cent patients reported no pain and 20 per cent reported mild occasional grittiness. Patient satisfaction was graded 8.9 out of 10; 81.6 per cent defined TFU as convenient and 75.5 per cent of patients preferred TFU to routine outpatient review. No additional visits were required. Research limitations/implications - Non-randomised with no control group; small sample size. One patient was unable to be contacted. Practical implications - Post-operative TFU can be suitably targeted to low-risk patients following uncomplicated cataract surgery. This study demonstrated a high patient satisfaction. A larger, randomised study is in progress to assess this further. Originality/value - This is the first study reporting TFU results and patient satisfaction to the usual alternative two-week outpatient review. PMID:27142949

  3. Increasing cataract surgery to meet Vision 2020 targets; experience from two rural programmes in east Africa

    Lewallen, S; Roberts, H; Hall, A.; Onyange, R; Temba, M; Banzi, J; Courtright, P.

    2005-01-01

    Background: The numbers of cataract surgeries done in sub-Saharan Africa fall short of Vision 2020 targets. Over a few years, two programmes in rural east Africa both achieved significant increases in the number of cataract surgeries they provide, resulting in cataract surgical rates of 1583 for Kwale District in Kenya and 1165 for Kilimanjaro Region in Tanzania. Key components of success in these two programmes are described.

  4. Management of Intraoperative Miosis during Pediatric Cataract Surgery using Healon 5

    Vishal Jhanji; Namrata Sharma; Vajpayee, Rasik B

    2011-01-01

    Purpose : We describe a technique for achieving pupillary dilatation in order to manage and counteract intraoperative miosis during pediatric cataract surgery using viscoadaptive viscoelastic (sodium hyaluronate 2.3%). Materials and Methods : The technique of viscomydriasis was used in six eyes with pediatric cataracts with intraoperative pupillary miosis. Results : Pupillary dilatation was achieved and maintained in all eyes throughout cataract surgery. All the surgical steps includ...

  5. A Comparison of Different Operating Systems for Femtosecond Lasers in Cataract Surgery

    Wu, B. M.; Williams, G. P.; Tan, A.; Mehta, J. S.

    2015-01-01

    The introduction of femtosecond lasers is potentially a major shift in the way we approach cataract surgery. The development of increasingly sophisticated intraocular lenses (IOLs), coupled with heightened patient expectation of high quality postsurgical visual outcomes, has generated the need for a more precise, highly reproducible and standardized method to carry out cataract operations. As femtosecond laser-assisted cataract surgery (FLACS) becomes more commonplace in surgical centers, fur...

  6. Is ultrasonography essential before surgery in eyes with advanced cataracts?

    Salman Amjad

    2006-01-01

    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.

  7. Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery

    Adriana Maria Drummond Brandão

    2008-04-01

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

  8. Phacoemulsification cataract surgery in a large cohort of diabetes patients: visual acuity outcomes and prognostic factors

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit; La Cour, Morten

    2011-01-01

    To assess visual acuity outcomes after phacoemulsification cataract surgery in a large population of diabetic patients with all degrees of diabetic retinopathy.......To assess visual acuity outcomes after phacoemulsification cataract surgery in a large population of diabetic patients with all degrees of diabetic retinopathy....

  9. The challenges in improving outcome of cataract surgery in low and middle income countries

    Robert Lindfield

    2012-01-01

    Full Text Available Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO. Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved.

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

    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)

  11. Using corneal topography design personalized cataract surgery programs

    Jin-Ou Huang

    2014-08-01

    Full Text Available AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment. METHODS: Totally 202 cases(226 eyescataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed. RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3.0mm sclera tunnel incision group there were no statistically significance difference. After 55.8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced. CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

  12. Perioperative prophylaxis for endophthalmitis after cataract surgery in Iran

    Marzieh Katibeh

    2015-01-01

    Full Text Available Purpose: To describe prophylactic patterns employed against endophthalmitis after cataract surgery in Iran. Methods: This cross-sectional study included 486 ophthalmologists filling in a self-administered questionnaire during the 20 th Annual Congress of the Iranian Society of Ophthalmology in December 2010, Tehran, working in both private and academic medical centers. Prophylactic measures used preoperatively, intraoperatively and postoperatively and self-reported rates of endophthalmitis were assessed as the main outcome measurements. Results: In the preoperative phase, 75.5% of surgeons used povidone-iodine in the conjunctival sac and 71.4% of them did not use antibiotics. The rate of intraoperative prophylaxis was 61.9% either in the form of intracameral antibiotics or subconjunctival injection (mostly cephazolin or gentamicin. Only 7.8% of participants used intracameral cephalosporins. Postoperative antibiotics [mostly chloramphenicol (57% and ciprofloxacin (28%] were used by 94.2% of surgeons. On average, ten years of practice were required to observe one case of endophthalmitis. Conclusion: The surgeons in present setting used various prophylactic regimens against endophthalmitis after cataract surgery. Setting a local and evidence-based clinical practice guideline seems necessary.

  13. Clinical significance of glycosylated hemoglobin determination on diabetic cataract surgery

    Hong-Fen Zhu

    2013-08-01

    Full Text Available AIM: To evaluate the efficacy and clinical significance ofglycosylated hemoglobin(HbAlcdetermination on diabetic cataract surgery.METHODS: Totally 105 patients with diabetes(120 monocularundergone phacoemulsification in our hospital from March 2012 to March 2013 were enrolled into the observation group(glycosylated hemoglobin determination group, HbA1c RESULTS:Glycated hemoglobin determination group: the mean visual acuity recovery was 0.72, the incidence of TASS was 83.3%, and DDD was 45.5. Blood glucose group: those were 0.498, 93.7%, and 88.6. The difference of incidence, degree and occurrence time of TASS(SAS 15.0 software analysisand the degree of visual recovery between the two groups were statistically significant(PPCONCLUSION:Glycosylated hemoglobin determination is the gold standard to measure blood sugar preoperation and has important significance for choosing the right time for diabetic cataract surgery. TASS was significantly reduced in the patients with preoperative standard glycosylated hemoglobin, the visual acuity of them improved significantly, and DDD values were significantly lower.

  14. Conjunctival sac bacterial flora isolated prior to cataract surgery

    Suto C

    2012-01-01

    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

  15. Endothelial cell loss and refractive predictability in femtosecond laser-assisted cataract surgery compared with conventional cataract surgery

    Krarup, Therese; Holm, Lars Morten; la Cour, Morten; Kjaerbo, Hadi

    2014-01-01

    PURPOSE: To investigate the amount of endothelial cell loss (ECL) and refractive predictability by femtosecond laser-assisted cataract surgery (FLACS) compared to conventional phacoemulsification cataract surgery (CPS). METHODS: Forty-seven patients had one eye operated by FLACS and the...... preoperatively, 1-3 days postoperatively and 3 months postoperatively. RESULTS: Three days postoperatively, mean ECL was 249 cells/mm(2) (SD 744) (9.1%) by FLACS and 235 cells/mm(2) (SD 681) (8.2%) by CPS (p = 0.87). Three months postoperatively, mean ECL was 274 cells/mm(2) (SD 358) (11.4%) by FLACS...... compared with 333 cells/mm(2) (SD 422) (13.9%) by CPS, (p = 0.30) 3 months postoperatively, hexagonality was decreased by 1.8% (SD 30) by FLACS and by 1.4% (SD 13) by CPS, (p = 0.84). The mean absolute difference from the attempted refraction was 0.37 dioptres (D) (SD 0.33) by FLACS and 0.41 D (SD...

  16. Predictability of Intraocular Lens Power Calculation After Simultaneous Pterygium Excision and Cataract Surgery.

    Kamiya, Kazutaka; Shimizu, Kimiya; Iijima, Kei; Shoji, Nobuyuki; Kobashi, Hidenaga

    2015-12-01

    This study was aimed to assess the predictability of intraocular lens (IOL) power calculation after simultaneous pterygium excision and phacoemulsification with IOL implantation. We retrospectively reviewed the clinical charts of 60 eyes of 60 consecutive patients (mean age??standard deviation, 73.5??7.0 years) who developed pterygium and cataract. We determined visual acuity (logMAR), manifest spherical equivalent, manifest astigmatism, corneal astigmatism, and mean keratometry, preoperatively and 3 months postoperatively. Corrected visual acuity was significantly improved from 0.19??0.20 preoperatively to -0.06??0.07 postoperatively (P?pterygium size (r?=?-0.378, P?=?0.033). Simultaneous pterygium and cataract surgery was safe and effective, and the accuracy was moderately predictable. However, it should be noted that a significant myopic shift occurred postoperatively, possibly resulting from the steepening of the cornea after pterygium removal, especially when the size of pterygium was large. PMID:26717362

  17. Orbital cellulits following cataract surgery under peribulbar anaesthesia

    Mukherjee, Chandoshi

    2015-01-01

    Full Text Available [english] Introduction: Orbital cellulits following cataract surgery is extremely rare. We describe a case of orbital and facial cellulitis that occurred after routine cataract operation with peribulbar anaesthesia. There were no preoperative systemic or ocular risk factors for postoperative infection. Case description: An 89-year-old man presented to eye casualty, the day after he underwent an uneventful phacoemulsification and posterior chamber lens implantation in the left eye under peribulabr anaesthesia, with soreness, swelling and reduced visual acuity (6/18 in the operated eye. On initial presentation periorbital swelling was noted, the eye was minimally tender, intraocular pressure was raised at 28 mHg and fundoscopy was limited due to a hazy cornea. The patient was discharged on topical medication with a diagnosis of allergic reaction to postoperative drops.The following day, the patient re-presented with worsening orbital swelling involving the left cheek. Ocular findings remained unchanged. CT scan revealed left orbit soft tissue swelling and a locule of air medial to the medial rectus. There were no signs of sinus infection or periosteal inflammation. A diagnosis of left orbital and facial cellulitis was made and the patient was treated with intravenous antibiotics.Discussion: Our patient did not have any predisposing risk factors, therefore most likely cause of cellulitis is surgical trauma during administration of the peribulbar block. This case illustrates the need for adequate skin preparation before the administration of peribulbar anaesthesia and minimal tissue trauma during the procedure.

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

    A Asgari

    2013-10-01

    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.

  19. Hospitalization after Cataract Surgery in a Nationwide Managed-Care Population

    Wang, Sophia Y.; Blachley, Taylor S.; Andrews, Chris A.; Ayanian, John Z.; Lee, Paul P.; Stein, Joshua D.

    2016-01-01

    Purpose Little is known regarding the extent by which patients undergoing outpatient cataract surgery are at risk for postoperative hospitalization. We sought to determine the percentage of patients undergoing cataract surgery who were subsequently hospitalized, the patient characteristics associated with postoperative hospitalization, and the reasons for hospitalization. Methods We identified all beneficiaries of a large U.S. managed care network age ≥40 years old who underwent ≥1 cataract surgery from 2001–2011. All enrollees who required inpatient hospitalization within 7, 14, 30, and 90 days following initial cataract surgery and the reasons for hospitalization were determined. Logistic regression was performed to assess factors that significantly impacted the odds of requiring postoperative hospitalization. Results Among the 64,981 patients who underwent cataract surgery, rates of hospitalization within 7, 14, 30, and 90 days were 0.3%, 0.5%, 1.3% and 4.2%, respectively. Among the 10,674 patients who had no major preexisting medical comorbidities, 0.1% were hospitalized within 7 days. The odds of hospitalization increased by 35% (OR = 1.35 [CI, 1.23–1.48]) with the presence of each additional comorbidity and by 14% with each additional hospitalization in the 3 years prior to cataract surgery (OR = 1.14 [CI, 1.10–1,18]). Those who were hospitalized in the 30 days prior to cataract surgery had 524% increased odds of being hospitalized within 7 days after cataract surgery (OR = 6.24, [CI, 3.37–11.57]) compared to those with no record of preoperative hospitalization. Postoperative hospitalizations were most commonly due to cardiovascular conditions, comprising over 25% of primary diagnoses associated with hospitalization. Conclusions The risk of hospitalization after cataract surgery is low, and is very low among those with no major preexisting medical comorbidities. Opportunities may exist to limit comprehensive preoperative evaluation and testing to those who have serious pre-existing medical comorbidities. PMID:26901594

  20. Coaxial Microincision Cataract Surgery versus Standard Coaxial Small-Incision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials

    Shentu, Xingchao; Zhang, Xin; Tang, Xiajing; Yu, Xiaoning

    2016-01-01

    Background We conducted this meta-analysis to compare the outcomes of coaxial microincision cataract surgery (C-MICS) and standard coaxial small incision cataract surgery (C-SICS). Methods The outcomes of randomized controlled trials (RCTs) reporting C-MICS and C-SICS were collected from PubMed, Web of Science, and The Cochrane Library in May 2015. The final meta-analysis was conducted on the following intraoperative and postoperative outcomes: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), cumulative dissipated energy (CDE), mean surgery time, endothelial cell loss percentage (ECL%), best corrected visual acuity (BCVA), increased central corneal thickness (CCT), laser flare photometry values and surgically induced astigmatism (SIA). Results A total of 15 RCTs, involving 1136 eyes, were included in the final meta-analysis. No significant between-group differences were detected in EPT, BSS use, CDE, BCVA, laser flare photometry values or increased CCT. However, the C-MICS group showed less SIA (at postoperative day 7: p<0.01; at postoperative day 30 or more: p<0.01) and greater ECL% (at postoperative day 60 or more: p<0.01), whereas the C-SICS group required a shorter UST (p<0.01). Conclusions The present meta-analysis suggested that the C-MICS technique was more advantageous than C-SICS in terms of SIA, but C-MICS required a longer UST and induced a higher ECL%. Further studies should be done to confirm our results. PMID:26745279

  1. Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials

    Xiaoyun Chen; Wei Xiao; Shaobi Ye; Weirong Chen; Yizhi Liu

    2015-01-01

    The aim of this study was to evaluate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification cataract surgery (CPCS) in the treatment of cataract. Randomized controlled trials (RCTs) were searched in PubMed, Embase and the Cochrane Central Register of Controlled Trials. Nine qualified studies with a total of 989 eyes were included. Compared with CPCS, FLACS significantly reduced mean phaco energy and effective phacoemulsification...

  2. Phacoemulsification versus small incision cataract surgery in patients with uveitis

    Rahul Bhargava

    2015-10-01

    Full Text Available AIM: To compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS in patients with uveitic cataract.METHODS:In aprospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI. A P value of <0.05 was considered statistically significant.RESULTS:One hundred and twenty-six of 139 patients (90.6% completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1 or inability implant an intraocular lens (IOL because of insufficient capsular support following posterior capsule rupture (n=5. There was significant improvement in vision after both the procedures (paired t-test; P<0.001. On first postoperative day, uncorrected distance visual acuity (UDVA was 20/63 or better in 31 (47% patients in Phaco group and 26 (43.3% patients in SICS group (P=0.384. The mean surgically induced astigmatism (SIA was 0.86±0.34 dioptres (D in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002. At 6mo, corrected distance visual acuity (CDVA was 20/60 or better in 60 (90.9% patients in Phaco group and 53 (88.3% in the manual SICS group (P=0.478. The mean surgical time was significantly shorter in the manual SICS group (10.8±2.9 versus 13.2±2.6min (P<0.001. Oral prednisolone, 1 mg/kg body weight was given 7d prior to surgery, continued post-operatively and tapered according to the inflammatory response over 4-6wk in patients with previously documented macular edema, recurrent uveitis, chronic anterior uveitis and intermediate uveitis. Rate of complications like macular edema (Chi-square, P=0.459, persistent uveitis (Chi-square, P=0.289 and posterior capsule opacification (Chi-square, P=0.474 were comparable between both the groups.CONCLUSION:ManualSICS and phacoemulsification do not differ significantly in complication rates and final CDVA outcomes. However, manual SICS is significantly faster. It may be the preferred technique in settings where surgical volume is high and access to phacoemulsification is limited, such as in eye camps. It may also be the appropriate technique for uveitic cataract under such circumstances.

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

    Saeed, Ayman

    2012-02-01

    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.

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

    Dhaliwal Upreet

    2007-01-01

    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.

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

    Venkatesh Rengaraj

    2009-01-01

    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.

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

    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

  7. Blood Pressure and Heart Rate Alterations through Music in Patients Undergoing Cataract Surgery in Greece

    Kyriakoula Merakou; Georgia Varouxi; Anastasia Barbouni; Eleni Antoniadou; Georgios Karageorgos; Dimitrios Theodoridis; Aristea Koutsouri; Jenny Kourea-Kremastinou

    2015-01-01

    INTRODUCTION Music has been proposed as a safe, inexpensive, nonpharmacological antistress intervention. The purpose of this study was to determine whether patients undergoing cataract surgery while listening to meditation music experience lower levels of blood pressure and heart rate. METHODS Two hundred individuals undergoing cataract surgery participated in the study. Hundred individuals listened to meditation music, through headphones, before and during the operation (intervention group) ...

  8. Anaesthetic Management of Cataract Surgery in a Patient with Sturge-Weber Syndrome

    Vasantha Kumar

    2015-05-01

    Full Text Available Sturge-Weber Syndrome (SWS, also called as encephalo trigeminal angiomatosis, is a rare congenital syndrome, characterized by lepto meningeal haemangioma, a facial port-wine stains distributed over the trigeminal nerve area, (usually involving one side and glaucoma. During cataract surgery, there may be rupture of choroid haemangioma, leading to excessive bleeding, or of haemangioma involving the airway, leading to difficult mask ventilation, laryngoscopy and intubation. We discuss the anaesthetic management of the patient with SWS for cataract surgery.

  9. The clinical utility of new combination phenylephrine/ketorolac injection in cataract surgery

    Lawuyi LE; Gurbaxani A

    2015-01-01

    Lola Elizabeth Lawuyi, Avinash Gurbaxani Moorfields Eye Hospital Dubai, Dubai, UAE Abstract: The maintenance of mydriasis throughout cataract extraction surgery and the control of ocular inflammation are crucial for successful surgical outcomes. The development of miosis during cataract surgery compromises the visualization of the surgical field and working space for surgeons. This may lead to complications that include posterior capsular tear and associated vitreous loss, longer surgical t...

  10. ANTERIOR CAPSULE STAINING USING 0.025% TRYPAN BLUE IN ALL PHACOEMULSIFICATION CATARACT SURGERIES

    Karthigeyan

    2013-01-01

    ABSTRACT: PURPOSE: To describe the use of anterior capsule staining in all phacoemulsification cataract surgery using a 0.025% trypan blue solution . METHODS: Thirty eyes of 30 patients with cataracts were submitted to phacoemulsification using a direct injection of 0.2 to 0.5 ml of 0.025% trypan blue in the anterior chamber through the side port before injecting viscoelastic injection. All patients h ad preop ophthalmologic examination prior to surgery. RESULTS:...

  11. Methicillin resistance of Staphylococcus species among health care and nonhealth care workers undergoing cataract surgery

    Olson, Randall; Donnenfeld, Eric; Bucci, Frank A; Price, Francis W.; Raizman, Michael; Solomon, Kerry; Devgan, Uday; Trattler, William; Steven; Wallace, R. Bruce; Callegan, Michelle; Brown, Heather; Peter J McDonnell; Conway, Taryn; Schiffman, Rhett M

    2010-01-01

    Purpose: The purpose of this study is to characterize the bacterial flora of the ocular and periocular surface in cataract surgery patients and to determine the prevalence of methicillin resistance among staphylococcal isolates obtained from health care workers (HCWs) and non-HCWs. Methods: In this prospective, multicenter, case series study, eyelid and conjunctival cultures were obtained from the nonoperative eye of 399 consecutive cataract patients on the day of surgery prior to application...

  12. EVALUATION OF VISUAL ACUITY AND QUALITY OF LIFE AFTER CATARACT SURGERY IN KOLAR DISTRICT

    Kanthamani

    2014-01-01

    Full Text Available INTRODUCTION: Cataract is a highly treatable condition due to advances in cataract surgery procedures. The aim of cataract surgery is to improve visual function which in turn will improve overall quality of life. OBJECTIVE : To evaluate visual acuity and qu ality of life after cataract surgery. MATERIALS & METHODS : Five hundred patients having senile cataract attending the outpatient department of ophthalmology at R.L.JALAPPA Hospital between January 2011 to March 2011 were included in the study. Cataract ext raction was performed using manual small incision cataract surgery ( SICS and rigid PMMA posterior chamber intraocular lenses was implanted in all patients. Visual acuity - pre & post operatively was recorded for every patient. The visual acuity was divide d into grades for the purpose of statistical analysis. Quality of life was assessed by a questionnaire analyzing distant & near vision , social functions and cataract related symptoms. Each item in the questionnaire was scored and total score was calculated for each patient and graded. RESULTS : After 6 weeks postoperatively , 455(91% subjects had BCVA of 6/18 or better , 39(7.8% had vision lesser than 6/18 but better than 6/60 and 6(1.3% subjects had BCVA 6/60 seller equivalent or worse. In this study pre - o perative general function was 22.2 3.25 , social function was 5.68 1.07 and visual function was 15.76 1.05. Post operatively general function score was 53.05 11.59 , social functions was 13.35 3.07 and visual function was 23.23 3.18. Post - operati ve score was high resulting in significant improvement in quality of life (p<0.00l. CONCLUSION : Quality of life with respect to physical capability , social functions and mental health improved after cataract surgery.

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

    Lou, Astrid R.; Madsen, Kristoffer Hougaard; Julian, Hanne O.; Toft, Peter B.; Kjaer, Troels W.; Paulson, Olaf B.; Prause, Jan U.; Siebner, Hartwig R.

    2013-01-01

    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......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...

  14. Photodynamic treatment of lens epithelial cells for cataract surgery

    Lingua, Robert W.; Parel, Jean-Marie A.; Simon, Gabriel; Li, Kam

    1991-06-01

    Photodynamic therapy (PDT) eiiploying Dihematopor*iyrin ethers (DHE) (Photofrin II) at pharmacologic lvels, has been denonstrate3 to kill rabbit lens epithelial cells, in vivo. This in vitro study, reports on the minimal necessary parameters for rabbit lens epithelial cell death. Explants of rabbit lenses were incubated in various concentrations of DHE (1O,, 100, 500, 1000 ug/ml) for 1, 2, or 5 minutes. 30 to 120 Joules/an of collimated 514.5 nm Argon laser light re delivered to the locier concentrations of 10, 50, and 100 ug,'ml DHE treated cells. One hundre1 fifteen explants were treated, in all. Higher concentrations of DHE alone (500 and 1000 ug/ml) were sufficient to induce cellular swelling. Lower concentrations required light for cellular effect. Trypan blue staining revealed cell death at these minimal pa9ieters: DHE 50 ug/ml, incubation 1 minute, 514.5 r Argon light 1.0 Watt/an for 30 sec (30 Joules) . In future studies, these rameters will be tested in vivo, for their ability to eliminate lens epithelial proliferation after cataract surgery.

  15. MANUAL SMALL - INCISION CATARACT SURGERY USING AC MAINTAINER UNDER LIGNOCAINE 2% JELLY AND INTRACAMERAL LIDOCAINE

    Rahul

    2015-08-01

    Full Text Available M anual small incision cataract surgery (MSICS is a very popular technique of cataract surgery in India. Its a surgery which is done and in short time and in a country like India with a huge back - log of cataract blindness this surgery is very useful. OBJECTIVE: To evaluate the outcome of manual small incision cataract surgery (MSICS with AC mantainer under topical anesthesia with lignocaine 2% jelly and intracameral lignocaine . MATERIALS AND METHODS : This study was a prospectiv e interventional case series. One hundred patients of senile cataract were operated by MSICS under topical anesthesia using lignocaine 2% jelly and intracameral 1% lignocaine. The patients and the single operating surgeon were given a questionnaire to eval uate their experience in terms of pain, surgical experience and complications. RESULTS : The mean pain score was 0.82(SD0.97. 63 patients (63% had a pain score of zero, that is, no pain. 37 patients (37 % had a score of 3 or less, that is, mild to none pain. 95 surgeries were free of complications while 5 had complications but they were not related to anaesthesia. Surgeons experience was favorable in terms of patients cooperation, anterior chamber stability, difficulty, and complications. CONCLUSIONS: MSICS can be comfortably performed under topical anesthesia with lignocaine jelly and intracameral lignocaine, which makes the surgery patient - friendly, without compromising the outcome.

  16. Surgery for sight: outcomes of congenital and developmental cataracts operated in Durban, South Africa.

    Gogate, P; Parbhoo, D; Ramson, P; Budhoo, R; Øverland, L; Mkhize, N; Naidoo, K; Levine, S; du Bryn, A; Benjamin, L

    2016-03-01

    PurposeTo study the visual outcomes of congenital and developmental cataract surgery and determine variables for presentation for pediatric cataract surgery in KwaZulu Natal province of South Africa.MethodsCare-givers of children presenting with cataract to a quaternary centre were asked when they first detected the condition. The reasons for delay between detection and surgery were studied. The children underwent a comprehensive eye examination and then appropriate surgery. They were prospectively followed up for 3 months and visual acuity and stereopsis were noted. Delay in presentation for surgery and visual outcomes were co-related with demographic and clinical factors.ResultsEighty-three non-traumatic cataract surgeries in 50 children were studied. Twenty-six (52%) were males, mean age was 3 years 10 months (SD 3yrs 4 months). The mean delay between identification and surgery was 20.7 months (SD 18 months). Twenty-six (52%) children had >15 months interval between diagnosis and surgery. Only mother's occupation was significantly associated with delay (P=0.017). Post-surgery 17/69 (24.7%) had visual acuity ≥6/18, 20/69 (29.0%) had vision between 6/24-6/60, whereas 32/69 (46.3%) had visual acuity ≤6/60. The final vision was associated with age (P=0.031), delay between diagnosis and surgery (PHealth promotion activities aimed at mothers are important in improving visual outcomes. PMID:26611841

  17. Cataracts

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  18. Comparison of postoperative corneal changes between dry eye and non-dry eye in a murine cataract surgery model

    Jin Woo Kwon; Yeon Woong Chung; Choi, Jin A; Tae Yoon La; Dong Hyun Jee; Yang Kyung Cho

    2016-01-01

    AIM: To compare the effects of the surgical insult of cataract surgery on corneal inflammatory infiltration, neovascularization (NV) and lymphangiogenesis (LY) between the dry eye and non-dry eye in murine cataract surgery models. METHODS: We established two groups of animals, one with normal eyes (non-dry eye) and the second with induced dry eyes. In both groups, we used surgical insults to mimic human cataract surgery, which consisted of lens extraction, corneal incision and suture. Afte...

  19. Meta-analysis to compare the safety and efficacy of manual small incision cataract surgery and phacoemulsification

    Parikshit Gogate; Optom, Jyoti Jaggernath B.; Swapna Deshpande; Kovin Naidoo

    2015-01-01

    Purpose: A systematic review and meta-analysis comparing the safety, efficacy, and expenses related to phacoemulsification versus manual small incision cataract surgery (SICS). Methods: PubMed, Cochrane, and Scopus databases were searched with key words manual SICS 6/18 and 6/60; astigmatism and endothelial cell loss postoperatively, intra- and post-operative complications, phacoemulsification, and comparison of SICS and phacoemulsification. Non-English language manuscripts and manuscript...

  20. Cataracts

    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.)

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

    Dooley, I

    2012-02-01

    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.

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

    Yuan Rongdi

    2011-03-01

    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.

  3. REASONS FOR DELAYED UTILIZATION OF CATARACT SURGERY AMONG PATIENTS ATTENDING A TERTIARY REFERRAL CENTRE, MAHARASHTRA .

    Gadekar

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Cataract is a major cause of vision impairment in many low - income settings. Cataract blindness is a disease which has severe economic repercussions and adversely affects the productivity of country. However, despite rapid increase in the availability of quality services, surgical acceptance is still low in some segments of society. AIM : To study the various reasons for delayed utilization of cataract surgery. METHODS : In this cross sectional study 450 patients above 40 years of age who were admitted in ophthalmology ward for cataract surgery were enrolled by systematic random sampling technique. Socio - demographic data was collected by interviews in local language on predesigne d and semi struct ur ed proforma. The various reasons for delayed utilization of cataract surgery were asked to them. Statistical tests applied were chi square test and percentages. RESULTS : Majority of the study subjects were illiterate females above 60 yea rs of age belonging to lower socioeconomic status. Most of the study subjects were Hindus from rural area having unilateral blindness. The various reasons for delayed utilization of cataract surgery were economic problems (76.7%, ignorance by patient (29. 1%, fear of operation (26.4%, ignorance by head of family (22.4% and suspicion about improvement of vision after surgery (21.5%. Some subjects gave reasons as lack of accompanying person, fear of surgery causing death, lack of time, its God will and la ck of transport. CONCLUSION : The predominant reason for delayed utilization of cataract surgery was economic constraints. Other reasons were ignorance by patients and head of family, fear of operation and death, suspicion about improvement of vision, God’s will, lack of accompanying person and lack of transport

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

    Barry, Peter

    2014-01-01

    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.

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

    Munk, Sofie J; Heegaard, Steffen; Mosbech, Holger; Garvey, Lene H

    2013-01-01

    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...

  6. 42 CFR 1001.1701 - Billing for services of assistant at surgery during cataract operations.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Billing for services of assistant at surgery during cataract operations. 1001.1701 Section 1001.1701 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE... PROGRAMS Permissive Exclusions § 1001.1701 Billing for services of assistant at surgery during...

  7. Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

    Su-Na Lee

    2014-01-01

    Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

  8. BARRIERS RESPONSIBLE FOR DELAYED UTILIZATION OF CATARACT SURGERY: AN EYE CAMP STUDY FROM CENTRAL INDIA

    Umesh; Chanchlani; Singh; Roshan

    2014-01-01

    INTRODUCTION: Blindness is one of the significant social problems in India with 7 million of the total 45 million blind people in the world residing in our country. Apart from health and status of vision, there are many other socio-economic factors and perceptions, which influence the decision making of the people for getting operated for cataract. But very few studies have been done on the social factors influencing the utilization of cataract surgery. MATERIAL AND METHODS: I...

  9. Influence of cataract surgery and blood pressure changes caused by sodium restriction on retinal vascular diameter

    Takatoshi Tano

    2010-11-01

    Full Text Available Takatoshi Tano1, Yoshimune Hiratsuka2, Koichi Ono1, Akira Murakami11Department of Ophthalmology, Juntendo University School of Medicine, Tokyo; 2National Institute of Public Health, Tokyo, JapanPurpose: To investigate the impact of cataract surgery and blood pressure changes induced by one week of sodium restriction on retinal vascular diameter.Methods: Fundus photographs of 200 patients were obtained before and one week after cataract surgery. For one week after admission, 100 patients received sodium restriction and 100 patients (ie, the control group did not receive sodium restriction. The diameter of the retinal vessels and blood pressure were compared between the sodium restriction group and the control group. The vascular diameter was measured using an objective computer-based method.Results: Neither group had a significant change in the diameter of the retinal vessels after cataract surgery. Although there was no significant change in retinal arterial and venular diameter in the sodium restriction group, one-week sodium restriction significantly reduced mean blood pressure. However, multiple linear regression analyses indicated that an increase in retinal arteriolar diameter was significantly associated with diabetes, hyperlipidemia, and alcohol intake.Conclusion: Cataract surgery and blood pressure reduction induced by one week of sodium restriction resulted in no significant change in retinal arteriolar diameter.Keywords: cataract surgery, hypertension, retinal blood vessel diameter, retinal fundus camera, sodium restriction.

  10. Cataract surgery in a population-based cohort of patients with type 1 diabetes

    Grauslund, Jakob; Green, Anders; Sjlie, Anne K

    2011-01-01

    ABSTRACT. Purpose: To estimate the long-term cumulative incidence of cataract surgery and associated risk factors in a 25-year follow-up of a population-based cohort of patients with type 1 diabetes. Methods: Based on insulin prescriptions, a population-based cohort of 727 patients with type 1...... diabetes was identified in 1973. In 1981-1982 diabetic retinopathy was graded and other markers of diabetes were measured in 573 patients who participated in a clinical baseline examination. Based on data from the Danish National Patient Registry, patients were followed until November 2006 and cataract...... surgery was evaluated during follow-up. Results: The 25-year crude cumulative incidence of cataract surgery was 20.8% (117 of 562 patients at risk), corresponding to a mortality-adjusted incidence of 29.4% [95% confidence interval (CI) 25.6-33.1%]. Median age and duration of diabetes at the time of...

  11. Cataract Surgery in Elderly Patients: Impact on Life Quality and Functionality

    Armando Rafael Milanés Armengol

    2012-11-01

    Full Text Available Background: cataract surgery becomes highly valuable in our days because it acts on one of the leading causes of preventable blindness. Objective: To assess the impact of cataract surgery on the functionality and life quality of the elderly. Methods: case series study of all elderly patients who attended Ophthalmology Consultation at the Integral Diagnostic Center Mesones in Bolivar, Anzoategui State, Venezuela, from February to November 2007 for cataract surgery and who met the inclusion criteria. A survey and a set of assessment tools were applied in order to measure: functional status, siymptoms score and visual VF-14 function index which provided an assessment of life quality in two stages: in the preoperative stage and three months after surgery, thus allowing restoration of the various functions after surgery. Results: There was a significant improvement in visual acuity represented by a visual recovery of a 92%; according VF-14 index of visual function, life quality improved in a 92 %; general validism was recovered in 482 patients and 57 of them are considered to depend on other people for only one activity of their daily living, 6.1% of patients still present symptoms related to symptom score. Conclusions: patients who underwent cataract surgery showed evidence of improvement in visual acuity, functionality and life quality.

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

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

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

    Thomas R

    2000-01-01

    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.

  14. Role of socio-economic factors in cataract surgery utilization in JIPMER Pondicherry

    Prasanna T

    2007-01-01

    Full Text Available Background : This study was conducted in JIPMER & Kurusukuppam, Pondicherry. Objectives : To identify the socioeconomic factors influencing the utilization of cataract surgery & to identify the persons motivating the patients to utilize these services. This was a case-control study; cases were patients (age group 50-70 years who were operated in JIPMER for senile cataract without complications and one control was selected for each case. Controls were also of the same age group residing at Kurusukuppam with complaints of dimness of vision and who had not undergone cataract surgery, selected by random sampling. Both the groups were interviewed using a pretested interview schedule. Results : Subjects who were literate and with high school education and more and with income more than Rs.1050 (class III utilized the cataract surgery services more. In majority of cases, motivation for getting operated comes from relatives. Peer groups who have undergone the surgery before, were the predominant sources of health information about the surgery. Higher income & higher education affect the utilization significantly. Relatives & Previously operated peers play an important role.

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

    Goktug Demirci

    2013-01-01

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

  16. Induced astigmatism after cataract surgery - a retrospective analysis of cases from the University of Port Harcourt Teaching Hospital, Nigeria

    A. O. Adio

    2011-12-01

    Full Text Available Visual rehabilitation after cataract surgery may often be disappointing due to induction of corneal astigmatism following issues in realigning, point to point, the corneal wound margin in the process of surgery despite biometry and use of the appropriateintraocular lens. The purpose of this study is to determine the amount of surgically induced astigmatism after sutured cataract extraction-extracapsular cataract extraction (ECCE and intracapsular cataract extraction (ICCE and intraocular lens (IOLimplantation in the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Folders of all cataract patients operated on in the eye theatre of the aforenamed tertiary facility between2002 and 2006 were considered.  Relevant patient details and intraoperative and postoperative management were examined and reported upon. One hundred and fourteen eyes (114 of one hundred patients who had cataract surgeries done within the five-year period of this study were examined. ECCE + IOL implantation were examined in the period under review. The post-operative refraction objectively and subjectively was retrieved from the records of each patient. The post-operative cylinderpower (total astigmatism was recorded.Of 114 eyes, only 83 eyes (72.8% had refraction results postoperatively due to loss of fol-low-up. The total number with astigmatism was 57(68.7%. Forty-two had against-the-rule (73.7%, twelve (21.1% with-the-rule, while five (0.09% were oblique. The mean post-operative astigmatism was 1.85 D. The surgically induced corneal astigmatism was highest with ECCE with PCIOL. Astigmatism less than 2 D was highest in this group (ECCE with IOL while ICCE with ACIOL had the highest number with astigmatism in the range between 2 D and 4 D. The total astigmatism which was mainly with-the-rule (vertical plus cylinder did not seem to impair severely the post-operative visual acuity of the patients.In conclusion, surgically induced astigmatism affected almost 75% of the patients operated and refracted within the period under review. This can be reduced with better operating skills using small incision suture-less techniques. Existing postoperative astigmatism can be reduced by suture cutting at specific periods particularly if there is follow-up at the critical periods. (S Afr Optom 2011 70(275-80

  17. Femtosecond laser combined with non-chopping rotation phacoemulsification technique for soft-nucleus cataract surgery: a prospective study.

    Chen, Hui; Lin, Haotian; Chen, Wan; Zhang, Bo; Xiang, Wu; Li, Jing; Chen, Weirong; Liu, Yizhi

    2016-01-01

    Soft-lens cataract surgeries are becoming increasingly common for cataract surgeons and chopping the soft nucleus using conventional techniques is problematic. We introduced a femtosecond laser combined with a non-chopping rotation phacoemulsification technique for soft-nucleus cataract surgery and evaluated the safety and efficacy of using this technique. Sixty-six patients with soft-nucleus cataracts ranging from grade 1~3 were divided into 3 groups based on nuclear staging. Those groups were further divided into three subgroups: femtosecond laser pretreatment combined with a non-chopping rotation phacoemulsification technique (subgroup 1), conventional manual cataract surgery with a non-chopping rotation technique (subgroup 2) and conventional manual cataract surgery with a quick-chop technique (subgroup 3).Patients were followed up at 1, 7, and 30 days after surgery. There was an 84.6% and a 63.34% reduction in ultrasound time and cumulative dissipated energy, respectively, between the subgroup 1 and the subgroup 3; and this was associated with a 36.1% and 29.7% reduction in endothelial cell loss and aqueous flare. There were no adverse events at the follow-up times. With its reduced ultrasound energy, endothelial cell loss and aqueous flare, the femtosecond laser pretreatment combined with a non-chopping rotation technique was more efficient than conventional manual cataract surgery for soft-nucleus cataracts. PMID:26728573

  18. BARRIERS RESPONSIBLE FOR DELAYED UTILIZATION OF CATARACT SURGERY: AN EYE CAMP STUDY FROM CENTRAL INDIA

    Umesh

    2014-03-01

    Full Text Available INTRODUCTION: Blindness is one of the significant social problems in India with 7 million of the total 45 million blind people in the world residing in our country. Apart from health and status of vision, there are many other socio-economic factors and perceptions, which influence the decision making of the people for getting operated for cataract. But very few studies have been done on the social factors influencing the utilization of cataract surgery. MATERIAL AND METHODS: It was a hospital-based, descriptive study. The study subjects were recruited from the Ophthalmology department from cataract camp held in Chirayu medical College, Hospital during October 2013 to January 2014. RESULTS: In present study, insufficient family income and no one to accompany (60% and 10% was responded by majority of the subjects. In present study, the barriers for delayed utilization of cataract surgery like could manage to do daily work was responded by 513 (85.5% out of total 600 subjects, could see with the other eye clearly 470 (78.3%, busy with work 118 (19.6%, being female70 (11.6%, fear of surgery 115 (19.1%, old age 200 (33.3%, fear that surgery could lead to loss of eyesight 55 (9.1%, it was Gods will 35 (5.8%, fear about the cost of surgery 375 (62.5% and fear that surgery could lead to death was responded by 15 (2.5% out of total 600 subjects. CONCLUSION: Expansion of outreach programmes to different communities rather than concentrate in urban areas, and offering cataract surgical services at affordable rates will also be of help. Health Education has a great role to play as well, especially in creating awareness. Adequate dissemination of information through various media is usually will be very helpful

  19. Morphological features in eyes with endophthalmitis after cataract surgery - histopathology and optical coherence tomography assessment

    Solborg Bjerrum, Søren; Prause, Jan Ulrik; Fuchs, Josefine; la Cour, Morten; Kiilgaard, Jens Folke

    2016-01-01

    PURPOSE: To assess the ocular damage that occurs in eyes with postoperative endophthalmitis after cataract surgery (PE) based on optical coherence tomography (OCT) retinal scans of PE eyes and histological specimens of eyes removed due to PE. METHODS: Case-control study and case series. Fifty-one...

  20. Three cases of post-cataract surgery endophthalmitis due to Rhizobium (Agrobacterium) radiobacter.

    Moreau-Gaudry, Viviane; Chiquet, Christophe; Boisset, Sandrine; Croize, Jacques; Benito, Yvonne; Cornut, Pierre Loïc; Bron, Alain; Vandenesch, François; Maurin, Max

    2012-04-01

    We present three unrelated post-cataract surgery endophthalmitis cases caused by Rhizobium radiobacter, hospitalized in three different hospitals. Early diagnosis was obtained in two cases by bacterial DNA detection in vitreous samples. All patients recovered from infection, but pars plana vitrectomy was needed in two patients due to rapid clinical deterioration. PMID:22259203

  1. Application of hands chopping cataract surgery in patients with microcoria

    Bing-Jie Zhang

    2014-06-01

    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.

  2. Lack of effect of preoperative norfloxacin on bacterial contamination of anterior chamber aspirates after cataract surgery.

    Chitkara, D. K.; Manners, T.; Chapman, F; Stoddart, M G; Hill, D.; Jenkins, D.

    1994-01-01

    Eighty patients undergoing routine standardised extracapsular cataract surgery with lens implantation were divided randomly into two groups in a prospective double blind study comparing effects of preoperative norfloxacin eyedrops with placebo on bacterial contamination of anterior chamber aspirates after surgery. Pathogenic organisms were identified from 19 (24%) of the aspirates. The most commonly isolated organisms were coagulase negative Staphylococcus species. There was no statistical di...

  3. A prospective study on postoperative pain after cataract surgery

    Porela-Tiihonen S; Kaarniranta K; Kokki M; Purhonen S; Kokki H.

    2013-01-01

    Susanna Porela-Tiihonen,1 Kai Kaarniranta,2 Merja Kokki,1 Sinikka Purhonen,1 Hannu Kokki1 1Department of Anesthesia and Operative Services, Kuopio University Hospital, School of Medicine, University of Eastern Finland, Kuopio, Finland; 2Department of Ophthalmology, Kuopio University Hospital, School of Medicine, University of Eastern Finland, Kuopio, Finland Purpose: To evaluate postoperative pain and early recovery in cataract patients. Patients and methods: A total of 201 patients who under...

  4. Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results

    Chang JS; Flynn Jr HW; Miller D.; Smiddy WE

    2013-01-01

    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, c...

  5. Recognizing Cataracts

    ... may be less sharp than it once was. One cause of impaired eyesight later in life is cataracts. A cataract is ... just a few weeks, and many have improved eyesight after a few days. Recent ... cataract surgery is a personal one that should be made between you and your ...

  6. Preoperative visual acuity among cataract surgery patients and countries' state of development: a global study

    Shaheen P Shah

    2011-10-01

    Full Text Available OBJECTIVE: To describe the preoperative surgical case mix among patients undergoing cataract extraction and explore associations between case mix, country level of development (as measured by the Human Development Index, HDI and cataract surgery rates (CSRs. METHODS: Ophthalmologists in 50 countries were invited to join the newly-established International Eye Research Network and asked to complete a web-based questionnaire about their eye hospitals. Those who complied received a data collection form for recording demographic and clinical data on 100 consecutive patients about to undergo cataract surgery. Countries were ranked into five HDI categories and multivariable regression was used to explore associations. FINDINGS: Ophthalmologists at 112 eye hospitals (54% of them nongovernmental in 50 countries provided data on 11 048 cataract procedures over 9 months in 2008. Patients whose visual acuity (VA before surgery was < 6/60 in the better eye comprised 47% of the total case mix in poorly developed countries and 1% in developed countries (P < 0.001. Overall, 72% of the eyes undergoing surgery had a VA < 6/60. Very low VA before cataract surgery was strongly associated with poor development at the country level and inversely associated with national CSR. CONCLUSION: The proportion of patients with very poor preoperative VA is a simple indicator that can be easily measured periodically to monitor progress in ophthalmological services. Additionally, the internet can be an effective tool for developing and supporting an ophthalmological research network capable of providing a global snapshot of service activity, particularly in developing countries.

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

    Jian-He Xiao

    2013-09-01

    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.

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

    Kohji Nishida

    2008-10-01

    Full Text Available 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 surgery in normal patients, and also investigated the risk factors for postoperative increase of IOP in each group.Methods: Fifty consecutive patients without systemic disease who have bilateral and symmetrical cataracts underwent uncomplicated cataract surgery in both eyes (100 eyes in total. Postoperatively, topical diclofenac was applied 4 times daily to one eye, and topical betamethasone to the other eye in each patient. IOP and best corrected logMAR visual acuity (BCVA in each eye were measured up to 8 weeks. Total surgery time and effective phacoemulsification time (EPT for each case was recorded.Results: BCVA in both diclofenac- and betamethasone-treated eyes significantly improved after the cataract surgery; however, no statistical difference in VA was noted between the diclofenac- and betamethasone-treated eyes throughout the observation period. IOP in the diclofenac-treated eyes decreased with time, in contrast to the IOP in the betamethasone-treated eyes, which showed a slight increase. At 4 and 8 weeks postoperatively, there was significant difference between these two eye groups. Multiple regression analysis revealed that postoperative increase in IOP at 8 weeks in the betamethasone-treated eyes was closely correlated with total surgery time and EPT, but the IOP in the diclofenac-treated eyes showed no correlation with any surgical or clinical parameters.Conclusions: Postoperative increase in IOP after cataract surgery was affected by total surgery time and EPT in the betamethasone-treated eye. The time for surgery and EPT is longer in complicated cases including patients with a hard nucleus or small pupils, and also longer for beginning surgeons and in older patients. In these cases, diclofenac in place of betamethasone as a postoperative topical antiinflammatory drug is recommended for the prevention of postoperative increase in IOP.Keywords: intraocular pressure, cataracts, visual acuity, betamethasone, diclofenac

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

    Tarighat Monfared MH

    2000-07-01

    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.

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

    Tarighat Monfared MH

    2001-07-01

    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.

  11. Cataract surgery: emotional reactions of patients with monocular versus binocular vision

    Roberta Ferrari Marback

    2012-12-01

    Full Text Available PURPOSE: To analyze emotional reactions related to cataract surgery in two groups of patients (monocular vision - Group 1; binocular vision - Group 2. METHODS: A transversal comparative study was performed using a structured questionnaire from a previous exploratory study before cataract surgery. RESULTS: 206 patients were enrolled in the study, 96 individuals in Group 1 (69.3 ± 10.4 years and 110 in Group 2 (68.2 ± 10.2 years. Most patients in group 1 (40.6% and 22.7% of group 2, reported fear of surgery (p<0.001. The most important causes of fear were: possibility of blindness, ocular complications and death during surgery. The most prevalent feelings among the groups were doubts about good results and nervousness. CONCLUSION: Patients with monocular vision reported more fear and doubts related to surgical outcomes. Thus, it is necessary that phisycians considers such emotional reactions and invest more time than usual explaining the risks and the benefits of cataract surgery.Ouvir

  12. Preoperative automatic visual behavioural analysis as a tool for intraocular lens choice in cataract surgery

    Heloisa Neumann Nogueira

    2015-04-01

    Full Text Available Purpose: Cataract is the main cause of blindness, affecting 18 million people worldwide, with the highest incidence in the population above 50 years of age. Low visual acuity caused by cataract may have a negative impact on patient quality of life. The current treatment is surgery in order to replace the natural lens with an artificial intraocular lens (IOL, which can be mono- or multifocal. However, due to potential side effects, IOLs must be carefully chosen to ensure higher patient satisfaction. Thus, studies on the visual behavior of these patients may be an important tool to determine the best type of IOL implantation. This study proposed an anamnestic add-on for optimizing the choice of IOL. Methods: We used a camera that automatically takes pictures, documenting the patient’s visual routine in order to obtain additional information about the frequency of distant, intermediate, and near sights. Results: The results indicated an estimated frequency percentage, suggesting that visual analysis of routine photographic records of a patient with cataract may be useful for understanding behavioural gaze and for choosing visual management strategy after cataract surgery, simultaneously stimulating interest for customized IOL manufacturing according to individual needs.

  13. Clinical observation on the treatment of glaucoma with cataract through triple surgery

    Dan Yu

    2014-04-01

    Full Text Available AIM: To observe the therapeutic effect of triple surgery in the treatment of glaucoma with cataract at different stages.METHODS: Totally 31 patients(55 eyeswith glaucoma and cataract were treated with phacoemulsification, lens implantation and trabeculectomy. Preoperation and postoperation of visual acuity, intraocular pressure, filtering bleb and postoperation complications were observed.RESULTS: After 6mo postoperation, the vision was significantly improved. The intraocular pressure was controlled in normal range and filtering bleb was good. There was a little complications after operation.CONCLUSION: Phacoemulsification intraocular lens implantation with anti-glaucoma establishes new aqueous humor outflow. It can effectively decrease intraocular pressure, deepen anterior chamber and improve vision, reduce all kinds of complications after simple glaucoma surgery.

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

    Shan-Jun Wu

    2013-12-01

    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.

  15. An analysis of ophthalmology trainees' perceptions of feedback for cataract surgery training

    Saedon H

    2013-01-01

    Habiba Saedon Birmingham Midland Eye Centre, Birmingham, West Midlands, UK Objectives: To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design: Cross-sectional qualitative study. Participants: Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods: Semi-structured interviews were c...

  16. An analysis of ophthalmology trainees’ perceptions of feedback for cataract surgery training

    Saedon, Habiba

    2013-01-01

    Objectives To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design Cross-sectional qualitative study. Participants Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods Semi-structured interviews were conducted via telephone or face to face. Interviews were transcribed and underwen...

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

    H. Zahedi

    2004-01-01

    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....

  18. New technique to demonstrate corneal magnification using trypan blue in cataract surgery

    Frederico F. Marques; Daniela M.V. Marques; Robert H. Osher

    2011-01-01

    PURPOSE: To demonstrate the corneal magnification using trypan blue in cataract surgery. METHODS: Eight eyes of eight patients undergoing phacoemulsification with an intraocular lens implantation were enrolled in this study. After staining the anterior capsule with Trypan Blue 0.1% and performing the capsulorhexis, the excised anterior capsule was placed on the corneal surface. By observing and measuring the relationship between the border of the excised anterior capsule and the intracameral ...

  19. Astigmatism management in cataract surgery with Precizon® toric intraocular lens: a prospective study

    Vale, Carolina; Menezes, Carlos; Firmino-Machado, J; Rodrigues, Pedro; Lume, Miguel; Tenedório, Paula; Menéres, Pedro; Brochado, Maria do Céu

    2016-01-01

    Purpose The purpose of this study was to evaluate the visual and refractive outcomes and rotational stability of the new aspheric Precizon® toric intraocular lens (IOL) for the correction of corneal astigmatism in cataract surgery. Setting Department of Ophthalmology, Hospital Geral de Santo António – Centro Hospitalar do Porto, EPE and Hospital de Pedro Hispano, Matosinhos, Portugal. Design This was a prospective clinical study. Patients and methods A total of 40 eyes of 27 patients with cor...

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

    Dong-Mei Cai

    2013-11-01

    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 3.871.12s and 4.211.06s before and after the treatment, with no significant difference(P>0.05; it was respectively 3.981.04s and 8.981.30s 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.

  1. Application of small incision surgery in free treatment for poverty alleviation in patients with cataract

    Qin Yin

    2015-01-01

    Full Text Available AIM:To study the application of small incision surgery in free treatment for poverty alleviation in patients with cataract. METHODS: Sixty patients(70 eyeswith high cataract with poverty free treatment from January 2010 to December 2013 in department of ophthalmology in our hospital were selected as study objects. electro cardio gram(ECGand chest X-ray examination were performed. The small incision combined with intraocular lens(IOLimplantation operation was undergone. The patients were followed up for 3mo to observe and compare postoperative vision and diopter changes, and analyze the related complications.RESULTS: The best visual acuity was 0.6, while the lowest vision for hand 3mo after the operation, a total of 65 eyes(93%vision was better than that before the operation: the eye axis less than 30mm(25.87~29.41mmhad 55 eyes, eye axis more than 30mm(30.02~31.47mmhad 10 eyes; and 5 eyes whose visual acuity had no significant changes.CONCLUSION: The small incision cataract treatment is simple, better curative effect and high safety, it is more suitable for free treatment in poverty alleviation cataract application.

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

    Ansari Imran A

    2008-02-01

    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.

  3. Clinical application of capsular tension ring on cataract surgery in patients with pseudoexfoliation syndrome after trabeculectomy

    Yi Zhang

    2014-09-01

    Full Text Available AIM:To investigate the safety and efficacy of capsular tension ring(CTRinsertion combined with phacoemulsification and intraocular lens(IOLimplantation in patient with pseudoexfoliation syndrome after anti-glaucoma surgery.METHODS: A retrospective study was conducted of 10 eyes from 10 cataract patients with pseudoexfoliation syndrome following trabeculectomy surgery, and who underwent CTR insertion combined with phacoemulsification and IOL implantation between January, 2012 and June, 2013. All cases had nuclear cataracts(nuclear hardness Ⅱ 1 eye, nuclear hardness Ⅲ 4 eyes, nuclear hardness Ⅳ 5 eyes. One case with Ⅳ nuclear hardness cataract had iridodonesis and lens subluxation. Postoperative visual acuity, intra- and post-operative complications, anterior capsular opening, IOL position, and postoperative intraocular pressure(IOPwere assessed. Follow-ups ranged from 3 to 14mo. The t test was used to analyze the variables studied.RESULTS: All patients had a successful CTR insertion combined with phacoemulsification and IOL implantation. A modified CTR insertion was performed in one case, the others underwent a standard CTR insertion. The best corrected visual acuity(BCVAwas ≥0.5 in 3 eyes and 0.3-t=1.9955, P>0.05. The most common intrao- and post-operative complications were corneal edema, small pupil, residual cortex, spontaneous zonular dialysis.CONCLUSION: Suitable CTR insertion in appropriate occasion may be beneficial to patients with pseudoexfoliation syndrome after trabeculectomy during cataract surgery. It prevents the IOL decentration and decrease the surgical complication. Less complication occurs at the early stage.

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

    Yong - Hua Li

    2013-04-01

    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.

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

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

    2014-01-01

    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

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

    Osman Sevki Arslan

    2014-10-01

    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.

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

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

    2012-06-01

    Full Text Available 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.

  8. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II

    Parikshit Gogate

    2014-01-01

    Full Text Available Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery. Aim: To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts who underwent cataract surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and a "barriers to follow-up" questionnaire completed. Demographic data collected, visual acuity estimated, and ocular examination performed. Statistical Analysis: SPSS version 19. Results: Of the 262 children, only 53 (20.6% had been regularly following up with any hospital, 209 (79.4% had not. A total of 150 (57.3% were boys and the average age was 13.23 years (Std Dev 5 yrs. Poor follow up was associated with the older age group ( P 1 line with regular follow-up. Conclusion: Regular follow-up is important and improves vision; eye care practitioners need to take special efforts to ensure better follow-up.

  9. Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials.

    Chen, Xiaoyun; Xiao, Wei; Ye, Shaobi; Chen, Weirong; Liu, Yizhi

    2015-01-01

    The aim of this study was to evaluate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification cataract surgery (CPCS) in the treatment of cataract. Randomized controlled trials (RCTs) were searched in PubMed, Embase and the Cochrane Central Register of Controlled Trials. Nine qualified studies with a total of 989 eyes were included. Compared with CPCS, FLACS significantly reduced mean phaco energy and effective phacoemulsification time (EPT) required in the surgery. Central corneal thickness (CCT) was significantly lower in FLACS at 1 day of follow-up, but CCT and corneal endothelial cells count was comparable at 1 week of follow-up or longer. FLACS achieved a better visual outcome at postoperative 1 week and 6 months, but the difference was not significant at postoperative 1-3 months. Regard to surgical complications, the incidences of intraoperative anterior capsule tear, postoperative macular edema and elevated intraocular pressure were similar. In conclusion, femtosecond laser pretreatment can reduce phaco energy and EPT, which may reduce the heat damage to ocular tissues by ultrasound. This novel technique might be beneficial for patients with dense cataract and/or low preoperative endothelial cell values. Well-designed RCTs with longer follow-up are still necessary to provide more reliable evidence. PMID:26269445

  10. Striving for the perfect surgery in traumatic cataract following penetrating trauma in a tertiary care hospital at eastern Nepal.

    Panda, A; Kumar, S; Das, H; Badhu, B P

    2007-01-01

    This study analyzes the result of traumatic cataract surgery in a tertiary care hospital at eastern Nepal. It is a hospital-based study of 112 patients (age 15-62), who underwent cataract extraction for unilateral traumatic cataracts. The study was carried out to evaluate the surgical outcome of tramatic cataract. Thirty-eight eyes had associated posterior capsular defect. No serious postoperative complications were encountered. Posterior capsular opacification at the end of sixth week was evident only in two eyes. Best corrected visual acuity nof 6/18 or more at the eighth week was achieved in 61 (54%) eyes. Astigmatism of less than 3D was achieved in 82 (73%) eyes. Rational surgical approach in traumatic cataract provides encouraging results. To comment on actual outcome long term follow up is mandatory. PMID:18274567

  11. Visual acuity improvements after implantation of toric intraocular lenses in cataract patients with astigmatism: a systematic review

    Agresta Blaise

    2012-08-01

    Full Text Available Abstract Background Cataracts are a common and significant cause of visual impairment globally. We aimed to evaluate uncorrected distance visual acuity (UDVA as an outcome in treating astigmatic cataract patients to assist clinicians or ophthalmologists in their decision making process regarding available interventions. Methods Medline, Embase and Evidence Based Reviews were systematically reviewed to identify relevant studies reporting changes in UDVA, UIVA and UNVA after cataract surgery in presbyopic patients. Strict inclusion/exclusion criteria were used to exclude any non-relevant studies. Relevant outcomes (UDVA, UIVA and UNVA were identified from the studies retrieved through the systematic review process. Results The systematic review identified 11 studies which reported UCVA. All 11 studies reported UDVA. Four brands of toric intraocular lenses (IOLs were reported in these studies. All studies identified in the literature search reported improvements in UDVA following surgical implant of a toric IOL. The largest improvements in VA were reported using the Human Optics MicroSil toric IOL (0.74 LogMAR, UDVA and the smallest improvements were also reported using the Human Optics MicroSil toric IOL (0.23 LogMAR, UDVA in a different study. Conclusions The results of this systematic review showed the aggregate of studies reporting a beneficial increase in UDVA with the use of toric IOLs in cataract patients with astigmatism.

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

    Morkin MI

    2014-08-01

    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

  13. Cost-Utility Analyses of Cataract Surgery in Advanced Age-Related Macular Degeneration

    Ma, Yingyan; Huang, Jiannan; Zhu, Bijun; Sun, Qian; Miao, Yuyu; Zou, Haidong

    2016-01-01

    ABSTRACT Purpose To explore the cost-utility of cataract surgery in patients with advanced age-related macular degeneration (AMD). Methods Patients who were diagnosed as having and treated for age-related cataract and with a history of advanced AMD at the Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, were included in the study. All of the participants underwent successful phacoemulsification with foldable posterior chamber intraocular lens implantation under retrobulbar anesthesia. Best-corrected visual acuity (BCVA) and utility value elicited by time trade-off method from patients at 3-month postoperative time were compared with those before surgery. Quality-adjusted life years (QALYs) gained in a lifetime were calculated at a 3% annual discounted rate. Costs per QALY gained were calculated using the bootstrap method, and probabilities of being cost-effective were presented using a cost-effectiveness acceptability curve. Sensitivity analyses were performed to test the robustness of the results. Results Mean logarithm of the minimum angle of resolution BCVA in the operated eye increased from 1.37 ± 0.5 (Snellen, 20/469) to 0.98 ± 0.25 (Snellen, 20/191) (p < 0.001); BCVA in the weighted average from both eyes (=75% better eye + 25% worse eye) was changed from 1.13 ± 0.22 (Snellen, 20/270) to 0.96 ± 0.17 (Snellen, 20/182) (p < 0.001). Utility values from both patients and doctors increased significantly after surgery (p < 0.001 and p = 0.007). Patients gained 1.17 QALYs by cataract surgery in their lifetime. The cost per QALY was 8835 Chinese yuan (CNY) (1400 U.S. dollars [USD]). It is cost-effective at the threshold of 115,062 CNY (18,235 USD) per QALY in China recommended by the World Health Organization. The cost per QALY varied from 7045 CNY (1116 USD) to 94,178 CNY (14,925 USD) in sensitivity analyses. Conclusions Visual acuity and quality of life assessed by utility value improved significantly after surgery. Cataract surgery was a cost-effective intervention for patients with coexistent AMD. PMID:26605501

  14. Meta-analysis to Compare the Safety and Efficacy of Manual Small Incision Cataract Surgery and Phacoemulsification

    Gogate, Parikshit; Optom, Jyoti Jaggernath B.; Deshpande, Swapna; Naidoo, Kovin

    2015-01-01

    Purpose: A systematic review and meta-analysis comparing the safety, efficacy, and expenses related to phacoemulsification versus manual small incision cataract surgery (SICS). Methods: PubMed, Cochrane, and Scopus databases were searched with key words manual SICS 6/18 and 6/60; astigmatism and endothelial cell loss postoperatively, intra- and post-operative complications, phacoemulsification, and comparison of SICS and phacoemulsification. Non-English language manuscripts and manuscripts not indexed in the three databases were also search for comparison of SICS with phacoemulsification. Data were compared between techniques for postoperative uncorrected and corrected distance visual acuity (UCVA and best corrected visual acuity [BCVA], respectively) better than 6/9, surgical cost and duration of surgery. The Oxford cataract treatment and evaluation team scores were used for grading intraoperative and postoperative complications, uncorrected near vision. Result: This review analyzed, 11 comparative studies documenting 76,838 eyes that had undergone cataract surgery considered for analysis. UCVA of 6/18 UCVA and 6/18 BCVA were comparable between techniques (P = 0.373 and P = 0.567, respectively). BCVA of 6/9 was comparable between techniques (P = 0.685). UCVA of 6/60 and 6/60 BCVA aided and unaided vision were comparable (P = 0.126 and P = 0.317, respectively). There was no statistical difference in: Endothelial cell loss during surgery (P = 0.298), intraoperative (P = 0.964) complications, and postoperative complications (P = 0.362). The phacoemulsification group had statistically significantly less astigmatism (P = 0.005) and more eyes with UCVA of 6/9 (P = 0.040). UCVA at near was statistically significantly better with SICS due to astigmatism and safer during the learning phase (P = 0.003). The average time for SICS was lower than phacoemulsification and cost < of phacoemulsification. Conclusion: The outcome of this meta-analysis indicated there is no difference between phacoemulsification and SICS for BCVA and UCVA of 6/18 and 6/60. Endothelial cell loss and intraoperative and postoperative complications were similar between procedures. SICS resulted in statistically greater astigmatism and UCVA of 6/9 or worse, however, near UCVA was better. PMID:26180478

  15. Clinical application of personalized composite incision for cataract surgery on grassroots poverty alleviation

    Zhong-Yu Xu

    2013-08-01

    Full Text Available AIM:To investigate whether complex surgical incision in cataract surgery based on corneal astigmatism axial can reduce preoperative corneal astigmatism.METHODS: Cataract patients 100 cases(100 eyeswith corneal astigmatism more than 1.50D detected by keratometry were collected in this study. Scleral tunnel incision was made as the main incision according to diameter direction of maximum corneal refractive power, meanwhile, an auxiliary incision was performed on the other side of the main incision. Extracapsular cataract extraction with intraocular lens implantation was performed by a small-incision. The preoperative and postoperative(3 days, 1 month, 3, 6, 12 monthscorneal astigmatism and uncorrected visual acuity were measured.RESULTS: The preoperative and postoperative(3 days, 1 month, 3, 6, 12 monthsaverage corneal astigmatism were(+2.08±0.666D,(-1.06±0.75D,(+0.67±0.71D,(+1.11±0.77D,(+1.20±0.88D and(+1.30±0.68D, respectively. The preoperative and postoperative(3 days, 1 month, 3, 6, 12 monthsaverage uncorrected visual acuity were 0.30±0.19, 0.55±0.25, 0.69±0.21, 0.66±0.18, 0.65±0.20, 0.60±0.22. CONCLUSION: The use of composite and personalized incision in cataract surgery helps to reduce preoperative corneal astigmatism. Because of the advantage of simple process and low cost, this operation is suitable to popularize in poverty alleviation at the grassroots level.

  16. PREOPERATIVE ORAL CODEINE EFFECT ON POSTOPERATIVE CAUGH CONTROL IN CATARACT SURGERY

    H SOLTANI NEZHAD

    2003-03-01

    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.

  17. CATARACT SURGERY AND INTRAOCULAR LENS POWER CALCULATION IN A PATIENT WITH ANTERIOR MEGALOPHTHALMOS WITH NORMAL SIZED CRYSTALLINE LENS; CASE REPORT

    Glisic Selimir

    2015-12-01

    Full Text Available Cataract surgery and intraocular lens power calculation is challenging in patients with anterior megalophthalmos and cataract, with postoperative refractive surprise frequently reported. Deep anterior chamber in these patients substantially influence effective lens position. To minimize possibility of refractive surprise, we used Haigis formula that takes into account anterior chamber depth in the lens power calculation for our patient. Cataract was managed by phakoemulsification with standard intraocular lens implanted in the capsular bag. Postoperatively, satisfying refractive result was achieved and refractive surprise was avoided.

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

    Singh R

    2012-08-01

    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

  19. A retrospective study of the indications and outcomes of capsular tension ring insertion during cataract surgery at a tertiary teaching hospital

    Wang BZ

    2013-03-01

    Full Text Available Bob Z Wang, Elsie Chan, Rasik B Vajpayee The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia Background: The purpose was to determine preoperative indications, intraoperative procedures, and outcomes of capsular tension ring (CTR insertion during cataract surgery. Methods: A review of all patients undergoing cataract surgery with insertion of a CTR between July 2000 and June 2010 was conducted at The Royal Victorian Eye and Ear Hospital, a large tertiary teaching hospital in Victoria, Australia. Information relating to each patient's demographic details, preoperative assessment, surgical procedure, and postoperative assessment were obtained. Results: Eighty-four eyes of 82 patients were included in this study. The main indications for CTR insertion were previous trauma, pseudoexfoliation syndrome, and mature cataracts. Twenty-one eyes (25.0% did not have any obvious preoperative indication. A posterior capsule tear was the most common intraoperative complication (3.6%. An intraocular lens was successfully implanted in the bag in 72 eyes (85.7%. Postoperatively, the most common complications were a decentered intraocular lens (8.3% and persistent corneal edema (6.0%. Overall, 61 eyes (72.6% had better postoperative visual acuity compared with preoperative acuity, with 67 patients (79.8% achieving vision of 20/40 or better. Conclusion: For the majority of cases, CTR use in complex cataract surgeries is associated with improved postoperative outcomes. CTR implantation is most commonly required in patients with known risk factors for zonular instability. Keywords: capsular tension ring, cataract extraction, indications, outcomes

  20. Treatment costs of cystoid macular edema among patients following cataract surgery

    Schmier JK

    2016-03-01

    Full Text Available Jordana K Schmier,1 David W Covert,2 Carolyn K Hulme-Lowe,1 Anmol Mullins,3 Emmanuel M Mahlis4 1Health Sciences, Exponent Inc., Alexandria, VA, 2Health Economics, 3Global Market Access, 4US Pharma Medical Affairs, Alcon Inc., Fort Worth, TX, USA Purpose: The current costs of treating cystoid macular edema (CME, a complication that can follow cataract surgery, are largely unknown. This analysis estimates the treatment costs for CME based on the recently released US Medicare data. Setting: Nationally representative database. Design: Retrospective analysis of the 2011 through 2013 Medicare 5% Beneficiary Encrypted Files. Methods: Beneficiaries who underwent cataract surgery were identified and stratified by diagnosis of CME (cases or no diagnosis of CME (controls within 6 months following surgery. Claims and reimbursements for ophthalmic care were identified. Subgroup analyses explored the rates of CME in beneficiaries based on the presence of selected comorbidities and by the type of procedure (standard vs complex. Total Medicare and ophthalmic costs for cases and controls are presented. The analysis explored the effect of considering diabetic macular edema (DME and macular edema (ME as exclusion criteria. Results: Of 78,949 beneficiaries with cataract surgery, 2.54% (n=2,003 were diagnosed with CME. One-third of beneficiaries had one or more conditions affecting retinal health (including diabetes, 4.5% of whom developed CME. The rate of CME, at 22.5%, was much higher for those patients with preoperative DME or ME. Ophthalmic charges were almost twice as high for cases compared with controls (US$10,410 vs $5,950; payments averaged 85% higher ($2,720 vs $1,470 (both P<0.0001. Conclusion: Substantial costs can be associated with CME; beneficiaries whose retinas are already compromised before cataract surgery face higher risk. Cost savings could be realized with the use of therapies that reduce the risk of developing CME. Future analyses could identify whether and to what extent comorbidities influence costs. Keywords: claims analysis, costs and cost analysis, cystoid macular edema, diabetic retinopathy

  1. Non steroidal anti-inflammatory drugs for preventing cystoid macular edema after cataract surgeries:a Meta-analysis

    Xue-Jiao Xu

    2015-12-01

    Full Text Available AIM:To systematic evaluate the preventive effect of non-steroidal anti-inflammatory drugs(NSAIDson the cystoid macular edema(CMEafter the cataract surgery. METHODS:Searching literature which were published by March 2015 and which were the random control test(RCTon the preventive effect of NSAIDs on CME after the cataract surgery in PubMed, EMbase, Cochrane Library, MEDLINE, CNKI, Wanfang Data, Chongqing Weipu and Chinese biomedical literature database and through Internet with computer. Meanwhile, relevant articles, journals, conference papers and their reference were manually retrieved. According to inclusion and exclusion criteria,the study objects were limited.Revman5.0 software provided by the Cochrane Collaboration was used to analysis the incidence of CME after cataract surgeries.RESULTS:A total of 7 RCT were included in the study(1422 cases, 712 cases in the trial group, 710 cases in the control group. Using NSAIDs before and after cataract surgeries could significantly reduce the post-operative incidence of CME(OR=0.31, 95%CI:0.18?0.52, PCONCLUSION:Using NSAIDs before and after cataract surgeries can significantly reduce the incidence of postoperative CME. Due to the small sample size and the medium methodological quality, the conclusion is not powerful enough. More high-quality RCTs with larger sample size are needed to make the evaluation more objective, accurate and comprehensive.

  2. Complexities and challenges of surgical data collection from cataract patients: comparison of cataract surgery rates between 2001 and 2008 in all provinces of Argentina

    Van C. Lansingh

    2014-01-01

    Full Text Available Purpose: To compare the cataract surgical rate (CSR in 2001 with that in 2008 in all Argentinean provinces using current reporting methods and verify the accuracy of CSRs by crosschecking these methods with the number of sold intraocular lenses (IOLs within the country. Methods: A longitudinal study including public and private setups was conducted, and it included 40 ophthalmologists from 22 provinces who provided cataract surgery data for 2001 and 2008. Other data were obtained from the Ministry of Health. Estimates were crosschecked against the market data for sold intraocular lens (IOLs in 2008 and 2010. Results: The number of cataract surgeries increased 2.7-fold, from 62,739 in 2001 to 169,762 in 2008, with increases in every province except Mendoza. Although the population also increased by 9.4% during the same time period, the apparent CSR jumped from 1,744 to 4,313 per million population. The number of IOLs sold in Argentina in 2008 was 186,652, suggesting that the number of cataract surgeries performed was slightly greater than anticipated. Crosschecks with other countries using IOL sales data did not show discrepancies when compared with previously reported CSRs. Conclusions: Although the CSR in Argentina increased considerably from 2001 to 2008 for several reasons, the main reason was that thorough crosschecking between the number of surgeries reported and the number of IOLs sold revealed that the number of surgeries performed annually were being underestimated as a result of incomplete reporting by private practitioners. Furthermore, the presence of multiple societies of ophthalmology in the country complicated the process of obtaining accurate data.

  3. B - SCAN ULTRASONOGRAPHY BEFORE SURGERY I N EYES WITH ADVANCED CATARACTS: A USEFUL PROGNOSTIC TOOL

    Jatin

    2015-05-01

    Full Text Available BACKGROUND : Ocular ultrasonography is an important tool for evaluating the posterior segment in eyes with opaque media . In cases with dense cataract , where posterior segment evaluation by ophthalmoscopy is not possible , B - scan ultrasonography before surgery can help in surgical planning and guiding the expectations of patients . PURPOSE : To determine the relevance and prevalence of posterior segment abnormalities in patients with dense ca taracts prior to surgery by ultrasonography . DESIGN : Prospective diagnostic study . METHODS : Diagnostic B - scan ultrasound was performed on 158 eyes of 132 patients with dense cataract precluding visualization of fundus on ophthalmoscopy from January 2013 to December 2013 . Patients were divided in two groups , traumatic ( 22 and non - traumatic ( 136 . Patients in the age range of 1 to 79 years of both sexes were included . Detailed history and some basic eye examination techniques , like slit lamp and tonometry we re done . Patients having already posterior segment lesions and those who had previous history of ocular surgery were excluded from the study . RESULTS : 26 ( 16 . 4% patients , out of total 158 patients , had posterior segment lesions . Among traumatic group of 22 patients , 15 ( 68 . 1% had positive posterior segment lesions , while only 11 ( 8% patients in the non - traumatic group of 136 patients had positive posterior segment lesions . Out of the 26 positive cases , retinal detachment was found in 8 ( 5% patients , 7 ( 4 . 4% had posterior vitreous detachment , 7 ( 4 . 4% had vitreous hemorrhage , 2 ( 1 . 26% had retinal detachment with vitreous hemorrhage , 1 ( 0 . 63% had asteroid hyalosis , 1 ( 0 . 63% had intra - ocular foreign body . CONCLUSION : We concluded that B - scan ultrasound has sign ificant importance in the preoperative evaluation of patients with dense cataracts to detect pathologies that may influence the surgical strategy and the postoperative visual prognosis .

  4. Assessing patient satisfaction with cataract surgery under topical anesthesia supplemented by intracameral lidocaine combined with sedation

    Manuela Bezerril Cipião Fernandes

    2013-12-01

    Full Text Available PURPOSE: Ocular akinesia, the use of anticoagulants, and patient collaboration are some of the factors that must be taken into consideration when choosing the appropriate anesthesia for phacoemulsification cataract surgery. The satisfaction of patients with the use of topical anesthesia and conscious sedation for this procedure has not been enough described in Brazil. Conscious sedation allows patient walk and answer a voice command. To assess the satisfaction, pain, and perioperative hemodynamic alterations of patients subjected to phacoemulsification under conscious sedation and topical anesthesia supplemented with intracameral lidocaine. METHODS: Prospective cohort non-controlled study that included patients treated by the same surgical team over a 70-day period. Sedation was performed with midazolam at a total dose of 3 mg and topical anesthesia with 0.5% proxymetacaine chlorhydrate and 2% lidocaine gel combined with 2% lidocaine by intracameral route. The intraoperative vital parameters, scores based on the Iowa Satisfaction with Anesthesia Scale (ISAS, and the pain visual analog scale (VAS were recorded at several time points after surgery. RESULTS: A total of 106 patients were enroled in study (73.6% female, the mean age was 65.9 years. The surgical procedures lasted 11.2 minutes on average. The hemodynamic parameters did not exhibit significant changes at any of the investigated time points. The average ISAS score was 2.67 immediately after surgery and 2.99 eight hours after the surgery; this increase was statistically significant (p<0.0001. More than two-thirds (68.9% of the participants (73 patients did not report any pain in the transoperative period, and 98.1% of patients denied the occurrence of pain after surgery. CONCLUSIONS: Patients that received topical anesthesia supplemented by intracameral lidocaine combined with sedation for phacoemulsification cataract surgery reported adequate level of satisfaction with the anesthetic choice. Furthermore, the patients exhibited hemodynamic parameter stability and pain control.

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

    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)

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

    Arantes Tiago Eugênio Faria e

    2006-01-01

    Full Text Available PURPOSE: To evaluate the conjunctival bacterial flora and its antibiotic resistance pattern in eyes of patients undergoing cataract surgery. METHODS: From August to October 2004, 50 patients undergoing cataract surgery in the "Fundação Altino Ventura", Recife, Brazil, were prospectively evaluated. Conjunctival material was obtained on the day of surgery, before the application of topical anesthetic, antibiotic or povidone-iodine. The collected material was inoculated and bacterioscopic analysis was carried out. In the cases where there was bacterial growth, antibiotic susceptibility tests and cultures, for isolation and identification of the bacteria, were performed. RESULTS: Of the 50 eyes, 43 (86.0% had positive cultures. The coagulase-negative Staphylococcus (CNS, found in 27 (54.0% eyes, was the most frequent organism. More than 90% of the isolates of this bacterium were susceptible to cephalotin, vancomycin, chloramphenicol, ofloxacin and gatifloxacin; 70 to 90% were susceptible to gentamicin, cefotaxime, oxacillin and ciprofloxacin; and less than 70% were sensible to neomycin. Four (10.5% of the bacterial isolates were resistant to four or more antibiotics, two of them were CNS. CONCLUSION: The most frequent bacterium in the conjunctival flora is the coagulase-negative Staphylococcus. The isolates of this organism showed low susceptibility rate to neomycin, and high susceptibility rates to cephalotin, vancomycin, chloramphenicol, ofloxacin and gatifloxacin.

  7. Refractive results of cataract surgery using optical biometry and Haigis formula in eyes with refractive keratotomy

    Juan Carlos Snchez Caballero

    2013-04-01

    Full Text Available OBJECTIVE: To analyze refractive results in postoperative cataract surgery in eyes previously submitted to keratotomy using Haigis formula and data provided by IOL Masteroptical biometer. METHODS: The measurements for IOL calculation were obtained through optical biometry by partial coherence interferometry (IOL Master- Zeiss, 5.4 and 5.5 version that provides us with the axial length, the central keratometry of 2.5mm, white-to-white diameter and anterior chamber anatomical depth. The formula chosen was Haigis. The surgical technique applied was with the scleral incision at 1.5 mm from the limbus, with scleral-corneal tunnel of 2.2 mm wide, phacoemulsification using INFINITI Ozil- Alcon and implantation of hydrophobic acrylic aspheric intraocular lens - SN60WF- Alcon. RESULTS: We studied 20 eyes submitted to keratotomy in the past and currently with cataract with indication for cataract surgerywith intraocular lens implantation using phacoemulsification. Postoperative spherical equivalent was plano in 40% of the eyes and lower than -1.00 in 85% of the eyes. CONCLUSION: The optical biometry by partial coherence interferometry associated with Haigis formula is a valid alternative in IOL calculation for eyes submitted to keratotomy. The refractive results are highly predictable and reproducible.

  8. Delayed Descemet's membrane detachment after successful cataract surgery: a case report

    Aileen Walsh

    2012-10-01

    Full Text Available The detachment of Descemet's membrane can be a serious complication following cataract surgery, leading to severe corneal edema and reduced visual acuity. This report describes an unusual case of Descemet's membrane detachment 6 months after successful phacoemulsification, documented by anterior segment optic coherence tomography (OCT; RTVue, Optovue. The eye was treated successfully with pneumatic descemetopexy and transcorneal suturing, with reattachment of Descemet's membrane. This report should alert physicians that delayed corneal edema can be related to late-onset Descemet's membrane detachment, which requires proper treatment to avoid permanent corneal decompensation.

  9. Treatment costs of cystoid macular edema among patients following cataract surgery

    Schmier JK; Covert DW; Hulme-Lowe CK; Mullins A; Mahlis EM

    2016-01-01

    Jordana K Schmier,1 David W Covert,2 Carolyn K Hulme-Lowe,1 Anmol Mullins,3 Emmanuel M Mahlis4 1Health Sciences, Exponent Inc., Alexandria, VA, 2Health Economics, 3Global Market Access, 4US Pharma Medical Affairs, Alcon Inc., Fort Worth, TX, USA Purpose: The current costs of treating cystoid macular edema (CME), a complication that can follow cataract surgery, are largely unknown. This analysis estimates the treatment costs for CME based on the recently released US Medicare data. Setting: N...

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

    Yelda B zkurt

    2009-06-01

    Full Text Available Yelda B zkurt, Arzu Taskiran, Nadire Erdogan, Baran Kandemir, mer 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 318 years (group 1 and 19 eyes from 19 patients aged 9.1 5.2 (range 1.518 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

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

    Hjelmstad, David P.; Sayegh, Samir I.

    2013-03-01

    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.

  12. Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery

    Kessel, Line; Andresen, Jens; Tendal, Britta; Erngaard, Ditte; Flesner, Per; Hjortdal, Jesper

    2016-01-01

    evaluated as surgical complications and residual astigmatism. CLINICAL RELEVANCE: Postoperative astigmatism is an important cause of suboptimal UCDVA and need for distance spectacles. Toric IOLs may correct for preexisting corneal astigmatism at the time of surgery. METHODS: We performed a systematic...... literature search in the Embase, PubMed, and CENTRAL databases within the Cochrane Library. We included randomized clinical trials (RCTs) if they compared toric with non-toric IOL implantation (± relaxing incision) in patients with regular corneal astigmatism and age-related cataracts. We assessed the risk...

  13. Astigmatism management in cataract surgery with Precizon® toric intraocular lens: a prospective study

    Vale C

    2016-01-01

    Full Text Available Carolina Vale,1 Carlos Menezes,2 J Firmino-Machado,3 Pedro Rodrigues,2 Miguel Lume,1 Paula Tenedório,2 Pedro Menéres,1 Maria do Céu Brochado1 1Department of Ophthalmology, Hospital Geral de Santo António – Centro Hospitalar do Porto, EPE, Porto, 2Department of Ophthalmology, Hospital de Pedro Hispano, Matosinhos, 3Public Health Unit, ACES – Porto Ocidental, Porto, Portugal Purpose: The purpose of this study was to evaluate the visual and refractive outcomes and rotational stability of the new aspheric Precizon® toric intraocular lens (IOL for the correction of corneal astigmatism in cataract surgery.Setting: Department of Ophthalmology, Hospital Geral de Santo António – Centro Hospitalar do Porto, EPE and Hospital de Pedro Hispano, Matosinhos, Portugal.Design: This was a prospective clinical study.Patients and methods: A total of 40 eyes of 27 patients with corneal astigmatism greater than 1.0 diopter (D underwent cataract surgery with implantation of Precizon® toric IOL. IOL power calculation was performed using optical coherence biometry (IOLMaster®. Outcomes of uncorrected (UDVA and best-spectacle corrected distance visual acuities (BCDVA, refraction, and IOL rotation were analyzed at the 1st week, 1st, 3rd, and 6th month’s evaluations.Results: The median postoperative UDVA was better than preoperative best-spectacle corrected distance visual acuity (0.02 [0.06] logMAR vs 0.19 [0.20] logMAR, P<0.001. At 6 months, postoperative UDVA was 0.1 logMAR or better in 95% of the eyes. At last follow-up, the mean spherical equivalent was reduced from -3.35±3.10 D to -0.02±0.30 D (P<0.001 with 97.5% of the eyes within ±0.50 D of emmetropia. The mean preoperative keratometric cylinder was 2.34±0.95 D and the mean postoperative refractive cylinder was 0.24±0.27 D (P<0.001. The mean IOL rotation was 2.43°±1.55°. None of the IOLs required realignment.Conclusion: Precizon® toric IOL revealed very good rotational stability and performance regarding predictability, efficacy, and safety in the correction of preexisting regular corneal astigmatism associated with cataract surgery. Keywords: astigmatism, cataract surgery, toric intraocular lens, stability, implantation outcomes

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

    Soliman Mahdy MAE

    2012-03-01

    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, (ρ were as follows: CDE (ρ = 0.425, aspiration time (ρ = 0.176, and volume (ρ = 0.278. Also, ECLoss% was significantly correlated with the grade of nuclear opalescence (Kendall’s tau τ = 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 

  15. Long-Term Changes in Subfoveal Choroidal Thickness After Cataract Surgery.

    Yılmaz, Tolga; Karci, Ayse Aslihan; Yilmaz, İhsan; Yılmaz, Ahu; Yıldırım, Yusuf; Sakalar, Yildirim Bayezit

    2016-01-01

    BACKGROUND Cataract surgery is associated with the development of late-onset age-related macular degeneration (AMD). The pathogenic mechanism is still not fully established. The purpose of this study was to evaluate the possible changes in central macula thickness (CMT) and subfoveal choroid thickness (SCT) after uneventful cataract surgery. MATERIAL AND METHODS A total of 65 eyes of 65 patients who underwent phacoemulsification and intracapsular lens implantation were included in this prospective study. Patients had not undergone previous ocular surgery and had no other ocular abnormality. CMT and SCT were measured at baseline and postoperatively at week 1 and months 1, 3, 6 and 12 via spectral domain optical cohorence tomography (SD-OCT). RESULTS CMT was 252.4±27.6 μm (mean ±SD) preoperatively, then 253.5±29.8, 256.1±28.7, 257.4±27.2, 253.18±23.7, and 252.8±21.7 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. There were insignificant changes in CMT, and it returned to baseline at six months after surgery (all p>0.05). SCT was 237.4±21.6 μm preoperatively, and 240.5±24.8, 241.2±25.7, 242.7±26.3, 243.1±24.2, and 244.2±21.4 μm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. Although there was an increase in SCT during follow-up, the difference between preoperative and postoperative values was not significant (p>0.05). CONCLUSIONS Uncomplicated phacoemulsification induces subclinical changes in CMT, probably due to the inflammatory insult of surgery, and CMT returns to baseline value. There were slight, insignificant increases in choroid thickness during follow-up, and this did not return to baseline during follow-up. Changes in the choroid after cataract surgery may provide clues to the development of late-onset AMD. PMID:27158971

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

    Matsuura K

    2014-09-01

    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 Womens 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 (povidoneiodine [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 surgeons 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

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

    Huan Yang

    2014-05-01

    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(χ2=1.344, Pχ2=0.146, Pχ2=0.236, Pχ2=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.

  18. PREVALENCE OF GLAUCOMA IN PATIENTS UNDERGOING CATARACT SURGERY IN RURAL SET UP IN SOUTHERN INDIA

    Bharathi

    2015-05-01

    Full Text Available PURPOSE: To determine the prevalence and types of glaucoma in rural patients posted for cataract surgery under eye camps at a tertiary care hospital . BACKGROUND: Glaucoma is the second leading cause of blindness in the adult pop ulation in India. The global prevalence of glaucoma for population aged 40 to 80 years is estimated to be 3.54% and the projected number of people with glaucoma worldwide will increase to 111.8 million in 2040. This creates a need for early diagnosis and p rompt management of glaucomas especially in the underprivileged rural areas that lack awareness and facilities. METHODOLOGY: A cross - sectional study was conducted at a regional ophthalmic center for all the patients posted for cataract surgery under eye ca mps. Study was carried out for duration of one year and included 1400 patients. The patients underwent detailed workup to detect the presence of glaucomas and were treated accordingly if the disease was detected. RESULTS: The overall prevalence of glaucoma in our study population was 2.14%. Amongst them, 0.78% had primary open angle glaucoma, 0.14% had primary angle closure glaucoma and 1.21% of them had pseudoexfoliative glaucoma. The prevalence of glaucomas increased with increasing age. CONCLUSION: With increasing life expectancy the number of glaucoma patients is constantly growing large in our country. Early case detection rate is of utmost importance to reduce the disease burden in the rural population where awareness in terms of routine eye screening is very low

  19. Curative effects of small incision cataract surgery versus phacoemulsification: a Meta-analysis

    Chang-Jian Yang

    2013-08-01

    Full Text Available AIM: To evaluate the curative efficacy of small incision cataract surgery(SICSversus phacoemulsification(Phaco.METHODS: A computerized literature search was carried out in Chinese Biomedical Database(CBM, Wanfang Data, VIP and Chinese National Knowledge Infrastructure(CNKIto collect articles published between 1989-2013 concerning the curative efficacy of SICS versus Phaco. The studies were assessed in terms of clinical case-control criteria. Meta-analysis were performed to assess the visual acuity, the complications rates between SICS and Phaco 90 days after surgery. Treatment effects were measured as risk difference(RDbetween SICS and Phaco. Fixed and random effect models were employed to combine results after a heterogeneity test. RESULTS:A total of 8 studies were included in our Meta-analysis. At 90 days postoperative time, there were no significant differences between the two groups at the visual acuity >0.5(P=0.14; and no significant differences on the complications rates of corneal astigmatism, corneal edema, posterior capsular rupture and anterior iris reaction(P>0.05.CONCLUSION: These results suggest that there is no different on the curative effects of SICS and Phaco for cataract.

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

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D; Pedersen, Court; Gerstoft, Jan; Kronborg, Gitte; Obel, Niels

    2011-01-01

    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...

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

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D; Pedersen, Court; Gerstoft, Jan; Kronborg, Gitte; Obel, Niels

    2011-01-01

    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 53150 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...

  2. Changes in central corneal thickness and endothelial cell count pediatric cataract surgery

    To evaluate the mean changes in Central Corneal Thickness (CCT) and Endothelial Cell Count (ECC) in eyes after pediatric cataract surgery with foldable intraocular lens using scleral tunnel incision micro-surgical technique. Study Design: Qausi experimental study. Place and Duration of Study: Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi, from May 2011 to March 2012. Methodology: Fifty-two eyes of 37 children with pediatric cataract were included in the study. Extracapsular Cataract Extraction (ECE) with foldable Intra Ocular Lens (IOL) implantation using sclera tunnel incision was performed in all children. Endothelial Cell Count (ECC) and Central Corneal Thickness (CCT) were recorded before surgery and 1 month, 3 months and 6 months after surgery and the effect of currently practiced surgical technique on ECC and CCTwas evaluated. Results: The mean age at the time of surgery was 8.8 ± 2.7 years (range: 4 to 15 years). The postoperative ECC and CCT were significantly different from the pre-operative values. Mean pre-operative ECC was 3175.3 ± 218.4 cell/mm2 and in first postoperative month the mean ECC was 3113.4 ± 210.8 cell/mm2 (p<0.0001). In the 3rd and 6th month postoperative means ECC were 3052 ± 202.5 cell/mm2 (p<0.0001) and 3015 ±190.6 cell/mm2 (p<0.0001), respectively. The mean cell loss at first postoperative month was 1.95% and at 3rd and 6th postoperative month were 3.9% and 5.05%, respectively. Mean pre-operative CCT was 514 ± 49.9 micro m and first postoperative mean CCT after 1 month was 524.1 ± 25 micro m (p = 0.084). After the 3rd and 6th months postoperative, mean CCT were 527.3 ± 24.6 micro m, and 530 ± 24.5 micro m, respectively. Third and 6th months postoperative means were significantly higher than baseline CCT, p = 0.024 and 0.007, respectively. Conclusion: Endothelial cell loss with closed chamber micro-surgical technique using scleral tunnel incision is within acceptable limits and within the range of normal ECC in children. (author)

  3. Intracameral dexamethasone reduces inflammation on the first postoperative day after cataract surgery in eyes with and without glaucoma

    Diane TW Chang

    2009-05-01

    Full Text Available Diane TW Chang, Michael C Herceg, Richard A Bilonick, Larissa Camejo, Joel S Schuman, Robert J NoeckerDepartment of Ophthalmology, University of Pittsburgh Medical Center, Eye Center, Pittsburgh, PA, USAPurpose: To evaluate whether dexamethasone injected intracamerally at the conclusion of surgery can safely and effectively reduce postoperative inflammation and improve surgical outcomes in eyes with and without glaucoma.Methods: Retrospective chart review of 176 consecutive eyes from 146 patients receiving uncomplicated phacoemulsification (PE (n = 118 total, 82 with glaucoma, glaucoma drainage device (GDD (n = 35, combined PE/GDD (n = 11 and combined PE/endoscopic cyclophotocoagulation (n = 12. Ninety-one eyes from 76 patients were injected with 0.4 mg dexamethasone intracamerally at the conclusion of surgery. All eyes received standard postoperative prednisolone and ketorolac eyedrops. Outcomes were measured for four to eight weeks by subjective complaints, visual acuity (VA, slit-lamp biomicroscopy, intraocular pressure (IOP and postoperative complications.Results: Dexamethasone significantly reduced the odds of having an increased anterior chamber (AC cell score after PE (p = 0.0013. Mean AC cell score ± SD in nonglaucomatous eyes was 1.3 ± 0.8 in control and 0.8 ± 0.7 with dexamethasone; scores in glaucomatous eyes were 1.3 ± 0.7 in control and 0.9 ± 0.8 with dexamethasone. Treated nonglaucomatous eyes had significantly fewer subjective complaints after PE (22.2% vs 64.7% in control; p = 0.0083. Dexamethasone had no significant effects on VA, corneal changes, IOP one day and one month after surgery, or long-term complications.Conclusions: Intracameral dexamethasone given at the end of cataract surgery significantly reduces postoperative AC cells in eyes with and without glaucoma, and improves subjective reports of recovery in nonglaucomatous eyes. There were no statistically significant risks of IOP elevation or other complications in glaucomatous eyes.Keywords: cataract surgery, glaucoma, steroid, dexamethasone, inflammation, intraocular pressure

  4. Relationships of pain assessment with time perception and satisfaction for cataract surgeries in patients under topical anesthesia

    Mei-Na Huang

    2015-10-01

    Full Text Available AIM:To investigate the relationships of pain assessment with time perception and satisfaction for cataract surgeries in patients under topical anesthesia. METHODS:Ninety patients with 90 eyes received cataract surgeries were included. Pain in surgery was assessed by using Visual Analogue Scales(VAS. According to VAS results, the patients were classified into three groups: Level-I pain group(VAS:0 score, level-? pain group(VAS:1?3 scores, level-? pain group(VAS:>3 scores. The differences of the three groups on age, sex, laterality, objective duration of the operations, subjective duration and satisfaction for the surgeries were analyzed. RESULTS:No statistically significant differences between every two groups on age, sex and laterality were detected(P>0.05. The actual operation time and subjective duration was relatively long in the surgery examples with higher pain scores(PPCONCLUSION:The accuracy of time perception and satisfaction for surgeries decreased with the aggravation of intraoperative pain in patients under topical anesthesia. So it is an important part of preoperative education and visits to let the patients understand that the feeling of pain cannot be used as a judgment whether the cataract surgery is successful.

  5. Comparison of the effects of remifentanil and alfentanil on intraocular pressure in cataract surgery

    Godrat Akhavanakbari

    2013-01-01

    Full Text Available Background: Anesthesia for ophthalmic surgery requires management of intraocular pressure (IOP during perioperative period. In an open eye, in conditions such as after traumatic injury or during cataract surgery, IOP increase can lead to permanent vision loss. Administration of narcotics concomitant with anesthetics has the ability to reduce this increase of IOP. This clinical trial aims to compare the efficacy of remifentanil and alfentanil in preventing an increase in IOP after administration of succinylcholine, intubation and during anesthesia. Methods: This double-blind clinical trial was conducted on 50 patients undergoing elective general surgery for cataracts. Patients were randomly divided into two groups. Alfentanil (20 μg/kg in 30 s for group 1 and remifentanil (1 μg/kg in 30 s for group 2 were injected before induction of anesthesia, and 0.5 μg/kg/min alfentanil for group 1 and 0.1 μg/kg/min remifentanil for group 2 were infused during the anesthesia. Systolic and diastolic blood pressure, heart rate, and IOP from normal eye were measured before the induction, after administration of thiopental and succinylcholine, after tracheal intubation, and 2 min later, and were repeated in 2-min intervals until the end of operation. Results: IOP decreased after injection of anesthetics and remained lower all through the operation in both groups, but IOP decreased after injection of succinylcholine in remifentanil group while it increased in alfentanil group (P<0.05. Conclusions: Results of this study indicate benefits of both remifentanil and alfentanil in managing IOP after induction and during anesthesia. It seems that remifentanil is better than alfentanil in controlling the IOP after injection of succinylcholine.

  6. Uveitis-glaucoma-hyphema syndrome caused by posterior chamber intraocular lens--a rare complication in pediatric cataract surgery.

    Lin, Chun-Ju; Tan, Chau-Yi; Lin, Szu-Yuan; Jou, Jieh-Ren

    2008-01-01

    We report a case of postoperative uveitis-glaucome-hyphema (UGH) syndrome following pediatric cataract surgery due to posterior chamber intraocular lens (PC-IOL). Slit-lamp examination revealed the optic of PC-IOL migrated into anterior chamber. The PC-IOL explantation was performed and ocular inflammation subsided. PMID:19230361

  7. A comparative study of complications of cataract surgery with phacoemulsification in eyes with high and normal axial length

    Hamid Fesharaki

    2012-01-01

    Conclusions: As the results illustrate, in this survey, age and high axial length were statistically significant risk factors for incidence of intraoperative complications of cataract surgery with phacoemulsification technique. Anticipation of these complications and also preparation and prophylactic measures may decrease incidence of these complications.

  8. Comparison of surgically induced astigmatism in various incisions in manual small incision cataract surgery

    Nidhi Jauhari

    2014-12-01

    Full Text Available AIM:To determine the surgically induced astigmatism (SIA in Straight, Frown and Inverted V shape (Chevron incisions in manual small incision cataract surgery (SICS.METHODS:A prospective cross sectional study was done on a total of 75 patients aged 40y and above with senile cataract. The patients were randomly divided into three groups (25 each. Each group received a particular type of incision (Straight, Frown or Inverted V shape incisions. Manual SICS with intraocular lens (IOL implantation was performed. The patients were compared 4wk post operatively for uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA and SIA. All calculations were performed using the SIA calculator version 2.1, a free software program. The study was analyzed using SPSS version 15.0 statistical analysis software.RESULTS:The study found that 89.5% of patients in Straight incision group, 94.2% in Frown incision group and 95.7% in Inverted V group attained BCVA post-operatively in the range of 6/6 to 6/18. Mean SIA was minimum (-0.880.61D90 degrees with Inverted V incision which was statistically significant.CONCLUSION:Inverted V (Chevron incision gives minimal SIA.

  9. Liquefaction for cataract extraction

    Labiris, Georgios; Toli, Aspasia; Polychroni, Damaskini; Gkika, Maria; Angelonias, Dimitrios; Kozobolis, Vassilios P.

    2016-01-01

    A systematic review of the recent literature regarding the implementation of the liquefaction in cataract surgery and its short-term and long-term outcomes in various parameters that affect the quality of patients' life, including visual rehabilitation and possible complications was performed based on the PubMed, Medline, Nature and the American Academy of Ophthalmology databases in November 2013 and data from 14 comparative studies were included in this narrative review. Liquefaction is an innovative technology for cataract extraction that uses micropulses of balanced salt solution to liquefy the lens nucleus. Most studies reported that liquefaction is a reliable technology for mild to moderate cataracts, while fragmentation difficulties may be encountered with harder nuclei. PMID:26949656

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

    Mohammad Ali Zare

    2011-01-01

    Full Text Available Anterior megalophthalmos, a rare hereditary disorder, is macrocornea (horizontal corneal diameter more than 13 mm in association with enlarged lens-iris diaphragm and ciliary ring. One of the major challenging issues in the cataract surgery of these patients is preventing intraocular lens (IOL malposition, because of probable large capsular bag. Several approaches have been selected by previous surgeons, such as, custom-made anterior chamber IOLs. In this study, we show a normal capsular bag diameter despite ciliary ring enlargement, with application of ultrasound biomicroscopy (UMB. We suggest that in cases of anterior megalophthalmos without phacodonesis, UBM could measure the actual size of the capsular bag and obviate the need for further procedures.

  11. New technique to demonstrate corneal magnification using trypan blue in cataract surgery

    Frederico F. Marques

    2011-08-01

    Full Text Available PURPOSE: To demonstrate the corneal magnification using trypan blue in cataract surgery. METHODS: Eight eyes of eight patients undergoing phacoemulsification with an intraocular lens implantation were enrolled in this study. After staining the anterior capsule with Trypan Blue 0.1% and performing the capsulorhexis, the excised anterior capsule was placed on the corneal surface. By observing and measuring the relationship between the border of the excised anterior capsule and the intracameral capsulorhexis opening, the effect of corneal magnification was clearly demonstrated and calculated by linear method. RESULTS: The average magnification of the cornea was 20.88% using linear method with an average area magnification of 47.53%. CONCLUSION: The capsulorhexis stained by trypan blue is useful to demonstrate the magnification provided by the cornea helping to design an intended opening size.

  12. Application of trypan blue before continuous curvilinear capsulorhexis in the surgery for all white or over ripe stage cataract

    Chun-Tao Zhang; Yuan He; Jun Jia

    2016-01-01

    AIM:To discuss the application of trypan blue before continuous curvilinear capsulorhexis(CCC)during the surgery for all white or over ripe stage cataract. METHODS:Forty-two eyes in 42 patients with cataract in all white or over ripe stage were selected. During the operations, 0.2mL trypan blue(0.6mg/mL)was injected into the anterior chambers of all the 42 eyes. The anterior capsule was stained to light blue. Then the CCC was conducted. The density of corneal endothelial cells and the percent...

  13. Bean-shaped ring segments for capsule stretching and centration of bag-in-the-lens cataract surgery.

    Tassignon, Marie-Jos; Dhubhghaill, Sorcha N

    2014-01-01

    The bag-in-the-lens (BIL) is a unique approach to IOL placement in cataract surgery. The BIL intraocular lens (IOL) is suspended centrally, supported by the anterior and posterior capsulorhexes. The placement confers a high degree of centration and stability; however, it is dependent on capsular and zonular integrity. In this report, we describe a patient with posttraumatic cataract featuring a sector of iris and suspensory zonule loss. The insertion of custom-designed bean-shaped segments provides capsular tension over the area of defect and a central aperture designed to support the BIL IOL. PMID:24355717

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

    Wei Ching-Kuo

    2012-10-01

    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.

  15. Which colours are seen by the patient during cataract surgery? Results of an intraoperative interview.

    Wenzel, M; Schulze Schwering, M

    2016-03-01

    PurposeTo discover what cataract patients see during phacoemulsification and if these light phenomena influence their anxiety levels during surgery.MethodsIn all, 200 patients were interviewed intraoperatively at the Eye Hospital, Petrisberg, Trier, Germany. The quality of the visual experiences was described and if these were pleasant, neutral or unpleasant. Systemic sedation was noted.ResultsAmong 200 patients (209 eyes): 88 were men (91 eyes; 44%) and 112 were women (118 eyes; 56%). Median age (years): men (71), women (70). Mean operating time was 8 min. 49/209 (23%) were not anxious before and during surgery. 110/209 (52%) were more anxious before than during surgery, 50/209 (24%) were still anxious during surgery, 27/209 (13%) got sedation with midazolam (1-5 mg). Colours in descending order seen: blue, red, pink, yellow, green, purple, turquois, and orange. The most dominant colour combination was red/blue. Structures were seen by 162/209 (78%). Most (61%) intraoperative visual experiences were pleasant, 38% were neutral, and 1% found them transiently unpleasant. Three patients felt blinded by the light of the operating microscope.ConclusionsThe experience of colours and other light phenomena was pleasant for most patients during phacoemulsification under topical anaesthesia. They occur spontaneously when the patient is fixating on the operating light. They are not dependent on the individual or environment. Sedation only in 13%. Direct questioning for visual sensations by the operating surgeon may lead to less need for sedation and lead to less side effects for elderly and multimorbidity people postoperatively. The surgeon can use this knowledge to reassure patients during surgery. PMID:26563653

  16. A comprehensive review of Cataract (Kaphaja Linganasha) and its Surgical Treatment in Ayurvedic Literature.

    Dhiman, K S; Dhiman, Kamini; Puri, Samita; Ahuja, Deepak

    2010-01-01

    Ayurveda the science of life, since its origin is serving the mankind throughout in health & disease state of life. Shalakyatantra, one of its specialized branch deals with the science of Ophthalmology, Otorhinolaryngology, Orodental surgery & Head; was contributed and developed by Rajrishi Nimi, the King of Videha, who was a colleague of Atreya, Punarvasu, Dhanwantri, Bharadwaja, Kashyapa etc. The available literature related to this speciality is reproduced from original text of Nimitantra in Uttartantra of Sushruta samhita. So Rajrishi Nimi deserves all the credit and regards for Shalakyatantra and for being the first eye surgeon on this earth. The fact regarding the technique of cataract surgery adopted by ancient surgeons is still a matter of debate. Most of the medical fraternity accepts cataract surgery of ancient surgeons as couching procedure but after going through forth coming pages, the prevailing concept will prove to be a myth. It started with extra capsular extraction through small incision during the period of Sushruta Samhita but later shifted to couching like technique by Acharya Vagbhatta. Secondly, the objective of this literary research paper is to find proper co-relation of the disease cataract to those mentioned in Ancient Ayurvedic classic. Linganasha has been inadvertently taken as cataract but this is neither logical nor in accordance with classics. We find detailed description of cataract's differential diagnosis, indications, contra- indications, pre/intra/post operative procedures and complication in ancient texts of Ayurveda. Not only this, vivid description of treatment of various complications of cataract surgery are also given. Needless to say, no other surgically treatable diseases & its complications except Kaphaja Linganasha are given this much attention. PMID:22131692

  17. Comparison of postoperative corneal changes between dry eye and non-dry eye in a murine cataract surgery model

    Jin Woo Kwon

    2016-02-01

    Full Text Available AIM: To compare the effects of the surgical insult of cataract surgery on corneal inflammatory infiltration, neovascularization (NV and lymphangiogenesis (LY between the dry eye and non-dry eye in murine cataract surgery models. METHODS: We established two groups of animals, one with normal eyes (non-dry eye and the second with induced dry eyes. In both groups, we used surgical insults to mimic human cataract surgery, which consisted of lens extraction, corneal incision and suture. After harvesting of corneas on the 9th postoperative day and immunohistochemical staining, we compared NV, LY and CD11b+ cell infiltration in the corneas. RESULTS: Dry eye group had significantly more inflammatory infiltration (21.75%±7.17% vs 3.65%±1.49%; P=0.049. The dry eye group showed significantly more NV (48.21%±4.02% vs 26.24%±6.01%; P=0.016 and greater levels of LY (9.27%±0.48% vs 4.84%±1.15%; P=0.007. In corneas on which no surgery was performed, there was no induction of NV in both the dry and non-dry group, but dry eye group demonstrated more CD11b+ cells infiltration than the non-dry eye group (0.360%±0.160% vs 0.023%±0.006%; P=0.068. Dry eye group showed more NV than non-dry eye group in both topical PBS application and subconjunctival PBS injection (P=0.020 and 0.000, respectively. CONCLUSION: In a murine cataract surgery model, preexisting dry eye can induce more postoperative NV, LY, and inflammation in corneal tissue.

  18. Comparison of postoperative corneal changes between dry eye and non-dry eye in a murine cataract surgery model

    Kwon, Jin Woo; Chung, Yeon Woong; Choi, Jin A; La, Tae Yoon; Jee, Dong Hyun; Cho, Yang Kyung

    2016-01-01

    AIM To compare the effects of the surgical insult of cataract surgery on corneal inflammatory infiltration, neovascularization (NV) and lymphangiogenesis (LY) between the dry eye and non-dry eye in murine cataract surgery models. METHODS We established two groups of animals, one with normal eyes (non-dry eye) and the second with induced dry eyes. In both groups, we used surgical insults to mimic human cataract surgery, which consisted of lens extraction, corneal incision and suture. After harvesting of corneas on the 9th postoperative day and immunohistochemical staining, we compared NV, LY and CD11b+ cell infiltration in the corneas. RESULTS Dry eye group had significantly more inflammatory infiltration (21.75%7.17% vs 3.65%1.49%; P=0.049). The dry eye group showed significantly more NV (48.21%4.02% vs 26.24%6.01%; P=0.016) and greater levels of LY (9.27%0.48% vs 4.84%1.15%; P=0.007). In corneas on which no surgery was performed, there was no induction of NV in both the dry and non-dry group, but dry eye group demonstrated more CD11b+ cells infiltration than the non-dry eye group (0.360%0.160% vs 0.023%0.006%; P=0.068). Dry eye group showed more NV than non-dry eye group in both topical PBS application and subconjunctival PBS injection (P=0.020 and 0.000, respectively). CONCLUSION In a murine cataract surgery model, preexisting dry eye can induce more postoperative NV, LY, and inflammation in corneal tissue.

  19. Comparing resident cataract surgery outcomes under novice versus experienced attending supervision

    Puri S

    2015-09-01

    Full Text Available Sidharth Puri,1 Amanda E Kiely,2 Jiangxia Wang,3 Alonzo S Woodfield,4 Saras Ramanathan,5 Shameema Sikder21Johns Hopkins School of Medicine, Baltimore, MD, 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 3Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 4Kaiser Permanente South Sacramento Medical Center, Sacramento, 5San Francisco School of Medicine, University of California, San Francisco, CA, USAPurpose: To determine whether supervision by an attending new to surgical teaching or an experienced attending measurably influences intraoperative complications rates or outcomes in phacoemulsification performed by ophthalmology residents.Setting: Single tertiary hospital.Design: Retrospective cohort study. Methods: Resident-performed phacoemulsification cases supervised by one novice attending (N=189 and experienced attending (N=172 over 1 year were included. Data included: resident year, patient age, sex, preoperative risk factors (4+ dense/white/brunescent cataracts, Flomax, zonular dialysis, pseudoexfoliation, glaucoma risk, post-vitrectomy, intraoperative risk factors (Trypan blue, iris hooks, and intraoperative complications (capsule tears, vitreous loss, zonular dialysis, zonular dehiscence, burns, nuclear fragment loss, Descemet’s tear. Experienced attending data were compared against those of the novice attending.Results: Regarding preoperative risks, experienced attending cases more likely involved 4+ cataract (P=0.005, Flomax (P<0.001, or glaucoma risk (P=0.001. For intraoperative risks, novice attending cases more likely involved Trypan blue (P<0.001. Regarding complications, novice attending cases were associated with vitreous loss (P=0.002 and anterior capsule tears (P<0.001. When comparing total complications, the novice attending was more likely to have both increased number of cases with complications and total complications than the experienced attending. The novice attending’s overall complication rate trended downward (rate from 28% in first 25 cases to 6.67% in last 15.Conclusion: Early cases for the novice attending were accompanied by greater complications (vitreous loss and anterior capsule tear, likely due to a learning curve. Surgical judgment in the operating room likely develops with experience. Training programs may focus on these specific areas to aid new instructors. Keywords: cataract surgery, attending experience, complication rate

  20. Laser welding in penetrating keratoplasty and cataract surgery of pediatric patients: early results

    Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Malandrini, Alex; Canovetti, Annalisa; Lenzetti, Ivo; Capozzi, Paolo; Valente, Paola; Buzzonetti, Luca

    2013-03-01

    Diode laser welding of ocular tissues is a procedure that enables minimally invasive closure of a corneal wound. This procedure is based on a photothermal effect: a water solution of Indocyanine Green (ICG) is inserted in the surgical wound, in order to stain the corneal tissue walls. The stained tissue is then irradiated with a low power infrared diode laser, delivering laser light through a 300-μm core diameter optical fiber. This procedure enables an immediate closure of the wounds: it is thus possible to reduce or to substitute the use of surgical threads. This is of particular interest in children, because the immediate closure improves refractive outcome and anti-amblyopic effect; moreover this procedure avoids several general anaesthesia for suture management. In this work, we present the first use of diode laser welding procedure in paediatric patients. 5 selected patients underwent cataract surgery (Group 1), while 4 underwent fs-laserassisted penetrating keratoplasty (Group 2). In Group 1 the conventional surgery procedure was performed, while no stitches were used for the closure of the surgical wounds: these were laser welded and immediately closed. In Group 2 the donor button was sutured upon the recipient by 8 single stitches, instead of 16 single stitches or a running suture. The laser welding procedure was performed in order to join the donor tissue to the recipient bed. Objective observations in the follow up study evidenced a perfect adhesion of the laser welded tissues, no collateral effects and an optimal restoration of the treated tissues.

  1. Comparison of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients

    Zhan-Jiang Liu

    2016-01-01

    Full Text Available AIM:To investigate the effects of Bigbag and Rayner620H intraocular lens in cataract surgeries in high myopia patients. METHODS:Seventy-seven patients(128 eyeswere treated by phacoemulsification combined with intraocular lens implantation from January 2014 to March 2015 in our hospital. Thirty-nine patients(65 eyeswere treated with Bigbag intraocular lens, 38 cases(63 eyeswere treated with Rayner620H. The best corrected visual acuity(BCVAdistribution, the actual refractive value, the difference between predictive refractive value and actual refractive value and complications were measured and recorded in the two groups at 1mo after surgeries. RESULTS:The difference between the two groups on BCVA are statistically significant(PWilcoxon rank sum test. The differences between predictive refractive value and actual refractive value of the two groups were statistically significant(PPCONCLUSION:The effect of Bigbag intraocular lens for patients with phacoemulsification and intraocular lens implantation is good, and it can reduce the risk of complications.

  2. Suspensão de cirurgia de catarata e suas causas Reasons for cataract surgery cancelation

    Rodrigo Pessoa Cavalcanti Lira

    2001-10-01

    Full Text Available Com o objetivo de verificar as causas de suspensão de cirurgia de catarata e sugerir medidas para melhorar a eficiência do serviço prestado à população, foi realizado um estudo transversal no serviço de oftalmologia de um hospital universitário do Estado de São Paulo. A amostra foi composta por 200 indivíduos. A média de idade foi de 68± 11,4 anos. As causas de suspensão de cirurgia foram: condição clínica desfavorável (23,1%; horário cirúrgico insuficiente (35,9%; e não comparecimento do paciente (41%. Os fatores causadores foram, majoritariamente, as razões sociais e o funcionamento do hospital.To study the reasons for canceling cataract surgeries, and to suggest actions to improve the efficiency of patient care. A cross-sectional study was carried out in a university hospital's ophthalmology clinic of the state of São Paulo, Brazil. Two hundred subjects were randomly selected. The mean age was 68± 11.4 years old. The reasons for canceling surgery were: unpropitious clinical condition (23.1%; tight schedule (35.9%; and patient non-attendance (41%. Most of the reasons related to social issues and the hospital's administrative aspects.

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

    Goto, Y

    2012-02-03

    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.

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

    Hasan Razmjoo

    2014-01-01

    Full Text Available 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.

  5. Improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery

    Elliott, D; Patla, A.; Bullimore, M.

    1997-01-01

    AIMS—To determine the improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery.
METHODS—Clinical vision (monocular and binocular high and low contrast visual acuity, contrast sensitivity, and disability glare), functional vision (face identity and expression recognition, reading speed, word acuity, and mobility orientation), and perceived visual disability (Activities of Daily Vision Scale) were measured in 25 subjects before a...

  6. Sub-Conjunctival Injection of Antibiotics vs. Povidone-Iodine Drop on Bacterial Colonies in Phacoemulsification Cataract Surgery

    Panahibazaz, Mahamoudreza; Moosavian, Mojataba; Khataminia, Gholamreza; Feghhi, Mostafa; Yazdi, Farsim; Abbasi Montazeri, Effat

    2014-01-01

    Background: Postoperative endophthalmitis is one the most serious complications of cataract surgery. The majority of causative organisms in this destructive infection come from the patient’s own periocular flora. Efforts have been made to reduce the virulence of organisms in the eyelid and conjunctiva with perioperative topical antibiotics, preparation of surgical field, covering eyelids and conjunctival surface with 5% povidone–iodine solution and intracameral antibiotics at the time of surg...

  7. Inadvertent Trypan Blue Staining of Posterior Capsule during Cataract Surgery Associated with “Argentinian Flag” Event

    Prinzi, Robert A.; Alapati, Neeti M.; Gappy, Shawn S.; Dilly, Jason S.

    2016-01-01

    Trypan blue is common in visualizing the anterior capsule during cataract surgery. Inadvertent staining of the posterior capsule during phacoemulsification is a rare complication and there are few reports in the literature. The proposed mechanism of posterior capsule staining in previous reports includes a compromised zonular apparatus or iris retractors facilitating the posterior flow of trypan blue. We report the first case of trypan blue staining of the posterior capsule associated with th...

  8. New side-view imaging technique for observing posterior chamber structures during cataract surgery in porcine eyes

    Tasaka, Yoshitaka; Minami, Noriyoshi; SUZUKI, TAKASHI; Kawasaki, Shiro; Zheng, Xiaodong; Shiraishi, Atsushi; Uno, Toshihiko; Miyake, Kensaku; Ohashi, Yuichi

    2013-01-01

    Background To develop a side-view imaging technique for observing the dynamic behavior of posterior chamber structures (PCSs) in porcine eyes which mimics closed-eye cataract surgery in humans. Methods Enucleated porcine eyes were placed into liquid nitrogen for 5 seconds and immediately bisected at about a 45-degree angle to the equatorial plane. The anterior portion was attached firmly to a glass slide with superglue and sprinkled with wheat flour. Phacoemulsification and aspiration (PEA) w...

  9. Long-term outcomes of limbal relaxing incisions during cataract surgery: aberrometric analysis

    Monaco G

    2015-08-01

    Full Text Available Gaspare Monaco, Antonio ScialdoneDepartment of Ophthalmology, Ospedale Fatebenefratelli e Oftalmico, Milan, ItalyPurpose: To compare the final changes in corneal wavefront aberration by limbal relaxing incisions (LRIs after cataract surgery.Methods: This prospective cumulative interventional nonrandomized case study included cataract and astigmatic patients undergoing LRIs and phaco with intraocular lens implantation. LRIs were planned using Donnenfeld nomogram. The root mean square of corneal wave aberration for total Z(n,i(1≤n≤8, astigmatism Z(2,±1, coma Z(3–5–7,±1, trefoil Z(3–5–7,±2, spherical Z(4–6–8,0, and higher-order aberration (HOA Z(3≤n≤8 was examined before and 3 years after surgery (optical path difference-Scan II [OPD-Scan II]. Uncorrected distance visual acuity and best-corrected distance visual acuity (CDVA for distance, keratometric cylinder, and variations in average corneal power were also analyzed.Results: Sixty-four eyes of 48 patients were included in the study. Age ranged from 42 to 92 years (70.6±8.4 years. After LRIs, uncorrected distance visual acuity and best-corrected distance visual acuity improved statistically (P<0.01. The keratometric cylinder value decreased by 40.1%, but analysis of KP90 and KP135 polar values did not show any decrease that could be statistically confirmed (P=0.22 and P=0.24. No significant changes were detected in root mean square of total (P=0.61 and HOAs (P=0.13 aberrations. LRIs did not induce alteration in central corneal power confirming a 1:1 coupling ratio.Conclusion: LRIs determined a nonsignificant alteration of corneal HOA. Therefore, LRIs can be still considered a qualitatively viable mean in those cases where toric intraocular lenses are contraindicated or not available. Yet, the authors raise the question of nonpersonalized nomograms, as in the present study, LRIs did not reach the preset target cylinder. Keywords: astigmatism, ocular wavefront, intraocular lens, wavefront aberration

  10. Etiopathogenesis of cataract: An appraisal

    Varun B Gupta

    2014-01-01

    Full Text Available Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc., traumatic, complicated (inflammatory and degenerative diseases of eye, metabolic (diabetes, galactosemia etc., toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc. are implicated as significant risk factors in the development of cataract.

  11. Evaluating the different laser fragmentation patterns used in laser cataract surgeries in terms of effective phacoemulsification time and power

    Huseynova T

    2015-11-01

    Full Text Available Tukezban Huseynova,1 Mariko Mita,2 Christine Carole C Corpuz,1 Yuko Sotoyama,1 Minoru Tomita2,3 1Shinagawa LASIK Center, Tokyo, Japan; 2Tomita Minoru Eye Clinic Ginza, Tokyo, Japan; 3Wenzhou Medical College, Wenzhou, Peoples Republic of China Purpose: To evaluate the effects of the different fragmentation patterns for the lens nucleus in terms of the effective phacoemulsification time (EPT and power. Setting: Shinagawa LASIK Center, Tokyo, Japan. Design: Comparison study. Methods: Seventy-one eyes of 71patients had preoperative lens opacity grading based on the Emery-Little Classification (Grade 1and Grade 2. Eyes underwent femtosecond laser-assisted cataract surgery (Catalys Precision Laser System, for capsulotomy and lens fragmentation. For the lens fragmentation, either the quadrants softened (Quadrant or the quadrants complete (Complete pattern was used. The mean EPT and phacoemulsification (phaco power for each cutting pattern of Grades 1and 2cataracts were evaluated. Results: The mean EPT was 28.96seconds in the Quadrant Group and 16.31seconds in the Complete Group (P=0.006. The mean phaco power was 8.07% in the Quadrant Group and 4.77% in the Complete Group (P=0.0002. Comparing the Quadrant and Complete Groups of Grade 1cataract showed no significant difference in EPT (P=0.16, but showed a significant difference in phaco power (P=0.033. Comparing the Quadrant and Complete patterns of Grade 2cataract showed significant differences in both EPT (P=0.012 and phaco power (P=0.003. Using the Complete pattern showed a 44.7% reduction in EPT and a 40.9% reduction in phaco power when compared to the Quadrant Group. Conclusion: Using the smaller fragmentation pattern in femtosecond laser cataract surgery, the phaco time and power were reduced significantly when compared to the procedure with the larger fragmentation pattern. Keywords: effective phacoemulsification time (EPT, complete and quadrant fragmentation pattern

  12. Completion rates of anterior and posterior continuous curvilinear capsulorrhexis in pediatric cataract surgery for surgery performed by trainee surgeons with the use of a low-cost viscoelastic

    R Muralidhar

    2012-01-01

    Full Text Available Context : Pediatric cataract surgery is traditionally done with the aid of high-molecular-weight viscoelastics which are expensive. It needs to be determined if low-cost substitutes are just as successful. Aims : The study aims to determine the success rates for anterior and posterior capsulorrhexis and intraocular lens (IOL implantation in the bag for pediatric cataract surgery performed with the aid of a low-molecular-weight viscoelastic. Settings and Design : Nonrandomized observational study. Materials and Methods: Children less than 6 years of age who underwent cataract surgery with IOL implantation in the period May 2008-May 2009 were included. The surgeries were done by pediatric ophthalmology fellows. A standard procedure of anterior capsulorrhexis, lens aspiration with primary posterior capsulorrhexis, anterior vitrectomy, and IOL implantation was followed. Three parameters were studied: successful completion of anterior and posterior capsulorrhexis and IOL implantation in the bag. Results: 33 eyes of 28 children were studied. The success rate for completion was 66.7% and 88.2 % for anterior and posterior capsulorrhexis, respectively. IOL implantation in the bag was successful in 87.9%. Conclusions: 2% hydroxypropylmethylcellulose is a viable low-cost alternative to more expensive options similar to high-molecular-weight viscoelastics. This is of great relevance to hospitals in developing countries.

  13. Evaluation of the Ex-PRESS® P-50 implant under scleral flap in combined cataract and glaucoma surgery

    Huerva, Valentín; Soldevila, Jordi; Ascaso, Francisco J.; Lavilla, Laura; Muniesa, M. Jesús; Sánchez, M. Carmen

    2016-01-01

    AIM To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS® P-50 for combined cataract surgery and glaucoma. METHODS Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS® P-50 model placed under scleral flap was performed. RESULTS Out of 40 eyes of 40 patients (55% male and 45% female) completed the study during one-year follow-up. The mean of age was 76.6±11.02y. The intraocular pressure (IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg (Wilcoxon signed ranks test, P<0.001). A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control (<21 mm Hg). CONCLUSION Combined surgery of phacoemulsification with ExPRESS® P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation. PMID:27162726

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

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

    2012-04-01

    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.

  15. Visual Hallucinations in an Old Patient after Cataract Surgery and Treatment.

    Ozcan, Halil; Yucel, Atakan; Ates, Orhan

    2016-02-01

    Sensory visual pathologies, accompanying simple or complex visual hallucinations that occur in visually-impaired individuals due to ophthalmologic or brain pathologies related to visual pathways in patients without mental disorders, are defined as Charles Bonnet syndrome. Between 10% and 60% of the patients having age-related eye diseases involving retina, cornea and the lens, commonly with macular degeneration experience complex visual hallucinations depending on the severity of visual problems. The neurophysiology of the visual hallucinations in Charles Bonnet Syndrome is not clearly known, and they may differ in content and severity over time. In differential diagnoses of Charles Bonnet Syndrome, many aetiologies (drugs, uraemia, exposure to toxic materials, neurodegenerative and psychiatric conditions) need to be ruled out. In the treatment of Charles Bonnet syndrome, first the management of the reason of visual loss should be clarified if possible. If needed, neuroleptics, anticonvulsants, antidepressants, benzodiazepines, cognitive enhancer agents such as cholinesterase inhibitors can be used also. In this case, an 83-year-old female patient experiencing visual hallucinations as burning candles in both eyes' visual field after left eye cataract surgery, treated with 0.5 milligram/day risperidone will be presented. PMID:27026767

  16. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Amedo AO

    2016-04-01

    Full Text Available Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients’ cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05; frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05. Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher’s exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05. Keywords: cataract, residual corneal astigmatism, frown incision, straight incision

  17. Patient-specific finite-element simulation of the human cornea: a clinical validation study on cataract surgery.

    Studer, Harald P; Riedwyl, Hansjörg; Amstutz, Christoph A; Hanson, James V M; Büchler, Philippe

    2013-02-22

    The planning of refractive surgical interventions is a challenging task. Numerical modeling has been proposed as a solution to support surgical intervention and predict the visual acuity, but validation on patient specific intervention is missing. The purpose of this study was to validate the numerical predictions of the post-operative corneal topography induced by the incisions required for cataract surgery. The corneal topography of 13 patients was assessed preoperatively and postoperatively (1-day and 30-day follow-up) with a Pentacam tomography device. The preoperatively acquired geometric corneal topography - anterior, posterior and pachymetry data - was used to build patient-specific finite element models. For each patient, the effects of the cataract incisions were simulated numerically and the resulting corneal surfaces were compared to the clinical postoperative measurements at one day and at 30-days follow up. Results showed that the model was able to reproduce experimental measurements with an error on the surgically induced sphere of 0.38D one day postoperatively and 0.19D 30 days postoperatively. The standard deviation of the surgically induced cylinder was 0.54D at the first postoperative day and 0.38D 30 days postoperatively. The prediction errors in surface elevation and curvature were below the topography measurement device accuracy of ±5μm and ±0.25D after the 30-day follow-up. The results showed that finite element simulations of corneal biomechanics are able to predict post cataract surgery within topography measurement device accuracy. We can conclude that the numerical simulation can become a valuable tool to plan corneal incisions in cataract surgery and other ophthalmosurgical procedures in order to optimize patients' refractive outcome and visual function. PMID:23246043

  18. A Meta-analysis on the clinical efficacy and safety of optic capture in pediatric cataract surgery

    Zhou, Hong-Wei; Zhou, Fang

    2016-01-01

    AIM To evaluate the clinical efficacy and safety of optic capture in pediatric cataract surgery. METHODS Searches of peer-reviewed literature were conducted in PubMed, Embase and the Cochrane Library. The search terms were “optic capture” and “cataract”. The retrieval period ended in December 2014. Relevant randomized controlled trials (RCTs), case-control studies and cohort studies were included. Meta-analyses were performed. Pooled weighted mean differences and risk ratios with 95% confidence intervals were estimated. RESULTS Ten studies involving 282 eyes were included, 5 of which were RCTs involving 194 eyes. The application of optic capture significantly reduced both opacification of the visual axis (RR: 0.12; 95% CI: 0.02 to 0.85; P=0.03) and occurrence of geometric decentration (RR: 0.09; 95% CI: 0.02 to 0.46; P=0.004). But it did not significantly affect best corrected visual acuity (BCVA) (WMD: -0.01; 95%CI: -0.07 to 0.05; P=0.75) and influence the occurrence of posterior synechia (RR: 1.53; 95% CI: 0.84 to 2.77; P=0.17). Deposits in the anterior intraocular lens were significantly increased in the optic capture group early after surgery (RR: 1.40; 95% CI: 1.05 to 1.86; P=0.02) and at the last follow-up (RR: 2.30; 95% CI: 1.08 to 4.92; P=0.03). The quality of the evidence was assessed as high. CONCLUSION The application of optic capture significantly reduces opacification of visual axis and occurrence of geometric decentration but do not significantly improve BCVA with notable safety. PMID:27162735

  19. 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

    Amaryllis Avakian; Edmea Rita Temporini; Newton Kara-José

    2005-01-01

    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...

  20. Training a cataract surgeon

    M Babar Qureshi

    2014-07-01

    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.

  1. EFFECT OF PROPHYLACTIC BROMFENAC 0.09% ON CYSTOID MACULAR EDEMA ASSESSED USING OPTICAL COHERENCE TOMOGRAPHY QUANTIFICATION OF TOTAL MACULAR VOLUME AFTER CATARACT SURGERY

    Ramesh Chandra; Sanjeeva Kumar; Kishore Kumar; Giddaiah; Govardhan

    2015-01-01

    PURPOSE : To evaluate the efficacy of prophylactic administration of the topical nonsteroidal anti - inflammatory drug (NSAID) Bromfenac 0.09% on acute (within 4 weeks of surgery) cystoids macular edema (CME) and total macular volume (TMV) in patients having phacoemulsification cataract surgery. SETTING : Department of Ophthalmology, shantiram general hospital, nandyal. METHODS : This open - l abel nonmasked randomized (random number as...

  2. Correlation between contrast sensitivity and higher-order aberration based on pupil diameter after cataract surgery

    Yamaguchi T

    2011-12-01

    Full Text Available Takefumi Yamaguchi1,2, Kazuno Negishi1, Kazuhiko Ohnuma3, Kazuo Tsubota11Department of Ophthalmology, Keio University School of Medicine, Tokyo; 2Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba; 3Department of Medical System Engineering, Faculty of Engineering, Chiba University, Chiba, JapanBackground: The purpose of this study was to evaluate the correlation between contrast sensitivity and calculated higher-order aberrations based on individual natural pupil diameter after cataract surgery.Methods: This prospective study included 120 eyes from 92 patients who were randomized to receive one of four lenses, including three aspheric lenses (Acrysof SN60WF, Tecnis ZA9000, and Hoya Py60AD and one spherical lens (Acrysof SN60AT. Contrast sensitivity, higher-order aberrations of the whole eye, and pupil diameter under photopic and mesopic conditions were measured 1 month postoperatively. Higher-order aberrations were decomposed into Zernike coefficients, calculated according to individual pupil diameter. The correlation between higher-order aberrations and contrast sensitivity was evaluated.Results: There were no significant differences in contrast sensitivity function between the four types of lenses under photopic conditions. However, the contrast sensitivity function and area under log contrast sensitivity function in the aspheric lenses were significantly better than in the spherical lens under mesopic conditions. Under mesopic conditions, spherical aberration in eyes with aspheric lenses was significantly lower than in eyes with spherical lenses (P < 0.05. Under photopic conditions, coma aberration had a significant negative correlation with contrast sensitivity at 12 cycles/degree. Under mesopic conditions, spherical aberration had a significant negative correlation with contrast sensitivity at 3, 6, and 12 cycles/degree with glare, and with contrast sensitivity at 6 and 18 cycles/degree without glare.Conclusion: In terms of influence on visual function, coma aberration may be more significant under photopic conditions and spherical aberration under mesopic conditions.Keywords: mesopic conditions, spherical aberration, wavefront, photopic and mesopic conditions

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

    H Zahedi

    2004-10-01

    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.

  4. Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania

    Mwende, J; Bronsard, A; Mosha, M; Bowman, R; Geneau, R; Courtright, P

    2005-01-01

    Background: Childhood cataract is a leading cause of blindness in children in eastern Africa. High quality surgical services have been established at a few tertiary facilities in the region; however, there appears to be delay in presentation to hospital.

  5. Clinical experience with the first 40 cases with femtosecond laser cataract surgery technology: safety of the learning curve

    Joao Crispim

    2015-10-01

    Full Text Available ABSTRACT Objective: To evaluate the introduction of the femtosecond laser (FSL to perform the key steps of the traditional cataract surgery process and the operational difficulties and safety of this new technology during routine use in an operating room in Brazil. Methods A retrospective study was conducted using the first cases operated on at a single center using the laser platform LenSx/Alcon with a soft contact lens patient interface.All patients underwent a detailed preoperative assessment.The anterior capsulotomy, nuclear fragmentation, and corneal incisions were created with the FSL; then, the surgery was completed following the standard phacoemulsification procedure. The main outcome measurements were difficulties and complications related to the learning curve and an analysis of postoperative uncorrected distance visual acuity (UDVA. Results: Of 31 patients (40 eyes, 9 patients had FSL cataract surgery in both eyes.The mean age was 64 ± 12 years (ranging from 42 to 82, the mean cataract nuclear sclerosis was grading 2 ± 0.6 (ranging from 1 to 4, and the preoperative mean UDVA in logMAR was 0.4 ± 0.2 (ranging from 0.1 to 1.3. Anterior capsulotomy was complete in all patients, and scissors were not needed to cut off any intact portion. The postoperative corneal incisions were not completely linear and showed some irregularities. Laser phaco-fragmentation was effective, with the division of the nucleus into smaller segments easily performed before phacoemulsification.After 1 month, the postoperative mean UDVA in logMAR was 0.1 ± 0.1 (ranging from 0.0 to 0.4 (P < 0.0001. Conclusion: With increasing surgical cases and experience, the phacoemulsification steps are performed precisely and effectively with FSL pretreatment, resulting in a safe learning curve.

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

    MR Safavi

    2007-11-01

    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.

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

    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)

  8. Pediatric cataract: challenges and future directions

    Medsinge A

    2015-01-01

    Full Text Available Anagha Medsinge,1,2 Ken K Nischal1,2 1Pediatric Ophthalmology, Strabismus, and Adult Motility, Childrens Hospital of Pittsburgh of University of Pittsburgh Medical Center, (UPMC 2Universityof Pittsburgh School of Medicine, Pittsburgh, PA, USA Abstract: Cataract is a significant cause of visual disability in the pediatric population worldwide and can significantly impact the neurobiological development of a child. Early diagnosis and prompt surgical intervention is critical to prevent irreversible amblyopia. Thorough ocular evaluation, including the onset, duration, and morphology of a cataract, is essential to determine the timing for surgical intervention. Detailed assessment of the general health of the child, preferably in conjunction with a pediatrician, is helpful to rule out any associated systemic condition. Although pediatric cataracts have a diverse etiology, with the majority being idiopathic, genetic counseling and molecular testing should be undertaken with the help of a genetic counselor and/or geneticist in cases of hereditary cataracts. Advancement in surgical techniques and methods of optical rehabilitation has substantially improved the functional and anatomic outcomes of pediatric cataract surgeries in recent years. However, the phenomenon of refractive growth and the process of emmetropization have continued to puzzle pediatric ophthalmologists and highlight the need for future prospective studies. Posterior capsule opacification and secondary glaucoma are still the major postoperative complications necessitating long-term surveillance in children undergoing cataract surgery early in life. Successful management of pediatric cataracts depends on individualized care and experienced teamwork. We reviewed the etiology, preoperative evaluation including biometry, choice of intraocular lens, surgical techniques, and recent developments in the field of childhood cataract. Keywords: children, pediatric cataract, infantile cataract, aphakia, pseudophakia

  9. Long-Term Observation of Triplex Surgery for Cataract after Phakic 6H Implantation for Super High Myopia

    Liu, Xin; Wang, Xiaoying; Lu, Yi; Zheng, Tianyu; Zhou, Xingtao

    2016-01-01

    Purpose. To analyze the safety, effectiveness, and stability of triplex surgery for phakic 6H anterior chamber phakic intraocular lens explantation and phacoemulsification with in-the-bag IOL implantation for super high myopia in long-term observations. Methods. This retrospective case series evaluated 16 eyes of 10 patients who underwent triplex surgery. Best corrected visual acuity (BCVA), endothelial cell density (ECD), and associated adverse events were evaluated. Results. The mean follow-up time after the triplex surgery was 46 ± 14 months. The mean logMAR BCVA was significantly improved after triplex surgery (P = 0.047). One eye developed endophthalmitis five days postoperatively and underwent pars plana vitrectomy (PPV). Five eyes with preoperative severe endothelial cell loss developed corneal decompensation and underwent keratoplasty at a mean time of 9.4 ± 2.6 months after the triplex surgery. One eye had graft failure and underwent a second keratoplasty. The eye developed rhegmatogenous retinal detachment and underwent PPV with silicone oil 18 months later. ECD before the triplex surgery was not significantly different compared with that at last follow-up (P = 0.495) apart from these five eyes. Three eyes (18.8%) developed posterior capsule opacification. Conclusions. Triplex surgery was safe and effective for phakic 6H related complicated cataracts. Early extraction before severe ECD loss is recommended.

  10. Comparison of effect of nepafenac and diclofenac ophthalmic solutions on cornea, tear film, and ocular surface after cataract surgery: the results of a randomized trial

    Kawahara, Atsushi; Utsunomiya, Tsugiaki; Kato, Yuji; Takayanagi, Yoshinori

    2016-01-01

    Background The aim of this study was to compare the effects of nepafenac ophthalmic suspension 0.1% (Nevanac) and diclofenac sodium ophthalmic solution 0.1% (Diclod) on the cornea, tear film, and ocular surface after cataract surgery. Methods A total of 60 eyes (60 patients) were selected for this study, with no ocular diseases other than cataract (scheduled for cataract surgery by one surgeon). Patients were randomly enrolled to receive nepafenac or diclofenac in the perioperative period, and cataract surgery was performed using torsional microcoaxial phacoemulsification and aspiration with intraocular lens implantation via a transconjunctival single-plane sclerocorneal incision at the 12 o’clock position. We compared intra- and intergroup differences preoperatively and postoperatively in conjunctival and corneal fluorescein staining scores, tear film breakup times, Schirmer’s tests, the Dry Eye Related Quality of Life Scores, and tear meniscus areas using anterior segment optical coherence tomography. Results The diclofenac group had significantly higher conjunctival and corneal fluorescein staining scores at 4 weeks postoperatively compared with the nepafenac group (P<0.001). Within the diclofenac group, significantly higher conjunctival and corneal fluorescein staining scores were noted at 4 weeks postoperatively than those seen preoperatively (P<0.001) and at 1 week postoperatively (P<0.001). No statistically significant differences were found in any other items. Conclusions Nepafenac ophthalmic suspension 0.1% is considered safe for the corneal epithelium after cataract surgery. PMID:27019091

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

    Mansoori Tarannum

    2005-12-01

    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.

  12. Comparison of effect of nepafenac and diclofenac ophthalmic solutions on cornea, tear film, and ocular surface after cataract surgery: the results of a randomized trial

    Kawahara A

    2016-03-01

    Full Text Available Atsushi Kawahara,1–3 Tsugiaki Utsunomiya,4 Yuji Kato,2 Yoshinori Takayanagi3 1Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, Hokkaido, Japan; 2Sapporo Kato Eye Clinic, Sapporo, Hokkaido, Japan; 3Takayanagi Clinic, Kushiro, Hokkaido, Japan; 4Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan Background: The aim of this study was to compare the effects of nepafenac ophthalmic suspension 0.1% (Nevanac and diclofenac sodium ophthalmic solution 0.1% (Diclod on the cornea, tear film, and ocular surface after cataract surgery. Methods: A total of 60 eyes (60 patients were selected for this study, with no ocular diseases other than cataract (scheduled for cataract surgery by one surgeon. Patients were randomly enrolled to receive nepafenac or diclofenac in the perioperative period, and cataract surgery was performed using torsional microcoaxial phacoemulsification and aspiration with intraocular lens implantation via a transconjunctival single-plane sclerocorneal incision at the 12 o’clock position. We compared intra- and intergroup differences preoperatively and postoperatively in conjunctival and corneal fluorescein staining scores, tear film breakup times, Schirmer’s tests, the Dry Eye Related Quality of Life Scores, and tear meniscus areas using anterior segment optical coherence tomography. Results: The diclofenac group had significantly higher conjunctival and corneal fluorescein staining scores at 4 weeks postoperatively compared with the nepafenac group (P<0.001. Within the diclofenac group, significantly higher conjunctival and corneal fluorescein staining scores were noted at 4 weeks postoperatively than those seen preoperatively (P<0.001 and at 1 week postoperatively (P<0.001. No statistically significant differences were found in any other items. Conclusions: Nepafenac ophthalmic suspension 0.1% is considered safe for the corneal epithelium after cataract surgery. Keywords: nepafenac, diclofenac, cornea, tear film, ocular surface, cataract surgery

  13. Comparison of the current and a new RTVue OCT software version for detection of ganglion cell complex changes due to cataract surgery.

    Holl, Gbor; Naghizadeh, Farzaneh; Hsu, Sofia; Filkorn, Tams; Bausz, Mria

    2015-12-01

    The purpose was to compare the current (6.3) and a novel software version (6.12) of the RTVue-100 optical coherence tomograph (RTVue OCT) for ganglion cell complex (GCC) and retinal nerve fibre layer thickness (RNFLT) changes after phacoemulsification in healthy cataract eyes, and to investigate whether version 6.12, in which image segmentation is improved, provides benefits over version 6.3 for RNFLT and GCC imaging via mild cataract. One eye of 22 consecutive healthy cataract patients were imaged before and 1month after uncomplicated cataract surgery using RTVue-100 OCT software version 6.3. The images were analysed with both software versions. Signal strength index increased significantly after surgery for both RNFLT and the GCC measurements (p?0.0015). No difference was seen for any RNFLT parameter between the software versions and time points (p?0.0140). The GCC values did not differ between the versions either before or after surgery (p?0.4471), but all increased significantly after surgery with software version 6.12 (pGCC thickness and the decrease of GLV better than the current version. Although no significant difference between software versions was seen before surgery, our results suggest that version 6.12 may be more precise in measuring GCC parameters than the currently available version. PMID:25813376

  14. The tear substitutive therapy for prophylaxis and treatment of dry eye after cataract surgery

    V. N. Trubilin

    2014-07-01

    Full Text Available Purpose: To study the efficiency of tear substitutes based on hyaluronic acid at the patients after phacoemulsification for prophylaxis and postoperative therapy of dry eye syndrome.Methods: 168 patients (168 eyes were examined before cataract surgery. The average age was 69.2±5.7 years old. Patients were divided into four groups according to the presence of eye dry syndrome and following tear substitutive therapy. 55 patients with a mild case of DES (the first group were treated with Vismed® eye drops 1 drop given 3 times a day for 1 week before surgery and postoperatively. 10 patients with a moderate case of DES (second group were treated with Vismed gel® to use with the same periodicity. Patients without DES were divided into two groups: 50 of them (third group were treated to use Vismed® 1 drop 3 times a day postoperatively, the rest 53 didn’t undergo the course of treatment — «checkout group». The observation period was 45 days after operation. The study of tear secretion and osmolarity of tear fluid was performed before and after operative period.Results: 65 patients were first diagnosed a mild or moderate case of DES. On the third day after operation every group showed the increase of tear osmolarity, it was especially noticable among the patients of «checkout group» from 294 to 314 mOsm / l at the average. On the seventh day after operation all groups showed further negative dynamics, and in the «checkout» group comparing to initial indices was registered noticable worsening of the studied parameters (р≤0.05. By the 14th day after phacoemulsification patients from the 1st and the 3rd groups displayed the tendency to restoration of indices to the preoperative values. Indices of osmolarity and tear secretion restored among the patients from the 1st and the 2nd groups by the 21st day and even improved in comparison to the preoperative values of group 3. Meanwhile, «checkout» group’s indices fell to a level even lower than before the operation. By the end of the experiment (45th day after operation decrease of osmolarity and increase of functional tests was registered among all the groups, however, the results were more evident among the groups who underwent tear substitutive treatment.Conclusion: Performed experiment confirmed that tear substitutive therapy conducted in the postoperatively speeds up recovery and restores indices of tear secretion and osmolarity.

  15. Anesthetic dilemma in planning bilateral cataract surgery for an infant associated with congenital cardiac anomaly

    Devalina Goswami

    2015-01-01

    Full Text Available In a patient with tetralogy of Fallot (TOF and pulmonary atresia, treating the cardiac problem or the associated congenital illness is always a challenge. We describe the challenges and successful initial management of bilateral cataract to prevent visual loss in an infant with TOF with pulmonary atresia.

  16. SURGICALLY INDUCED ASTIGMATISM AFTER IMPLANTATION OF FOLDABLE AND NON - FOLDABLE LENSES IN CATARACT SURGERY BY PHACOEMULSIFICATION

    Vikas; Lubna; Chitra; Nikhilesh; Rajesh; Pawar; Seema,

    2015-01-01

    This prospective comparative study included 300 matched patients of different grades of senile cataract. All of them willfully underwent phacoemulsification at the hands of a single experienced surgeon, performing with a single and individual technique {Woodcutter’s technique 1 }; half of them were implanted with a foldable intraocular lens and ...

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

    Rafael, Iribarren; Guillermo, Iribarren.

    2013-06-01

    Full Text Available La ciruga moderna de facoemulsificacin del cristalino tiene una recuperacin muy rpida. La eleccin correcta del lente intraocular que se coloca en la ciruga permite, muchas veces, anticipar si el paciente va a precisar anteojos luego de la ciruga. Este estudio analiza una muestra de pacientes [...] con catarata, mostrando la frecuencia relativa de cambios mipicos que permiten a los pacientes ver de cerca sin lentes antes de la ciruga. Se estudiaron retrospectivamente una serie de pacientes consecutivos que realizaron ciruga electiva de catarata. El cambio refractivo mipico fue documentado comparando las prescripciones antiguas con la medicin subjetiva al momento del estudio. Los sujetos fueron agrupados de acuerdo a la presencia o ausencia de cambios mipicos, 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 aos, 109 (47.6%) varones. Se hall un cambio mipico, definido como un cambio mayor de - 0.5 dioptras, en 85 (37.1%, IC95%: 30.8-43.4%). El porcentaje de sujetos con cambio mipico fue significativamente mayor en aquellos que tenan mayor opacidad nuclear al tiempo del examen. En este estudio de pacientes no seleccionados que buscaban realizar ciruga de catarata, ms de un tercio tuvo cambios mipicos en la refraccin. Si el paciente lograba ver bien de cerca antes de la ciruga, esto debera 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.

  18. Cataract (image)

    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 ...

  19. Effective dose 50 of desflurane for laryngeal mask airway removal in anaesthetized children in cataract surgeries with subtenon block

    Sameer Sethi

    2015-01-01

    Full Text Available Background: Quantification of the depth of desflurane anesthesia required for laryngeal mask airway (LMA removal in children has been done with the use of intravenous fentanyl or caudal anesthesia. This study aimed to determine the end-tidal concentration of desflurane required for LMA removal in children without the use of caudal or opioid analgesia in children undergoing elective cataract surgery. Materials and Methods: Our study enrolled 25 American Society of Anesthesiologists I and II children aged 2-10 years, undergoing elective cataract surgery. Anesthesia was induced with sevoflurane and oxygen/nitrous oxide using face mask and a size 2 LMA inserted. A subtenon block was administered in all children before surgical incision. Desflurane was used for maintenance of anesthesia. Predetermined end tidal concentration of desflurane was maintained for 10 min at the end of surgery before LMA removal was attempted. End tidal concentrations were increased/decreased using the Dixon up-down method (with 0.5% as a step size in the next patient depending on the previous patient′s response. Patient responses to LMA removal were classified as "movement" or "no movement." Results: 50% effective dose (ED 50 for successful removal of the LMA with desflurane in the presence of subtenon block was 3.6% (3.20-3.97% and that the 95% ED 95 was 4.648% (4.15-6.47%. Conclusion: Laryngeal mask airway removal can be successfully accomplished in 50% and 95% anesthetized children at 3.6% and 4.65% end-tidal desflurane concentration.

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

    2008-01-01

    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.

  1. Implicaciones sociales, tecnolgicas y ticas de los resultados insatisfactorios en la ciruga de catarata Social, technological and ethical implications of unsatisfactory outcomes in cataract surgery

    Fidel Sal Ricardo Surez

    2010-08-01

    Full Text Available A nivel mundial, la catarata constituye la principal causa de ceguera evitable. Su alta prevalencia como causa de ceguera est muy asociada a la pobreza. La ciruga es el nico tratamiento verdaderamente efectivo y constituye el proceder quirrgico ms practicado en pases desarrollados, pues presenta una adecuada relacin coste-beneficio. Contradictoriamente, los estudios de base poblacional efectuados en los ltimos aos han revelado que existen resultados insatisfactorios en el 40 % de las operaciones de catarata efectuadas en pases subdesarrollados. Se exponen en este trabajo algunos elementos histricos y tecnolgicos relacionados con este tipo de operacin. Se analizan las principales causas de los resultados insatisfactorios y los dilemas ticos asociados a los mismos. Se recomienda la necesidad de evaluar los impactos de las operaciones de catarata como tecnologas sanitarias con efectos positivos y negativos tras su aplicacin.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.

  2. Clinical effects of conjunctival sac flushing using different concentration of povidoneiodine on corneal epithelium before cataract surgeries

    Xue-Lian Gu

    2015-10-01

    Full Text Available AIM:To determine the most optimal concentration of the safe usage of povidone-iodine(PVP-Iin the flushing to disinfect the conjunctive sac before cataract surgeries, in order to provide a scientific basis for clinical eye surgery work.METHODS:Sixty-two patients with phacoemulsification and intraocular lens implantation in our hospital from October 2012 to October 2014 were randomly divided into 0.25g/L PVP-I group(Ⅰand 5g/L PVP-I group(Ⅱ. Sterilizing effect and the complications postoperative were analyzed.RESULTS:The sterilizing effects of the two groups after flushing conjunctiva sac using different concentrations of PVP-I were both remarkable, but the difference between the two groups was not statistically significant(P>0.05. No endophthalmitis occurred in the two groups. Observing the corneal condition after rinsing, no severe conjunctival hyperemia, corneal edema and other serious complications occurred. There was slightly punctate corneal epithelial shedding in groupⅡ, and the difference was statistically significant(PPCONCLUSION:Using 0.25g/L PVP-I in the conjunctiva sac rinsing before surgeries can inhibit the growth of bacteria in the conjunctival sac, reduce the impact on the corneal epithelium thereby reducing the incidence of postoperative complications and the positive rate of bacterial culture, increasing the comfort degree of patients, bringing a better area for the surgeries.

  3. Genetics Home Reference: Hyperferritinemia-cataract syndrome

    ... Recent literature 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 ...

  4. Genetics Home Reference: Hypomyelination and congenital cataract

    ... 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 ...

  5. Elimination of avoidable blindness due to cataract: Where do we prioritize and how should we monitor this decade?

    Gudlavalleti VS Murthy

    2012-01-01

    Full Text Available Background: In the final push toward the elimination of avoidable blindness, cataract occupies a position of eminence for the success of the Right to Sight initiative. Aims: Review existing situation and assess what monitoring indicators may be useful to chart progress towards attaining the goals of Vision 2020. Settings and Design: Review of published papers from low and middle income countries since 2000. Materials and Methods: Published population-based data on prevalence of cataract blindness/visual impairment were accessed and prevalence of cataract blindness/visual impairment computed, where not reported. Data on prevalence of cataract blindness, cataract surgical coverage at different visual acuity cut offs, surgical outcomes, and prevalence of cataract surgery were analyzed. Scatter plots were used to look at relationships of some variables, with Human Development Index (HDI rank. Available data on Cataract Surgical Rate (CSR was plotted against prevalence of cataract surgery reported from surveys. Results: Worse HDI Ranks were associated with higher prevalence of cataract blindness. Most studies showed that a significant proportion of the blind were covered by surgery, while a fifth showed that a significant proportion, were operated before they went blind. A good visual outcome after surgery was positively correlated with higher surgical coverage. CSR was positively correlated with cataract surgical coverage. Conclusions: Cataract surgical coverage is increasing in most countries at vision <3/60 and visual outcomes after cataract surgery are improving. Establishing population-based surveillance of cataract surgical need and performance is a strong monitoring tool and will help program planners immensely.

  6. 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.

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

    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

  7. SURGICALLY INDUCED ASTIGMATISM AFTER IMPLANTATION OF FOLDABLE AND NON - FOLDABLE LENSES IN CATARACT SURGERY BY PHACOEMULSIFICATION

    Vikas

    2015-01-01

    Full Text Available This prospective comparative study included 300 matched patients of different grades of senile cataract. All of them willfully underwent phacoemulsification at the hands of a single experienced surgeon, performing with a single and individual technique {Woodcutter’s technique 1 }; half of them were implanted with a foldable intraocular lens and the other half with a non - foldable PMMA intraocular lens. All the patients undergoing phacoemulsification had an improvement in vision. There was no statistically significant difference in the surgically induced astigmatism after implanting foldable or non - foldable IOL

  8. [Extraction of a clear lens-cataract as refractive surgery in severe myopia].

    Izk, M; Oslanec, J; Gfrikov, J; Nikel, J

    1996-04-01

    Fukals operation (extraction of a transparent lens in severe myopia) was of a long time considered risky in particular because of possible retinal complications. Based on ten years experience (1985 - 1994) the authors provide evidence that modern microsurgical methods, in particular phacoemulsification make it possible to perform this operation at a qualitatively higher level, much more safety and with a lower rate of complications. In a group of 284 operated eyes with myopia (15.96 diopters) were 4.57% transparent lenses, 37.68% with mild partial turbidity and 57.75% with dense or complete turbidity. Corrected vision 5/5 - 5/10 was achieved in 44.37%. Peroperative prolapse of the vitreous body occurred in 5.28%. The most frequent late complication was secondary cataract (26.76%). During the mean follow-up period of 37.57 months there was no case of cystoid oedema of the macula or detachment of the retina. Extraction of a transparent lens or incipient cataract in severe myopia is becoming an alternative method of other refractive operations. PMID:8689549

  9. Comparison of the short term therapeutic effects by different incision triple surgery in treating angle-closure glaucoma with cataract

    Yan-Xia Shi

    2013-12-01

    Full Text Available AIM:To compare the therapeutic effects of different incision phacoemulsification with foldable intraocular lens implantation combined with trabeculectomy in treating angle-closure glaucoma complicated with cataract. METHODS: The retrospective study analyzed 70 patients(98 eyeswho performed phacoemulsification with foldable intraocular lens implantation combined with trabeculectomy. Single incision surgery(one-site approachwas performed on 34 patients(50 eyes, and double incision surgery(two-site approacheswas done on 36 patients(48 eyes. The differences of intraocular pressure control,filtering bleb, the density and preservation of corneal endothelium cells both pre-surgery and 1 month post-surgery or later complication. in the two groups were compared and analyzed.Follow-up was 12-24 months with a mean of 18.2 months.RESULTS: The average postoperative intraocular pressure in one-site groups was(10.16±4.31mmHg. The average postoperative intraocular pressure in two-site groups was(11.38±3.55mmHg. There were no statistically significant differences between the two groups(P>0.05regarding the postoperative intraocular pressure and the formation of filtering blebs(P>0.05. The density and area of corneal endothelium cells in the two-incision group pre-operation were comparable(P>0.05. However, in 1 month post-operation, the rate of the corneal endothelial cells loss in double incision group was superior compared to the single incision group(PCONCLUSION: Both single incision and double incision approach phacotrabeculectomy are effective in reducing intraocular pressure and can maintain the function of filtering blebs well. There are no statistically significant differences in the intraocular pressure reduction between the two approaches. The double incision approach is superior in minimizing the corneal endothelial cells loss compared to the single incision approach.

  10. Should patients set the agenda for informed, consent? A prospective survey of desire for information and discussion prior to routine cataract surgery

    Lee Teak Tan

    2008-08-01

    Full Text Available Lee Teak Tan1,2, Huw Jenkins1,2, John Roberts-Harry2, Michael Austin11Singleton Hospital, Swansea, UK; 2West Wales General Hospital, Carmarthen, UKPurpose: To ascertain the level of information relating to specific risks desired by patients prior to cataract surgery.Setting: Dedicated cataract surgery pre-assessment clinics of 2 hospitals in South West Wales, UK.Methods: Consecutive patients (106 were recruited prospectively. Of these, 6 were formally excluded due to deafness or disorientation. Eligible patients (100 were asked a set of preliminary questions to determine their understanding of the nature of cataract, risk perception, and level of information felt necessary prior to giving consent. Those who desired further information were guided through a standardized questionnaire, which included an audio-visual presentation giving information relating to each potential surgical complication, allowing patients to rate them for relevance to their giving of informed consent.Results: Of the entire group of 100, 32 did not wish to know “anything at all” about risks and would prefer to leave decision making to their ophthalmologist; 22 were interested only in knowing their overall chance of visual improvement; and 46 welcomed a general discussion of possible complications, of whom 25 went on to enquire about specific complications. Of these 25, 18 wished to be informed of posterior capsular (PC tearing, 17 of endophthalmitis, 16 each of dropped lens, retinal detachment and corneal clouding, and 15 of bleeding, sympathetic ophthalmia, and PC opacification.Conclusion: Patients differ in their desire for information prior to cataract surgery, with one significant minority favoring little or no discussion of risk and another wishing detailed consideration of specific risks. A system of consent where patients have a choice as to the level of discussion undertaken may better suit patients’ wishes than a doctor-specified agenda.Keywords: cataract extraction, informed consent, patient-centered care

  11. First experience with the new high-frequency femtosecond laser system (LDV Z8 for cataract surgery

    Pajic B

    2014-12-01

    Full Text Available Bojan Pajic,1–3 Iraklis Vastardis,1,2 Zisis Gatzioufas,1 Brigitte Pajic-Eggspuehler1 1Swiss Eye Research Foundation, Eye Clinic ORASIS, Reinach, Switzerland; 2Eye Hospital VIDAR-ORASIS Swiss, Department of Physics, Faculty of Sciences, University of Novi Sad, Novi Sad, Serbia; 3Medical Faculty, Military Medical Academy, University of Defense, Belgrade, Serbia Background: The purpose of this work is to report our experience using the new Z8 laser system for femtosecond laser-assisted cataract surgery (FLACS and to provide a sample of the performance and safety results using this new technology. Methods: This prospective observational study was performed at the Swiss Eye Research Foundation, Eye Clinic ORASIS, Reinach, Switzerland. Fourteen patients were subjected to unilateral FLACS. Capsulotomy and lens fragmentation were performed with the aid of the LDV Z8 femtosecond laser system. Ease of phacoemulsification (on a 4-point scale, completeness of capsulotomy (on a 10-point scale, time for preparation of femtosecond laser (minutes, effective phacoemulsification time (seconds, total duration of surgery (minutes, and safety of the procedure were evaluated. Results: Ease of fragmentation and completeness of capsulotomy were estimated at 3.9 and 9.9, respectively. The preparation time for femtosecond was 3.6±0.7 minutes, effective phacoemulsification time was 2.5±3.1 seconds, and total duration of the FLACS procedure was 16.3±4.5 minutes. No major complications were observed. Approximately 42% of all patients (6/14 showed Descemet’s folds directly postoperatively. Conclusion: FLACS with the LDV Z8 system was characterized by complete capsulotomy and highly effective and reproducible lens fragmentation. The safety of the procedure was very good as perceived by the surgeon operating in this observational case series. The cost to benefit ratio should be further debated by assessing the results of a major prospective study, which is required for valid evaluation of the efficiency and safety of the LDV Z8 laser system and of FLACS in general. Keywords: femtosecond laser, cataract surgery, effective phacoemulsification time, complications

  12. Efficacy on chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation

    Xiao-Ning Peng

    2014-04-01

    Full Text Available AIM: To study the clinical effects of chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation.METHODS:A total of 75 cases(80 eyes, in which loop-pad and chop knife were performed to chop nucleus before implanting intraocular lens. Visual acuity, postoperative astigmatism degree, intraoperative and postoperative complications were observed. The post-operative follow-up periods ranged from 3 to 12mo.RESULTS: The visual acuity was 0.3-0.5 in 37 eyes and 0.6 or better in 21 eyes at 1d, while was respectively in 43 eyes and in 26 eyes at 1mo. Compared with preoperative astigmatism(0.85±0.29D, there were significant difference at postoperative 1wk(1.75±0.55D(PP>0.05. Intraoperative posterior capsule rupture occurred in 4 eyes, which implantation was successful in 1 eye and 3 eyes was managed viaciliary sulcus. Two eyes had dermatoglyphic pattern edema in corneal endothelium which recovered after about 3d. Two eyes had local patchy opacities which recovered in 2wk. Two eyes had transient high intraocular pressure.CONCLUSION: The surgery is efficient, low cost, easy process and less complications, it is worth to be popularized.

  13. Cataracts and Dupuytren disease: a case report and review of the literature.

    Cutolo, Carlo A; Lombardo, Sara; Verticchio Vercellin, Alice C; Bertone, Chiara; De Amici, Mara; Antoniazzi, Elena; Milano, Giovanni

    2012-11-01

    Purpose. Dupuytren disease is an inherited proliferative and progressive connective disease. Ectopic disease may, however, be located distant from the palmar fascia. ?Methods. Case report and review of the literature. ?Results. We describe a case of symmetric bilateral posterior subcapsular cataracts associated with symmetric bilateral Dupuytren disease and symmetric bilateral Ledderhose disease in a 56-year-old Caucasian man. His medical history was negative for glucocorticoids intake, diabetes, and exposure to radiation. Serum transforming growth factor ? (TGF-?)1 concentration has been evaluated and was found to be almost double compared to the controls. ?Conclusions. We speculate that the TGF-? plays an important role for ocular and connective tissue disorders. PMID:23138664

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

    Edison Ferreira e Silva

    2007-08-01

    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.

  15. Comparative evaluation of ropivacaine and lignocaine with ropivacaine, lignocaine and clonidine combination during peribulbar anaesthesia for phacoemulsification cataract surgery

    Balbir Khan

    2012-01-01

    Full Text Available Background: Peribulbar block is the most common type of local anaesthesia administered for cataract surgery, and continuous efforts are on to find a long-acting local anaesthetic (LA drug with the safest pharmacological profile. Objectives: A double-blind, prospective and randomized study was carried out in our institute to compare the anaesthetic effects of ropivacaine with the combination of ropivacaine and clonidine in administration of peribulbar block for phacoemulsification cataract surgery. Methods: A total of 200 patients of both sexes aged 50-80 years of American Society of Anaesthesiologists grade I and II, scheduled for phacoemulsification cataract surgery under monitored anaesthesia care, were enrolled for the study. Patients were assigned into two groups of 100 each; ropivacaine group (R and ropivacaine clonidine group (RC. Group R received 10 mL of LA solution containing 5 mL of 2% lignocaine, 5 mL of 0.75% ropivacaine and 100 units of hyaluronidase while group RC received 8 mL of a similar mixture with the addition of clonidine 1 ?g/kg and saline to make a total volume of 10 mL. Heart rate (HR, mean arterial pressure (MAP, pulse oximetry (SpO 2 , respiratory rate (RR, intraocular pressure (IOP, eye muscle movement scores and quality of peribulbar block were observed and recorded throughout the study period at regular intervals. At the end of the research project, the data was compiled systematically and was subjected to statistical analysis using the ANOVA test with post hoc significance for continuous variables and Chi-square test for qualitative data. Value of P<0.05 was considered significant and P<0.0001 as highly significant. Results: Demographic characteristics, SpO 2 and RR were comparable in both the groups. Mean HR and MAP were also comparable after a significant variation in the first 2-3 min (P<0.05. Onset and establishment of sensory and motor blocks were significantly earlier in the RC group (P<0.05. IOP decreased significantly during the first 6-7 min in the RC group after the administration of the peribulbar block. Duration of analgesia was prolonged in the RC group (6.52.1 h as compared with the R group (4.21.8 h. The side-effect profile revealed a higher incidence of nausea, vomiting, headache and dizziness in Group R, while a considerably higher incidence of dry mouth was observed in Group RC. Conclusions: Addition of clonidine to ropivacaine not only decreases the total volume of LA to be used but also augments early onset and prolonged offset of sensory analgesia as well as provides smooth operating conditions with a good sedation level as well by providing a wider safety margin of LA.

  16. SURGICALLY INDUCED ASTIGMATISM AFTER 2.8 MM TEMPORAL AND NASAL CLEAR CORNEAL INCISIONS IN PHACOEMULSIFICATION CATARACT SURGERY OF SAME PATIENT

    Preeti

    2015-04-01

    Full Text Available PURPOSE: To evaluate and compare the surgically induced astigmatism in phacoemulsification cataract surgery after 2.8 mm temporal and nasal clear corneal incision of same patient . MATERIAL AND METHOD : This prospective study comprised a consecutive case series of 60 eyes. Eyes from 30 patients with phacoemulsification those were implanted with a 6.00 mm foldable intraocular le ns through a 2.8 mm horizontal clear corneal incision (temporal in the right eye , nasal in the left eye. RESULTS : T he outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA , at 1 and 3 months post - operatively. A 1 month the mean SIA was 0.81 D. for the temporal incision and 0.92 D for nasal incision (P = 0.139 at 3 months the mean SIA was 0.53 D for temporal incision and 0.62 D for nasal incision (P =0.309. The pre - operative parameters i.e. (UCVA , mean keratomet ry & keratometric cylinder between these groups were comparable. There was no statistically significant difference found between three groups pre - operatively . CONCLUSION : After cataract surgery using 2.8mm temporal and nasal horizontal corneal incision , t he induced corneal astigmatic changes was similar in both incision groups. Especially in Asian eyes , both temporal and nasal incisions (2.8 mm or less would be equally favourable for astigmatism neutral cataract surgery

  17. Effectiveness and Optical Quality of Topical 3.0% Diquafosol versus 0.05% Cyclosporine A in Dry Eye Patients following Cataract Surgery.

    Lee, Jang Hoon; Song, In Seok; Kim, Kyoung Lae; Yoon, Sam Young

    2016-01-01

    Purpose. To evaluate the effectiveness and optical quality of 3.0% topical diquafosol versus 0.05% cyclosporine A in dry eye patients following cataract surgery. Methods. In total, 40 eyes of 40 patients newly diagnosed with dry eye syndrome 1 week after cataract surgery were randomized to receive either 3.0% diquafosol ophthalmic solution six times daily or 0.05% cyclosporine A twice daily for 3 months. Outcome measures were tear film break-up time (TBUT), results on Schirmer 1 test, ocular surface staining score, the ocular surface disease index (OSDI) score, and higher-order aberrations (HOAs). Measurements were taken at baseline and at 1, 2, and 3 months. Results. In the diquafosol group, TBUT showed higher outcomes than the cyclosporine A group at 1 and 3 months. Both groups showed increased scores on Schirmer 1 test. The ocular surface staining score decreased in all periods in both groups. Vertical coma and total HOAs decreased more in the cyclosporine A group than in the diquafosol group at 3 months. Conclusion. Both 3.0% diquafosol and 0.05% cyclosporine A were effective in treating dry eye after cataract surgery. Diquafosol was more effective in increasing the tear secretion, but cyclosporine A was more effective in improving optical aberrations. PMID:26989503

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

    Micheli Patrícia de Fátima Magri

    2012-10-01

    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..

  19. Colirio de diclofenaco sdico en ciruga de catarata por facoemulsificacin Diclofenac sodium eyedrops in cataract's surgery by phacoemulsification

    Yanele Ruiz Rodrguez

    2011-06-01

    Full Text Available OBJETIVOS: Determinar la efectividad clnica del diclofenaco sdico en colirio para mantener la midriasis pupilar durante la ciruga de catarata por facoemusificacin y disminuir la inflamacin en el posoperatorio, en el Instituto Cubano de Oftalmologa "Ramn Pando Ferrer" durante el ao 2010. MTODOS: Se estudiaron 40 ojos distribuidos al azar en dos grupos de 20 cada uno: a se les aplic en el preoperatorio y posoperatorio tratamiento tpico de rutina, y b se les adicion diclofenaco sdico en colirio durante el preoperatorio y la primera semana del posoperatorio. Se midieron los dimetros pupilares al inicio de la ciruga y al finalizar la aspiracin de restos corticales. Se evaluaron los pacientes en el posoperatorio a las 24 horas, a los seis das y al mes de la intervencin; se observ la presencia o no de hiperemia cilioconjuntival y celularidad en cmara anterior. RESULTADOS: Se observ que los pacientes en quienes se utiliz el diclofenaco sdico en colirio mantuvieron mayor grado de midriasis. A las 24 horas el nmero de pacientes del grupo 1 que presentaron hiperemia cilioconjuntival y celularidad en el humor acuoso fue superior a los del grupo 2, mientras que a los seis das y al mes estas variables se comportaron de forma similar en ambos grupos de estudio. CONCLUSIONES: Se ha comprobado que el diclofenaco sdico en colirio es efectivo en el mantenimiento de la midriasis transoperatoria y ofrece ventajas al disminuir la inflamacin en la ciruga de catarata.OBJECTIVES: To determine the clinical effectiveness of diclofenac sodium eyedrops to maintain the pupillary mydriasis during cataract surgery by phacoemulsification and to decrease the postoperative inflammation in patients seen in the "Ramn Pando Ferrer" Cuban Institute of Ophthalmology over 2010. METHODS: Forty eyes were studied randomly distributed in two groups of 20 eyes each: a in preoperative and postoperative periods a routine topical treatment was applied and b eyedrops diclofenac sodium was added during the preoperative period and for the first week of postoperative period. The pupillary diameters were measured at onset of surgery and the end the aspiration or cortical remainders. The patients in the postoperative period were assessed at 24 hours, at 6 days and at month after intervention; there was or not of hyperemia cilioconjunctival and cellularity in the aqueous humor was higher than that of the group 2, whereas at 6 days and at month, these variables behaved if a similar way in both study groups. RESULTS: It was observed that the patients in whom the sodium diclofenac was used maintained a higher degree of mydriasis. After 24 hours of the surgery the number of patients of group I that showed cilioconjuntival injection and cellularity in anterior chamber was higher that the number of group 2, whereas after six days and after a month of the surgery these variables behaved in a similar form in both training groups. CONCLUSIONS: It was proved that the eyedrops diclofenac sodium is effective in maintenance of transoperative mydriasis and also decreases the inflammation in cataract's surgery.

  20. Quality assessment of cataract surgery in Denmark - risk of retinal detachment and postoperative endophthalmitis

    Bjerrum, Søren Solborg

    study showed that over a 10-year study period, the risk of PRD was increased by a factor of 4.2 irrespective of sex and age. The risk of PRD was highest in the first part of the postoperative period and then gradually decreased but remained statistically significantly higher than the risk of RD in non....../clinics were registered in the NPR. In general, the coding of the PE cases was not uniform and the lack of registration by the private hospitals/clinics meant that the NPR could not be used to monitor the true risk of PE. NPR data were also used in the third study (paper III) to examine whether patients who...... occurred within the first 5 months. The risk of surgical complications in this study was similar to or higher than the risk of complications in the landmark Endophthalmitis Vitrectomy Study from the early 1990s. In the fourth study (paper IV), we used data from all three Danish cataract registries to...

  1. Subperiosteal hematoma from peribulbar block during cataract surgery leading to optic nerve compression in a patient with parahemophilia

    Khokhar S

    2015-12-01

    Full Text Available Sudarshan Khokhar,1 Bhagabat Nayak,1 Bharat Patil,1 Milind Devidas Changole,1 Gautam Sinha,1 Reetika Sharma,1 Lipika Nayak2 1Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Department of Pediatrics, Loknayak Hospital, Maulana Azad Medical College, Delhi, India Abstract: A 17-year-old male presented with gradual painless diminution of vision since childhood. Slit lamp examination revealed both eyes having congenital cataract. Right eye lens aspiration was performed but was uneventful, and he prepared for left eye surgery after 7 days. Immediately after giving a peribulbar block, a complete akinesia, tight eyelids, and stony hard eyeball was noted. An abaxial proptosis of 7 mm was noted. Lateral canthotomy and inferior cantholysis were done and proptosis reduced to 5 mm. Bleeding time–clotting time was normal. Proptosis worsened to 8 mm the next day. Contrast-enhanced computed tomography scan showed inferolateral subperiosteal hematoma, but drainage could not be performed due to prolonged prothrombin time and activated prothrombin time. Fresh frozen plasma was transfused. Tarsorrhaphy was performed for exposure keratopathy after his coagulation profile became normal. Hematology evaluation after 2 weeks detected factor V deficiency, and was diagnosed as Owren's disease or parahemophilia. Keywords: peribulbar block, hematoma, subperiosteal, parahemophilia, optic nerve compression

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

    Solborg Bjerrum, Søren; Kiilgaard, Jens Folke; La Cour, Morten

    2015-01-01

    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...

  3. Changes in peripapillary retinal nerve fiber layer thickness in chronic glaucoma and non-glaucoma patients after phacoemulsification cataract surgery

    Olivia P. Perdana

    2015-12-01

    Full Text Available Background: Phacoemulsification is a common cataract operation nowadays. During phacoemulsification, variation in intraocular pressure (IOP may occur, which might change the retinal nerve fiber layer (RNFL thickness. This study was aimed to evaluate the change in peripapillary RNFL thickness and mean deviation (MD of visual field after phacoemulsification in chronic primary glaucoma and non-glaucoma patients. Methods: Cohort prospective study was done on 26 patients (13 chronic glaucoma eyes and 13 non-glaucoma eyes who underwent phacoemulsification. The changes in peripapillary RNFL thickness and MD of visual field were measured as the primary outcome. Comparison between pre- and post-surgery was analyzed with paired t-test, while unpaired t-test was used for comparison between groups.Results: There were no significant changes in RNFL thickness on both groups. Average RNFL thickness in glaucoma group before and after phacoemulsification were 94.920.0 ?m and 99.121.3 ?m, respectively (p>0.05. Average RNFL thickness in non-glaucoma group were 100.211.1 ?m and 101.76.8 ?m, respectively (p>0.05. Glaucoma patients yielded decreasing mean deviation (MD of visual field, but it was not statistically significant (p=0.071. In contrast, the MD of visual field after surgery was significantly increased in non-glaucoma group (p=0.005.Conclusion: Phacoemulsification tended to increase peripapillary RNFL thickness in glaucoma or non-glaucoma patients. The visual field tended to decrease in glaucoma patients, but was significantly increased in non-glaucoma patients.

  4. An analysis of the visual results when using toric lenses in cataract surgery

    Astor Grumann Junior

    2015-02-01

    Full Text Available Purpose: To evaluate the postoperative results when using the toric IOL during phacoemulsification. Methods: Retrospective cohort based study on the 95 eyes of 67 patients, selected by a census. Analyzed patients with cataracts who had undergone phacoemulsification placement with AcrySof® toric IOL from january 2010 to december 2012. For analysis purposes, it was considered successful when the residual astigmatism was d”0.75 diopters. The Wilcoxon test for related samples was used to compare non-parametric samples, while the Student T test was used for samples with normal distribution. A p d”0.05 significance level was granted. Results: The average age of the population was 73.00 (±10.87, there was a higher incidence of females (56.8% and no difference in the side of the affected eye. The average preoperative spherical component was 0.86 (±2.89, since the average cylindrical component was -1.53 (±1.09, with a predominance of the shaft against the rule (51.6%. The logarithmic visual acuity (logMAR preoperative average was 0.32 (±0.25. The average postoperative spherical component was -0.02 (±0.53. Surgical success was obtained in 71 eyes (74.7% having a significant decrease (p <0.001 in the cylindrical component and postoperative logarithmic visual acuity, with the respective values of - 0.61 (±0.55 and 0.08 (±0.14, with the remaining axis against the rule (33.7%. Conclusions: The toric lenses were safe and reproducible with regards to postoperative results and therefore an important option for obtaining excellent final refractometric results.

  5. EFFECT OF PROPHYLACTIC BROMFENAC 0.09% ON CYSTOID MACULAR EDEMA ASSESSED USING OPTICAL COHERENCE TOMOGRAPHY QUANTIFICATION OF TOTAL MACULAR VOLUME AFTER CATARACT SURGERY

    Ramesh Chandra

    2015-01-01

    Full Text Available PURPOSE : To evaluate the efficacy of prophylactic administration of the topical nonsteroidal anti - inflammatory drug (NSAID Bromfenac 0.09% on acute (within 4 weeks of surgery cystoids macular edema (CME and total macular volume (TMV in patients having phacoemulsification cataract surgery. SETTING : Department of Ophthalmology, shantiram general hospital, nandyal. METHODS : This open - l abel nonmasked randomized (random number assignment study comprised 100 eyes. Exclusion criteria included hypersensitivity to the NSAID drug class, aspirin/NSAID - induced asthma, and pregnancy in the third trimester. Bromfenac 0.09%was administered startin g 1 day before surgery and for 28 days after surgery for a total of 30 days. The outcome measure was macular swelling, which was quantified by the optical coherence tomography. RESULTS : At 1 month, there was a statistically significant difference in TMV be tween the control group (0.4420 mm3 and the Bromfenac 0.09%group (0.2392 mm3, with the Bromfenac 0.09%group having 45.8% less macular swelling ( P Z. 009. Multiple linear regression with backward selection indicated a 44.3% ( P Z. 013 and 46.1% ( P Z. 030 r eduction in macular swelling in the Bromfenac 0.09% group at 1 week and 1 month, respectively. CONCLUSION : Used prophylactically after cataract surgery, Bromfenac 0.09% was efficacious in decreasing postoperative macular edema

  6. A comparable study of clinical and optical outcomes after 1.8, 2.0 mm microcoaxial and 3.0 mm coaxial cataract surgery

    Yi-Bo Yu

    2016-03-01

    Full Text Available AIM: To evaluate the clinical and optical outcomes after clear corneal incision cataract surgery (CICS with three different incision sizes (1.8, 2.0 and 3.0 mm. METHODS: Eyes of 150 patients with age-related cataract scheduled for coaxial cataract surgery were randomized to three groups: 1.8, 2.0, or 3.0 mm CICS. Intraoperative data and postoperative outcomes including surgically induced astigmatism (SIA, the corneal incision thickness, wavefront aberrations and modulation transfer function (MTF of cornea were obtained. RESULTS: There were no significant differences among the three groups in demographic characteristics and intraoperative outcome. The 1.8 and 2.0 mm microincisions showed more satisfactory clinical outcomes than the 3.0 mm incision. The 1.8 mm incision showed significantly less SIA than the 2.0 mm incision until postoperative 1mo (P0.05. CONCLUSION: Converting from 3.0 mm CICS to 1.8 or 2.0 mm CICS result in better clinical and optical outcomes. However, when incision is 1.8 mm, the benefits from further reduction in size compared with 2.0 mm are limited. The necessity to reduce the incision size is to be deliberated.

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

    Huan Yang; Xiao-Yuan Qi; Wei-Zhong Ge

    2014-01-01

    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 poverty)patients in poverty-stricken region with the patients in urban district(hereafter referred to as urban)in 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 d...

  8. Three cases of extracapsular cataract extraction for radiation cataract

    Extracapsular cataract extraction and intraocular lens implantation was performed on 4 eyes of 3 patients with radiation cataract. Case 1 was a 60-year-old man who was exposed to the ionizing radiation of the atomic bomb in Hiroshima 730 meters from the center of the explosion. He developed atomic bomb radiation senile cataracts in both eyes. Despite cataract surgery, a central plaque remained on the posterior capsule in the region corresponding to the central dense opacity in both eyes. Case 2 was an 81-year-old man who was in a streetcar 1,000 meters from the center of the explosion at the time of the atomic bombing. Senile and radiation-induced cataract decreased the visual acuity in both eyes. After extracapsular cataract extraction in his right eye, central opacification and a fibrous white membrane remained on the posterior capsule. These were removed by Nd-YAG laser capsulotomy six days after surgery. Case 3 was a 56-year-old man who developed radiation cataract after radiation therapy to a malignant lymphoma in the right orbit. Phacoemulsification and aspiration could not remove the fibrous white membrane from the posterior capsule in this case. Central opacities and fibrous white membranes on the posterior capsule after cataract surgery appears to be a characteristic of radiation cataract. (author)

  9. Results of cataract surgery and plasma ablation posterior capsulotomy in anterior persistent hyperplastic primary vitreous

    Rajesh Sinha

    2013-01-01

    Full Text Available Purpose: To report the feasibility and outcome of lens aspiration, and Fugo blade-assisted capsulotomy and anterior vitrectomy in eyes with anterior persistent hyperplastic primary vitreous (PHPV. Materials and Methods: In this case series, 10 eyes of 10 patients with anterior PHPV underwent lens aspiration. The vascularized posterior capsule was cut with a Fugo blade (plasma knife and removed with a vitrector. A foldable posterior chamber intraocular lens (IOL was implanted in eight eyes and the outcomes were evaluated. Results: The mean age of patients was 16.8 ± 6.37 months (range: 5 to 28 months. The surgery was completed successfully in all eyes. There were no cases of intraocular hemorrhage intraoperatively. Foldable acrylic IOL was implanted in the bag in 3 eyes and in the sulcus in 5 eyes. Two eyes were microphthalmic and did no undergo IOL implantation (aphakic. None of the eyes had a significant reaction or elevated intraocular pressure postoperatively. The follow-up ranged from 4 to 21 months. All the pseudophakic eyes achieved a best corrected visual acuity of ≥20/200 with 50% (4/8 of these eyes with ≥20/60 vision. Conclusion: Lens aspiration followed by posterior capsulotomy with Fugo blade-assisted plasma ablation is a feasible technique for performing successful lens surgery in cases with florid anterior PHPV.

  10. Effect of simulated dynamic intraocular pressure on retinal thickness measured by optical coherence tomography after cataract surgery

    Ding Chen

    2012-12-01

    Full Text Available AIM: To investigate the effect of simulated dynamic intraocular pressure (SDIOP during uncomplicated phacoemulsification on postoperative macular and peripapillary retinal nerve fiber layer (RNFL thickness.METHODS: Macular and RNFL thicknesses in one eye of patients (n=30 undergoing uncomplicated phacoemulsification were measured by optical coherence tomography preoperatively and 1 week postoperatively. The best-corrected visual acuity, SDIOP, irrigation time (IT, effective phacoemulsification time, entire surgical duration, blood pressure, and heart rate were recorded.RESULTS: The mean SDIOP and IT was (74.9 27.4cmH2O and (178.4 21.6 seconds respectively. We divided our patients into two groups based upon IT with greater than 90cmH2O (P>90IT. In Group A (n=14, the P>90IT was greater than the mean P>90IT, and in Group B (n=16, the P>90IT was less than the mean P>90IT. For all patients there was a significant increase in macular thickness one week after cataract surgery (P=0.001. While the RNFL thickness tended to increase, the change was not significant. The postoperative macular thickness of Group A, (277.8 13.7?m, was significantly thicker than that of Group B, (267.9 15.0?m (P=0.004. The postoperative peripapillary RNFL thickness of Group A, (96.8 10.8 ?m, was not significantly different from Group B. For Group A, the change in macular thickness was positively correlated with P>90IT (R2=0.524, P=0.02. There was no statistical difference in postoperative visual acuity between Groups A and B. CONCLUSION: After uncomplicated phacoemulsification, increased macular thickness is associated with the IT under high SDIOP. The effect of high SDIOP is limited to the sub-clinical level.

  11. Late postoperative choroidal detachment following an uneventful cataract surgery in a patient on topical latanoprost.

    Krishnamurthy, Rashmi; Senthil, Sirisha; Garudadri, Chandrasekhar S

    2015-01-01

    Topical latanoprost is a most effective and commonly used antiglaucoma medication. Use of prostaglandin analogues (PGA) in the early postoperative period is controversial due to its proinflammatory properties. We report a case of a 64-year-old man with primary open angle glaucoma, post-trabeculectomy 17 years prior, with good intraocular pressure (IOP) control on topical levobunolol 0.5% and latanoprost 0.005%. He underwent a clear corneal phacoemulsification surgery in his left eye and the PGA was stopped. He had an uneventful postoperative course and was prescribed eyeglasses at 4-week follow-up. Two weeks later, he presented to the emergency department with decreased vision in the left eye, flat anterior chamber, IOP of 00 mm Hg and 360 choroidal detachment. The continued use of topical latanoprost in the operated eye was implicated as the cause. This case illustrates the serious vision-threatening side effect of PGA when used in the early postoperative period. PMID:26174734

  12. Cataract - adult

    ... or the difference between shades of colors Seeing halos around lights Frequent changes in eyeglass prescriptions Cataracts ... Wevill M. Epidemiology, pathophysiology, causes, morphology, and visual effects of cataract. In: Yanoff M, Duker JS, eds. ...

  13. Patient-reported benefit of ReSTOR® multi-focal intraocular lenses after cataract surgery: Results of Principal Component Analysis on clinical trial data

    Viala Muriel

    2008-01-01

    Full Text Available Abstract Background Restoration of functional distance and near vision independently of additional correction remains a goal for cataract surgery. ReSTOR®, a new multi-focal intraocular lens (IOL addresses this issue with an improvement in both distance and near vision, often without need for glasses. This analysis attempted to discuss the patient-reported benefit of ReSTOR® using a full but organised representation of data. Methods Two non-randomised, open-label clinical trials conducted in Europe and the United-States were conducted to compare the efficacy of ReSTOR® to AcrySof® mono-focal IOLs. A total of 710 patients in need of bilateral cataract extraction were included in the pooled study. The TyPE, a patient questionnaire, was fully completed by 672 of them before and after each eye surgery. The TyPE, composed of 67 items measuring overall visual functioning in both conditions (with and without wearing glasses, evaluates limitations, troubles and satisfaction in distance and near vision. A principal component analysis (PCA of the TyPE questionnaire was performed on pooled data from baseline and post-surgery observations in order to fully represent the change in the TyPE data over time. ReSTOR® and mono-focal groups were used as illustrative variables. The coordinates of the first 2 factors were compared between visits and between IOLs (ReSTOR® vs. mono-focal, using paired t-tests and t-tests, respectively. Results The first factor of the PCA explained 55% of the variance and represented 'visual functioning and patient satisfaction'. The second factor explained 6% of the variance and was interpreted as 'independence from glasses'. An overall difference in factorial coordinates in both factors was seen between baseline and the first eye surgery, and between the first and the second eye surgery. No difference between ReSTOR® and mono-focal IOL groups was observed at baseline. After surgery, ReSTOR® treated-patients had higher coordinates on both "visual functioning and satisfaction" and "independence from glasses" factors. Findings observed on the factorial plan were supported by statistical comparisons of factorial coordinates. Conclusion Both mono-focal and ReSTOR®-implanted patients improved their visual functioning after bilateral cataract surgery. Moreover, ReSTOR® patients reported an additional benefit in independence from glasses as well as in visual functioning and patient satisfaction.

  14. Reversible Cataract as the Presenting Sign of Diabetes Mellitus: Report of Two Cases and Literature Review

    Xiu Min Wang

    2012-03-01

    Full Text Available Background: Type 1 diabetes mellitus (T1DM is the most common form of diabetes in young children. Serious optic complications, e.g. diabetic retinopathy and diabetic cataract involvement, are not usually detected in T1DM patients at the onset of the disease.Case Presentation: Two girls aged 11 years and 9 years were hospitalized in our unit in 2008 and 2009. They presented cataracts 1 and 6 months before the diagnosis of T1DM, respectively. After blood glucose level was controlled by insulin therapy, the cataract was resolved, totally in one and partly in the other girl. Meanwhile, visual acuity of both cases recovered, closely associated with fluctuation of plasma glucose level. In this study, we describe the symptoms, probable mechanism and treatment of diabetic cataract.Conclusion: Early antihyperglycemic therapy and maintenance of stable blood glucose level may reverse acute diabetic cataract or prevent it from getting worse.

  15. Reversible Cataract as the Presenting Sign of Diabetes Mellitus: Report of Two Cases and Literature Review

    Jin, Yan Yan; Huang, Ke; Zou, Chao Chun; Liang, Li; Wang, Xiu Min; Jin, Ji

    2012-01-01

    Background Type 1 diabetes mellitus (T1DM) is the most common form of diabetes in young children. Serious optic complications, e.g. diabetic retinopathy and diabetic cataract involvement, are not usually detected in T1DM patients at the onset of the disease. Case Presentation Two girls aged 11 years and 9 years were hospitalized in our unit in 2008 and 2009. They presented cataracts 1 and 6 months before the diagnosis of T1DM, respectively. After blood glucose level was controlled by insulin therapy, the cataract was resolved, totally in one and partly in the other girl. Meanwhile, visual acuity of both cases recovered, closely associated with fluctuation of plasma glucose level. In this study, we describe the symptoms, probable mechanism and treatment of diabetic cataract. Conclusion Early antihyperglycemic therapy and maintenance of stable blood glucose level may reverse acute diabetic cataract or prevent it from getting worse. PMID:23056872

  16. Adolescent bariatric surgery: review on nutrition considerations.

    Nogueira, Isadora; Hrovat, Kathleen

    2014-12-01

    The prevalence of obesity in adolescents has dramatically increased over the past 3 decades in the United States. Weight loss surgery is becoming a viable treatment option for obese adolescents. The number of surgeries being performed yearly is rising, and this trend is likely to continue. Adolescent patients present a unique challenge to clinicians. There are currently best-practice recommendations and evidence-based nutrition guidelines for the treatment of the adolescent bariatric patient. A review of the current literature was performed to discuss bariatric surgery and nutrition for the adolescent patient. Studies show that most adolescents with obesity will become obese adults, thus increasing their risk of developing serious and debilitating health conditions. It is recommended that the candidates for surgery be referred to a practice that has a multidisciplinary team experienced in meeting the distinct physical and psychological needs of adolescents. Specific nutrition concerns for the adolescent bariatric patient include preoperative educational pathway, postoperative dietary progression, female reproduction, compliance with vitamin/supplementation recommendations, laboratory tests, and long-term monitoring. The medical literature has reported positive outcomes of bariatric surgery in adolescents with severe obesity. Before surgery is offered as an option, unique factors to adolescents must be addressed. The multidisciplinary clinical team must consider the adolescents' cognitive, social, and emotional development when considering their candidacy for surgery. As the number of adolescent bariatric surgery programs increases, continued research and long-term outcome data need to be collected and shared to base future treatment decisions. PMID:25332015

  17. Country-Wide Monitoring of Cataract Surgical Outcomes

    Moses C Chirambo

    2002-01-01

    Full Text Available The Lions SightFirst Eye Hospital (LSFEH in Lilongwe, Malawi, participated in the initial study to develop monitoring systems for cataract outcome. The pilot study took place between 1 June and 31 December, 2000. All surgery was done at the Lions SightFirst Hospital, Lilongwe. The number of cataract operations recorded in the study was 454.However, the proportion of patients seen for review was 89%, mainly because of active follow-up of those patients who did not come for review on their own.

  18. Effect of melatonin and gabapentin on anxiety and pain associated with retrobulbar eye block for cataract surgery: A randomized double-blind study

    Marzieh-Beigom Khezri

    2013-01-01

    Full Text Available Objectives: To compare the effect of melatonin and gabapentin on anxiety, pain, sedation scores, and satisfaction of surgeon in patients of cataract surgery. Materials and Methods: One hundred thirty patients aged between 35 and 85 years scheduled for cataract surgery were randomly allocated to three study groups to receive melatonin (6 mg, gabapentin (600 mg or placebo 90 min before arrival in the operating room. Pain, anxiety, and sedation scores during block and surgery as well as the surgeon?s satisfaction with the surgery were assessed. Results: Anxiety scores decreased significantly in melatonin and gabapentin groups compared to the placebo group after premedication and extended to early postoperative period. The level of anxiety showed no statistically significant difference between melatonin and gabapentin groups at any time of measurement. There were significant differences between the pain scores during retrobulbar placement in gabapentin versus placebo (95% CI 3 to 4; P = 0.001 and melatonin (95% CI 3 to 4; P = 0.040 groups. Also, there were significant differences between the sedation scores during retrobulbar placement in gabapentin and placebo groups (95% CI 2 to 2.5; P = 0.046. The difference in sedation scores during retrobulbar placement in melatonin versus gabapentin and placebo groups was not significant. Neither the intraoperative pain scores nor the postoperative pain scores were different between the three groups. The surgeon reported similar quality of operation conditions during surgery for the three study groups. Conclusion: The level of anxiety was significantly lower with both anxiolytic drugs compared to placebo. Furthermore, gabapentin decreased the pain and improved the sedation scores only during retrobulbar placement compared to the placebo.

  19. Bariatric surgery and pregnancy: literature review

    Pedro Ferrand Miranda

    2014-01-01

    Full Text Available Obesity has currently reached epidemic proportions, both in Chile and in the world. This condition is associated to a variety of maternal complications in all stages of the vital cycle and during pregnancy. Medical treatment has not proved successful thus resulting in an increase in bariatric surgery in recent years, even when it is not first line treatment. This literature review aims to report updated results of surgical treatment for obesity before and during pregnancy with respect to fertility, gestational diabetes, pre-eclampsia and pregnancy-induced hypertension. It also looks into the possible effects of surgery on fetal development, and its relation to premature delivery, fetal macrosomy, low birth weight and neural tube defects, as well as effects on maternal and fetal outcomes, mainly in nutrition. Lastly, we suggest some recommendations that arise from this review on the role of contraception, nutrition and time between surgery and pregnancy.

  20. Flora bacteriana conjuntival aps uso tpico de ciprofloxacino e gatifloxacino em cirurgia de catarata Conjunctival bacterial flora after topical use of ciprofloxacin and gatifloxacin in cataract surgery

    Tiago Eugnio Faria e Arantes

    2008-04-01

    Full Text Available OBJETIVO: Avaliar alteraes da flora conjuntival aps uso dos colrios de ciprofloxacino e gatifloxacino 0,3% na profilaxia dos pacientes submetidos facectomia. MTODOS: Quarenta pacientes submetidos a facectomia foram alocados em dois grupos, conforme o colrio antibitico utilizado: Grupo A: ciprofloxacino 0,3% e Grupo B: gatifloxacino 0,3%. Os pacientes usaram os colrios 1 hora antes da cirurgia e nos primeiros 14 dias ps-operatrios. Foi coletado material da conjuntiva em cinco momentos: 1 hora antes da cirurgia, sem medicaes tpicas (t0; imediatamente antes da aplicao de iodopovidona (PVPI (t1, antes do incio da cirurgia, aps iodopovidona (t2, 14 dias aps a cirurgia (t3 e 28 dias aps a cirurgia (t4. RESULTADOS: O uso de antibiticos no pr-operatrio diminuiu a positividade das culturas anteriores ao uso do iodopovidona em ambos os grupos; no Grupo A esta reduo no alcanou significncia estatstica (Grupo A - p=0,07 e Grupo B - p=0,04. A positividade das culturas foi reduzida nos dois grupos aps aplicao de iodopovidona e 14 dias aps a cirurgia (pPURPOSE: To evaluate alterations of the conjunctival flora after the use of 0.3% ciprofloxacin and gatifloxacin in the prophylaxis of patients undergoing cataract surgery. METHODS: 40 patients undergoing cataract surgery were distributed into two groups according to the use of antibiotic eye drops: Group A: 0.3% ciprofloxacin and Group B: 0.3% gatifloxacin. Both groups used antibiotic eye drops 1 hour before surgery and 14 days after surgery. Conjunctival material was collected at 5 time points: 1 hour before surgery, without any topical medication (t0; immediately before the application of povidone-iodine (PVPI (t1, before the beginning of surgery, after povidone-iodine (t2, 14 days (t3 and 28 days after surgery (t4. RESULTS: Preoperative antibiotics reduced the positivity of the cultures before the use of PVPI in both groups, although in Group A this reduction was not significant (Group A - p=0.07 and Group B - p=0.04. The number of positive cultures was reduced in all groups after the use of povidone-iodine and on the 14th postoperative day (p<0.05. In t4 there was a reduction in the frequency of coagulase-negative Staphylococcus in Group A compared with Group B (p<0.05; the susceptibility to ciprofloxacin was also reduced in all groups, when compared with t0. CONCLUSIONS: Gatifloxacin eye drops applied one hour before surgery significantly reduced the number of positive conjunctival cultures. Both antibiotics reduced the conjunctival flora when administered in the postoperative period.

  1. Small bowel emergency surgery: literature's review

    Di Saverio Salomone

    2011-01-01

    Full Text Available Abstract Emergency surgery of the small bowel represents a challenge for the surgeon, in the third millennium as well. There is a wide number of pathologies which involve the small bowel. The present review, by analyzing the recent and past literature, resumes the more commons. The aim of the present review is to provide the main indications to face the principal pathologies an emergency surgeon has to face with during his daily activity.

  2. Determinants of visual outcomes in femtosecond laser assisted cataract surgery and phacoemulsification: A nested case control study

    Rajiv Khandekar

    2015-01-01

    Conclusion: Visual outcomes at 6-8 weeks following CE were not different from FLACS. Visual outcomes following FLACS and CE were not influenced by the operating surgeon or severity of the cataract. The time required for FLACS was greater than that required for CE.

  3. Cataract surgery - series (image)

    ... the edge of the outer lining of the eye (cornea). The lens is then removed and replaced with an artificial ... a needle through a small incision on the eye. The end of the ... break up the lens, which is then sucked out through the needle. ...

  4. The efficacy of bromfenac ophthalmic solution 0.07% dosed once daily in achieving zero-to-trace anterior chamber cell severity following cataract surgery

    Silverstein SM

    2014-05-01

    Full Text Available Steven M Silverstein,1 Mitchell A Jackson,2 Damien F Goldberg,3 Mauricio Muñoz4On behalf of the Bromfenac Ophthalmic Solution 0.07% Once Daily Study Group1Silverstein Eye Centers, Kansas City, MO, USA; 2Jacksoneye, Inc., Lake Villa, IL, USA; 3Wolstan & Goldberg Eye Associates, Torrance, CA, USA; 4Bausch + Lomb, Irvine, CA, USAPurpose: To evaluate the efficacy of bromfenac ophthalmic solution 0.07% dosed once daily in achieving zero-to-trace (0–5 cells anterior chamber cells, following cataract surgery with posterior chamber intraocular lens implantation.Methods: The study designed employed two Phase III, double-masked, placebo-controlled, multicenter clinical trials of 440 subjects, randomized to either bromfenac ophthalmic solution 0.07% (n=222 or placebo (n=218. Subjects self-dosed once daily, beginning 1 day before undergoing cataract surgery with intraocular lens implantation (day −1 and again on the day of surgery (day 0 and for 14 days postoperatively. Follow-up was on days 1, 3, 8, and 15. The outcome measures included the percentage of subjects with zero-to-trace anterior chamber cells at each visit, as determined by the percentage of subjects with ≤5 anterior chamber cells, overall anterior chamber cell grades, and summed ocular inflammation score (SOIS (combined anterior chamber cell and flare scores.Results: The proportion of subjects with zero-to-trace anterior chamber cells was significantly higher in the bromfenac 0.07% group compared with the placebo group as early as day 3 (P=0.0007, continued at day 8 (P<0.0001, and through day 15 (P<0.0001. At day 15, 80.2% of subjects in the bromfenac 0.07% group achieved zero-to-trace anterior chamber cells compared with 47.2% of subjects who did so in the placebo group. The overall anterior chamber cell scores were significantly lower in the bromfenac 0.07% group compared with the placebo group at days 3, 8, and 15 (P<0.0001 at each visit. The SOIS were also significantly lower in the bromfenac group compared with the placebo group at days 3, 8, and 15 (P<0.0001 at each visit.Conclusion: Bromfenac ophthalmic solution 0.07%, dosed once daily was clinically effective in achieving zero-to-trace anterior chamber cell severity after cataract surgery and was superior to placebo in all anterior chamber cell severity and inflammation outcome measures.Keywords: ocular inflammation, anterior chamber inflammation, non-steroidal anti-inflammatory, cells and flare

  5. Cataract surgery: emotional reactions of patients with monocular versus binocular vision Cirurgia de catarata: aspectos emocionais de pacientes com visão monocular versus binocular

    Roberta Ferrari Marback

    2012-12-01

    Full Text Available PURPOSE: To analyze emotional reactions related to cataract surgery in two groups of patients (monocular vision - Group 1; binocular vision - Group 2. METHODS: A transversal comparative study was performed using a structured questionnaire from a previous exploratory study before cataract surgery. RESULTS: 206 patients were enrolled in the study, 96 individuals in Group 1 (69.3 ± 10.4 years and 110 in Group 2 (68.2 ± 10.2 years. Most patients in group 1 (40.6% and 22.7% of group 2, reported fear of surgery (pOBJETIVO: Verificar reações emocionais relacionadas à cirurgia de catarata entre pacientes com visão monocular (Grupo 1 e binocular (Grupo 2. MÉTODOS: Foi realizado um estudo tranversal, comparativo por meio de um questionário estruturado respondido por pacientes antes da cirurgia de catarata. RESULTADOS: A amostra foi composta de 96 pacientes no Grupo 1 (69.3 ± 10.4 anos e 110 no Grupo 2 (68.2 ± 10.2 anos. Consideravam apresentar medo da cirugia 40.6% do Grupo 1 e 22.7% do Grupo 2 (p<0.001 e entre as principais causas do medo, a possibilidade de perda da visão, complicações cirúrgicas e a morte durante o procedimento foram apontadas. Os sentimentos mais comuns entre os dois grupos foram dúvidas a cerca dos resultados da cirurgia e o nervosismo diante do procedimento. CONCLUSÃO: Pacientes com visão monocular apresentaram mais medo e dúvidas relacionadas à cirurgia de catarata comparados com aqueles com visão binocular. Portanto, é necessário que os médicos considerem estas reações emocionais e invistam mais tempo para esclarecer os riscos e benefícios da cirurgia de catarata.

  6. A Comparison of the American Society of Cataract and Refractive Surgery post-myopic LASIK/PRK Intraocular Lens (IOL calculator and the Ocular MD IOL calculator

    Hsu M

    2011-09-01

    Full Text Available David L DeMill1, Majid Moshirfar1, Marcus C Neuffer1, Maylon Hsu1, Shameema Sikder21John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USABackground: To compare the average values of the American Society of Cataract and Refractive Surgery (ASCRS and Ocular MD intraocular lens (IOL calculators to assess their accuracy in predicting IOL power in patients with prior laser-in-situ keratomileusis (LASIK or photorefractive keratectomy.Methods: In this retrospective study, data from 21 eyes with previous LASIK or photorefractive keratectomy for myopia and subsequent cataract surgery was used in an IOL calculator comparison. The predicted IOL powers of the Ocular MD SRK/T, Ocular MD Haigis, and ASCRS averages were compared. The Ocular MD average (composed of an average of Ocular MD SRK/T and Ocular MD Haigis and the all calculator average (composed of an average of Ocular MD SRK/T, Ocular MD Haigis, and ASCRS were also compared. Primary outcome measures were mean arithmetic and absolute IOL prediction error, variance in mean arithmetic IOL prediction error, and the percentage of eyes within ±0.50 and ±1.00 D.Results: The Ocular MD SRK/T and Ocular MD Haigis averages produced mean arithmetic IOL prediction errors of 0.57 and –0.61 diopters (D, respectively, which were significantly larger than errors from the ASCRS, Ocular MD, and all calculator averages (0.11, –0.02, and 0.02 D, respectively, all P < 0.05. There was no statistically significant difference between the methods in absolute IOL prediction error, variance, or the percentage of eyes with outcomes within ±0.50 and ±1.00 D.Conclusion: The ASCRS average was more accurate in predicting IOL power than the Ocular MD SRK/T and Ocular MD Haigis averages alone. Our methods using combinations of these averages which, when compared with the individual averages, showed a trend of decreased mean arithmetic IOL prediction error, mean absolute upper limit of IOL prediction error, and variance, while increasing the percentage of outcomes within ±0.50 D.Keywords: laser-in-situ keratomileusis, photorefractive keratectomy, intraocular lens calculator, ocular MD, American Society of Cataract and Refractive Surgery

  7. Radiation cataract

    This report reviews the relationship of ionizing radiation to the occurrence of cataracts (posterior lenticular opacities) among the A-bomb survivors in Hiroshima and Nagasaki. The new DS86 doses are available for 1,983 (93.4%) of the 2,124 A-bomb survivors analyzed in 1982. The DS86 kerma neutron component for Hiroshima is much smaller than its comparable T65DR component, but still 4.2 fold higher (0.38 Gy at 6 Gy) than that in Nagasaki (0.09 Gy at 6 Gy). Thus, if the eye is especially sensitive to neutrons, there may yet be some useful information on their effects, particularly in Hiroshima. Under the best fitting dose-response model, an L (gamma)-L (neutron) with two thresholds, both the gamma and neutron regression coefficients of the occurrence of cataracts on dose are positive and highly significant for the DS86 eye organ doses. The DS86 gamma coefficient is almost the same as that associated with the T65DR gamma dose, the ratio of the two coefficients being 1.1 (95% confidence limits: 0.5-2.3) for DS86 kerma in the individual dose data, and if the risks based on the DS86 eye organ dose and DS86 kerma are compared, the ratio is 1.3 (0.6-2.8). However, the risk estimates associated with neutron exposure are 6.4 (2.2-19.2) fold higher for the DS86 kerma than the T65DR kerma and 1.6 (0.5-2.3) fold higher for the DS86 eye organ dose than for the DS86 kerma. (author)

  8. Prevalence of second-eye cataract surgery and time interval after first-eye surgery in Iran: A clinic-based study

    Marzieh Katibeh

    2013-01-01

    Conclusion: The number of cataract operations in this tertiary eye care setting increased 1.5 fold over the study period. The proportion of second-eye operations also rose from 1/4 to 1/3 during the same time.

  9. Subperiosteal hematoma from peribulbar block during cataract surgery leading to optic nerve compression in a patient with parahemophilia

    Khokhar S; Nayak B; Patil B; Changole MD; Sinha G; Sharma R.; Nayak L

    2015-01-01

    Sudarshan Khokhar,1 Bhagabat Nayak,1 Bharat Patil,1 Milind Devidas Changole,1 Gautam Sinha,1 Reetika Sharma,1 Lipika Nayak2 1Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Department of Pediatrics, Loknayak Hospital, Maulana Azad Medical College, Delhi, India Abstract: A 17-year-old male presented with gradual painless diminution of vision since childhood. Slit lamp examination revealed both eyes having congenital cataract. Right eye lens as...

  10. Minimal invasive gastric surgery: A systematic review

    Kirti Bushan

    2015-01-01

    Full Text Available Background: As an alternate to open surgery, laparoscopic gastrectomy (LG is currently being performed in many centers, and has gained a wide clinical acceptance. The aim of this review article is to compare oncologic adequacy and safety of LG with open surgery for gastric adenocarcinomas with respect to lymphadenectomy, short-term outcomes (postoperative morbidity and mortality and long-term outcome (5 years overall survival and disease-free survival. Materials and Methods: PubMed was searched using query “LG” for literature published in English from January 2000 to April 2014. A total of 875 entries were retrieved. These articles were screened and 59 manuscripts ultimately formed the basis of current review. Results: There is high-quality evidence to support short-term efficacy, safety and feasibility of LG for gastric adenocarcinomas, although accounts on long-term survivals are still infrequent.

  11. Pacientes com astigmatismo submetidos cirurgia de catarata: LIO trica x LIO asfrica? / Patients with astigmatism who underwent cataract surgery by phacoemulsification: toric IOL x asferic IOL?

    Emilio de Almeida, Torres Netto; Marina Carvalho, Gulin; Marcio, Zapparoli; Hamilton, Moreira.

    2013-08-01

    Full Text Available OBJETIVOS: Comparar a acuidade visual dos pacientes que foram submetidos facoemulsificao com implante de LIO AcrySof trica versus LIO AcrySof IQ e avaliar a reduo da dioptria cilndrica (DC) ps-operatria. MTODOS: Estudo analtico retrospectivo de 149 olhos submetidos cirurgia de catara [...] ta por facoemulsificao, com astigmatismo ceratomtrico regular, simtrico, com 1 dioptria ou mais. Foram divididos em dois grupos. O grupo trica com 85 olhos e o grupo no trica com 64 olhos. No pr-operatrio foram avaliados dados topogrficos do olho a ser operado e refrao. No perodo ps-operatrio foram revisados dados da refrao e acuidades visuais com e sem correo. RESULTADOS: O astigmatismo corneano pr-operatrio variou de 1,00 a 5,6 DC em ambos os grupos, sendo que no grupo trica houve reduo mdia de 1,37 DC (p Abstract in english PURPOSES: Compare the visual acuity of patients who underwent cataract surgery by phacoemulsification with IOL AcrySof toric implantation versus AcrySof IQ and evaluate the reduction of cylindrical diopters (CD) in the postoperative period. METHODS: Analytical and retrospective study of 149 eyes w [...] ith 1 or more diopters of regular symmetrical keratometric astigmatism, which underwent cataract surgery by phacoemulsification. The eyes were divided into two groups: the toric group with 85 eyes and the non-toric group with 64 eyes. In the pre-operative phase, topographic data and refraction of each eye to be operated were assessed. In the postoperative phase, refraction and visual acuity with and without correction were measured. RESULTS: The preoperative topographic astigmatism ranged from 1.00 to 5.6 DC in both groups. Average reduction of 1.37 CD (p

  12. Increase in intraocular pressure is less with propofol and remifentanil than isoflurane with remifentanil during cataract surgery: A randomized controlled trial

    Kamran Montazeri

    2015-01-01

    Full Text Available Background: This double-blinded, randomized clinical trial was designed to evaluate intraocular pressure (IOP change in cataract surgery using the combination of propofol and remifentanil or the combination of isoflurane and remifentanil. Materials and Methods: One hundred sixty patients were randomly allocated to a maintenance anesthetic consisting of remifentanil + isoflurane (group I, normal saline + isoflurane (group II, propofol + remifentanil (group III or normal saline + propofol (group IV. IOP was measured at seven predefined time points, baseline (T0, 3 min after the start of continuous remifentanil infusion (T2, after induction of anesthesia (T3, immediately after laryngoscopy and intubation (T4, 5 min after laryngoscopy (T5, immediately after the block of continuous remifentanil infusion (T6 and 3 min after T6 (T7. Outcomes included IOP, systole blood pressure (SBP and diastole blood pressure (DBP, mean arterial pressure (MAP and heart rate (HR. Results: The mean of IOP in Group III was lower than other groups and in group IV was higher than other groups. At time point T4 and T5 differences in the mean of IOP between groups III and IV was significantly different (P > 0.05. The trend in changes in the mean of IOP was statistically significant among groups (P value = 0.01. The trends in changes in the mean of SBP, DBP and MAP were not significantly different among groups (P value = 0.41. HR in group III was significantly lower than other groups. The trend in changes in the mean of HR was significantly different among groups (P value = 0.002. Conclusion: Propofol with remifentanil was more effective than placebo or adding remifentanil to isoflurane in management of IOP in cataract surgery.

  13. Psychosocial adaptation to stoma surgery: a review.

    Bekkers, M J; van Knippenberg, F C; van den Borne, H W; Poen, H; Bergsma, J; vanBergeHenegouwen, G P

    1995-02-01

    During the last decade strong improvements have been made in the medical care of patients with a digestive tract stoma, particularly with regard to nursing skills and to the quality of collecting material for faecal products. Scientific investigation into the psychosocial adjustment of patients after stoma surgery has intensified as well, giving us indications for quality of life. These developments induced a review of the actual state of affairs in psychological issues. After evaluating the results of psychosocial stoma research, it can be concluded that the technical improvements in stoma care during the past decade did not result in a decline in psychosocial problems after stoma surgery. However, there are some serious problems when interpreting the results of studies in this field of investigation. Stoma surgery is not per se solely responsible for the reported psychosocial problems, first, because many conclusions are based on research studies with poor design and, second, because these studies lack a theoretical framework within which the process of psychosocial adjustment has been measured and explained. This review assesses the most current developments and controversies in this field. PMID:7595949

  14. Effectiveness of non-cardiac preoperative testing in non-cardiac elective surgery: a systematic review.

    Johansson, T; Fritsch, G; Flamm, M; Hansbauer, B; Bachofner, N; Mann, E; Bock, M; Sönnichsen, A C

    2013-06-01

    Elective surgery is usually preceded by preoperative diagnostics to minimize risk. The results are assumed to elicit preventive measures or even cancellation of surgery. Moreover, physicians perform preoperative tests as a baseline to detect subsequent changes. This systematic review aims to explore whether preoperative testing leads to changes in management or reduces perioperative mortality or morbidity in unselected patients undergoing elective, non-cardiac surgery. We systematically searched all relevant databases from January 2001 to February 2011 for studies investigating the relationship between preoperative diagnostics and perioperative outcome. Our methodology was based on the manual of the Ludwig Boltzmann Institute for Health Technology Assessment, the Scottish Intercollegiate Guidelines Network (SIGN) handbook, and the PRISMA statement for reporting systematic reviews. One hundred and one of the 25 281 publications retrieved met our inclusion criteria. Three test grid studies used a randomized controlled design and 98 studies used an observational design. The test grid studies show that in cataract surgery and ambulatory surgery, there are no significant differences between patients with indicated preoperative testing and no testing regarding perioperative outcome. The observational studies do not provide valid evidence that preoperative testing is beneficial in healthy adults undergoing non-cardiac surgery. There is no evidence derived from high-quality studies that supports routine preoperative testing in healthy adults undergoing non-cardiac surgery. Testing according to pathological findings in a patient's medical history or physical examination seems justified, although the evidence is scarce. High-quality studies, especially large randomized controlled trials, are needed to explore the effectiveness of indicated preoperative testing. PMID:23578861

  15. Técnica CoMICS para la cirugía de catarata por microfacoemulsificación CoMICS technique for cataract surgery through microphacoemulsification

    Juan Raúl Hernández Silva

    2010-06-01

    Full Text Available INTRODUCCIÓN: El doctor Robert H. Osher describió en el año 2003 una técnica para la cirugía de la catarata, denominada microfacoemulsificación coaxial o CoMICS, la cual se ha extendido mucho en Europa y América. El objetivo de la investigación fue valorar el comportamiento de esta técnica en la cirugía de catarata por facoemulsificación en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el año 2009. MÉTODOS. Se realizó un estudio longitudinal prospectivo de 41 ojos pertenecientes a 32 pacientes operados de catarata. Se analizaron variables como: la mejor agudeza visual con corrección y sin esta, el astigmatismo resultante, el equivalente esférico y la densidad celular endotelial. Fue comparado su comportamiento antes y después de la cirugía y se realizó el análisis de muestras pareadas mediante la prueba de rangos con signo de Wilcoxon. RESULTADOS. La media de la edad fue de 61 años. Predominaron el sexo masculino y el grupo de 60-79 años, la agudeza visual sin corrección y la mejor corregida, mejoran significativamente en el posoperatorio. El astigmatismo inducido fue menor de 0,5 D. Mejoró el equivalente esférico y la pérdida celular endotelial fue menor de 10 %. CONCLUSIONES. La microfacoemulsificación coaxial tiene resultados visuales positivos en los pacientes operados de catarata.INTRODUCTION: Dr Robert H. Osher described a new technique for cataract surgery in 2003, which was called Coaxial Microphacoemulsification or CoMICS and has been largely applied in Europe and America. The objective of this research study was to assess the behaviour of the CoMICS technique for cataract surgery through phacoemulsification at "Ramón Pando Ferrer" Cuban Institute of Ophtahlmology in 2009. METHODS: A prospective longitudinal study of 41 eyes from 32 patients operated on from cataract was conducted. Variables such as better visual acuity with/without correction, resulting astigmatism, spherical equivalent and endothelial cell density were analyzed. The behaviour of these variables before and after the surgery was compared together with the analysis of paired samples through Wilcoxon´s rank test. RESULTS: The average age was 61 years. Males, 60-79 y age group, visual acuity without correction and the best corrected acuity predominated. Induced astigmatism was under 0,5 D. Spheral equivalent improved whereas endothelial cell loss was lower than 10 %. CONCLUSIONS: Coaxial microphacoemulsification or CoMICS has positive visual results in patients operated on from cataract.

  16. Comparison of bromfenac 0.09% QD to nepafenac 0.1% TID after cataract surgery: pilot evaluation of visual acuity, macular volume, and retinal thickness at a single site

    Cable M

    2012-07-01

    Full Text Available Melissa CableDiscover Vision Centers, Independence, MO, USAPurpose: The purpose of this study was to investigate the clinical outcomes of bromfenac ophthalmic solution 0.09% once daily (QD and nepafenac 0.1% ophthalmic suspension three times daily following cataract extraction with posterior chamber intraocular lens implantation, specifically looking at any differences in Early Treatment Diabetic Retinopathy Study visual acuities, macular volume, and/or retinal thickness changes.Methods: Subjects were randomly assigned to receive either bromfenac (n = 10 QD or nepafenac (n = 10 three times daily. Dosing began 3 days before cataract surgery, continuing to day 21 postsurgery. In addition to the investigated nonsteroidal antiinflammatory drug regimen, all subjects received antiinfective intraoperative and postoperative standard of care. Subjects were followed at 1 day and 1, 3, and 6 weeks postoperatively. Study visit assessments included best-corrected visual acuity, biomicroscopy, summed ocular inflammation score (anterior chamber cells and flare grading, intraocular pressure measurement, adverse event recording, and concomitant medication review. Optical coherence tomography was performed at 1, 3, and 6 weeks.Results: Both treatment groups had similar baseline measurements. Outcomes for mean letters read (P = 0.318, mean change in macular volume (P = 0.665, and retinal thickness (P = 0.552 were not statistically different between the groups from baseline through week six, although independently only the bromfenac group demonstrated a statistically significant improvement in letters gained from baseline to week six (P = 0.040. In the same time period, mean macular volume and retinal thickening worsened in the nepafenac group, demonstrating a statistically significant increase (P = 0.006 at week six for macular volume when compared to baseline. One subject in the nepafenac group experienced recurrent inflammation at week six, was unmasked, and then rescued with bromfenac 0.09% QD and difluprednate 0.05% QD.Conclusion: Both bromfenac and nepafenac resulted in positive clinical outcomes of Early Treatment Diabetic Retinopathy Study visual acuities. Postoperative measurements of macular volume and retinal thickness of bromfenac subjects showed a trend toward improved vision, less retinal thickening, and more stable macular volumes overall.Keywords: NSAIDs, phacoemulsification, inflammation, cataract, macular volume, retinal thickness

  17. Cataract formation following vitreoretinal procedures

    Feng H

    2014-09-01

    Full Text Available Hao Feng, Ron A Adelman Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA Purpose: To evaluate the incidence and prevalence of cataract formation, progression, and extraction in patients that underwent vitreoretinal procedures and to evaluate factors that can potentially predispose patients to postoperative cataracts.Materials and methods: The medical records of consecutive patients who underwent vitreoretinal surgery at the Yale Eye Center with at least 6months of follow-up and no prior intraocular surgery were obtained. Preoperative, intraoperative, and postoperative data were recorded and analyzed in this retrospective observational study. The main outcome measures were defined as cataract extraction, formation, and progression after vitreoretinal procedures. The lens status of the surgical eye was recorded preoperatively and at 1month, 3months, 6months, 12months, 24months, and 36months postoperatively.Results: A total of 193eyes of 180patients fulfilled the inclusion criteria. The percentages of eyes with mild lens change were 96% after 20-gauge pars plana vitrectomy (PPV, 72% after small gauge (23- and 25-gauge PPV, 38% after scleral buckle (SB, 38% after pneumatic retinopexy (PR, and 91% after PPV plus SB (PPV+SB. Posterior subcapsular and nuclear sclerotic cataracts were the most common with almost all developing within 24months. There was no statistically significant difference (P=1.00 between the rate of cataract extraction after 20-gauge (41% and small gauge PPV (42%, but there was a statistically significant difference between PPV and non-PPV (SB, 6%; PR, 7%; P<0.001 and PPV and PPV+SB groups (69%; P=0.0063.Conclusion: Cataracts were common following PPV regardless of the gauge. SB and PR led to the lowest while PPV+SB led to the highest risk of postoperative cataracts. Keywords: cataracts, vitreoretinal surgery, vitrectomy, scleral buckle, pneumatic retinopexy

  18. Comparao de acuidade visual final: cirurgias de catarata com intercorrncias versus sem intercorrncias / Comparison of final visual acuity: cataract surgery with intraoperative complications versus non intraoperative complications

    Patrcia Mencaroni, Kange; Marcela Costa, Cruz; Daniel, Martin; Fabio, Hara; Renata Magrino, Pereira; Andr Berger Emiliano da, Silva.

    2015-06-01

    Full Text Available Objetivo Comparar a acuidade visual (AV) final dos pacientes submetidos cirurgia de catarata com e sem complicaes intraoperatrias e possveis fatores que contriburam para o resultado ao final do ps-operatrio. Mtodos Anlise dos pronturios de 179 pacientes, retrospectivo, longitudinal, ope [...] rados de fevereiro a julho de 2013 no Instituto Dr. Suel Abujamra, pela tcnica de facoemulsificao (FACO), divididos em dois grupos: com e sem complicaes intraoperatrias. Os dados obtidos foram analisados pelos mtodos teste-t para duas amostras ou Anlise de Varincia (ANOVA). Os critrios de excluso foram pacientes com cirurgia ocular prvia, retinopatia diabtica proliferativa ou no proliferativa grave, outras retinopatias, escavao do disco ptico igual ou maior que 0,7x0,7 ou uso de mais de dois hipotensores oculares, olho nico, catarata secundria uvete, traumtica ou congnita. Resultados Dos 179 pacientes, 37 (20,7%) tiveram complicaes intraoperatrias e 142 (79,3%) no tiveram complicaes intraoperatrias. A mdia da idade dos pacientes foi de 70,33 anos. O olho direito foi o operado em 49,7% dos casos, e o olho esquerdo em 50,3%. O diabetes mellitus estava presente em 29,05% dos casos, sendo 29,73% de pacientes com complicao e 28,87% sem complicaes. Do total, 77,65% atingiram uma AV final 20/40 ou melhor, sendo que nos pacientes com complicao a mdia para esta AV foi de 59,46% e no grupo sem complicaes foi de 82,40%. A principal complicao foi ruptura de cpsula posterior. Concluso Aps toda a anlise, verificamos que os fatores que implicaram com significncia estatstica em menor AV final foram as complicaes intraoperatrias e a idade dos pacientes. Abstract in english Objective Compare visual acuity (VA) of patients after cataract surgery with and without intraoperative complications regarding possible factors that contributed to the outcome on postoperative follow-up. Methods Longitudinal, retrospective study that evaluated 179 medical records of patients who u [...] nderwent cataract surgery under the technique Phacoemulsification (PHACO) in the Suel Abujamra Institute from february to july 2013. Patients were divided into two groups concerning presence or absence of intraoperative complications. Data were analyzed using t-test methods for two samples or (ANOVA) Analysis of Variance. Exclusion criteria were: patients with previous ocular surgery, retinopathy related to diabetes, either proliferative or severe non proliferative, other retinopathies, optic disc cup equal to or greater than 0,7x0,7, use of more than two ocular hypotensive medications, only one eye, cataract due to uveitis, trauma or congenital. Results 37 (20.7%) patients had intraoperative complications and 142 (79.3%) had not. Average age of patients was 70.33 years. There were 49.7% surgeries of the right eye and 50.3% of the left eye. There were 29.05% diabetic patients, of which 29.73% had intraoperative complications and 28.87% had not. From the 179 patients, 77.65% reached a final VA of 20/40 or better, considering that patients with intraoperative complications reached a VA of about 59.46% and patients without intraoperative complications of about 82.40%. The main complication was posterior capsular tear. Conclusion After entire evaluation, we realized that factors that influenced lower final VA, with statistical significance, were intraoperative complications and patient age.

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

    Sérgio Jacobovitz

    2003-06-01

    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.

  20. Manejo del síndrome de iris laxo intraoperatorio en la cirugía de cataratas Management of intraoperative floppy iris syndrome in the cataract surgery

    Belmary Aragonés Cruz

    2007-12-01

    Full Text Available El síndrome de iris laxo intraoperatorio se caracteriza por una tríada de signos: ondulación, prolapso, y miosis progresiva. Este síndrome puede observarse en pacientes que serán sometidos a cirugía de catarata y son portadores de hiperplasia prostática benigna u otra patología tratada con alfabloqueadores sistémicos. Si el oftalmólogo tiene conocimiento de esta terapia puede planificar una estrategia quirúrgica adecuada y de esta manera disminuir la tasa de complicaciones.The intraoperative floppy iris syndrome is characterized by a triad: wave, prolapse of the iris, and progressive miosis. This syndrome can be observed in patients that will undergo cataract surgery, who are carriers of benign prostatic hyperplasia or another pathology treated with systemic alphablockers. If the ophthalmologist is acquainted with this therapy, he/she may design a suitable surgical strategy to reduce complications after surgery.

  1. Acute traumatic cataracts

    This paper reports orbital CT scans of 15 patients with clinically diagnoses traumatic cataracts retrospectively reviewed to determine the presence of radiographically detectable lens abnormalities. Definite lens swelling was clinically observed in a lease five cases. Eleven patients, scanned 4 hours of 3 days after injury, revealed visible and measured decreased CT density of the cataractous lens compared with the normal contralateral lens (average mean difference, 28 HU), suggesting acute lens swelling. In one patient, lens morphologic changes but not HU differences were found, probably due to superimposed hemorrhage. Three patients, scanned 3-8 hours after injury, revealed no detectable lens abnormality. The findings suggest that CT is potentially capable of identifying traumatic cataracts

  2. Thyroid carcinoma, cataract and hearing loss in a patient after irradiation for facial hemangioma

    A rare case of a patient irradiated on the right side of the face for a large hemangioma during early childhood is reported. This patient suffers from sensorineural hearing loss in the right ear and a cataract of the right eye, and she underwent surgery for Hurtle cell carcinoma of the thyroid gland. The literature discussing radiation-induced hearing loss is reviewed. (author)

  3. Perfil socioeconmico e epidemiolgico dos pacientes submetidos cirurgia de catarata em um hospital universitrio Socioeconomic and epidemiologic profile of patients submitted to cataract surgery at a university hospital

    Beatriz de Abreu Fiuza Gomes

    2008-10-01

    Full Text Available OBJETIVO: Determinar as caractersticas scioeconmicas dos pacientes operados de catarata em hospital universitrio, avaliar o acesso unidade terciria e determinar o tempo de espera at o tratamento cirrgico. MTODOS: Estudo transversal, realizado atravs da reviso de pronturios de 148 pacientes operados de catarata escolhidos aleatoriamente durante o primeiro semestre de 2007. RESULTADOS: Os pacientes apresentaram idade mediana de 70,5 anos, com maior prevalncia de mulheres (60,1%, da raa branca (48,0%, com baixo grau de instruo (ensino fundamental incompleto, 50,7%, acuidade visual igual ou pior a 20/200 (57,4% e diagnstico realizado em consulta regular no hospital universitrio (47,8%. Apenas 9,4% dos pacientes operados foram diagnosticados na campanha de catarata. O tempo mdio entre o diagnstico e a cirurgia foi 3,5 meses e relacionou-se principalmente realizao dos exames oftalmolgicos e clnicos pr-operatrios. CONCLUSO: Os pacientes com baixa renda familiar so os principais usurios do Sistema nico de Sade (SUS e o acesso ao tratamento cirrgico demorado, resultando em viso subnormal incapacitante. Ressalta-se a importncia da campanha de catarata no ingresso de pacientes carentes ao hospital de alta complexidade.PURPOSE: To determine the socio-economic characteristics of the patients who were submitted to cataract surgery in a university hospital, to evaluate the accessibility to the tertiary health service and to determine the waiting time for cataract surgery. METHODS: A cross-sectional study of medical charts from 148 random patients who underwent cataract surgery during the first semester of 2007. RESULTS: The patients in this study had median of age of 70.5 years, and the major prevalence was of female (60.1%, caucasian (48.0%, with low educational level (incomplete fundamental study, 50.7%, best corrected visual acuity 20/200 or worst; the diagnosis of cataract was done at the University Hospital in a routine appointment (47.8%. Only 9.4% of patients submitted to the surgery had his diagnosis done in a cataract campaign. The average time between the diagnosis and the surgery was 3.5 months and the delay was mainly due to pre operative exams. CONCLUSION: The majority of patients in the Brazilian Public Health System have low family income. The system takes a long time to access surgical procedures that need to be addressed in a proper time manner. The result of the long wait is subnormal vision. It is important to highlight the cataract campaign in order to enroll patients with low income in a hospital of high complexity.

  4. Microbiota conjuntival en el preoperatorio de pacientes que se sometern a ciruga de cataratas / Microbial flora isolated from patient's conjunctiva previous to cataract surgery

    Fernando, Barra von-B; Henriette, Chabouty; Ren, Moreno; Freddy, Ortiz; Fernando, Barra M.

    2015-04-01

    Full Text Available Introduccin: La endoftalmitis post-ciruga de cataratas es una de las complicaciones post-operatorias ms temidas y devastadoras, pudiendo ocasionar secuelas graves, con un pronstico visual incierto. La profilaxis antimicrobiana de esta complicacin debe basarse en el conocimiento acabado de la mi [...] crobiota presente en el territorio conjuntival. Objetivo: Establecer bases microbiolgicas para una mejor profilaxis antimicrobiana de la endoftalmitis en ciruga de cataratas. Materiales y Mtodos: Estudio descriptivo, de corte transversal, prospectivo. A 118 pacientes se les tom muestra conjuntival pre-operatoria del fondo de saco inferior, sembrndola de inmediato en medios de cultivo. Las colonias desarrolladas se identificaron por mtodos manuales y mtodo de microdilucin y difusin en disco. Resultados: De 118 cultivos pre-operatorios, 106 (89,8%) desarrollaron colonias bacterianas. Se aislaron 159 bacterias conjuntivales como especie nica o cultivo mixta, siendo 95% grampositivas. El gnero Staphylococcus represent 76,1% del total de bacterias aisladas, siendo 82,6% Staphylococcus coagulasa negativa (SCN) y 17,4% Staphylococcus aureus. El 42% de los SCN y 38% de S. aureus presentaron resistencia a meticilina, presentando ambos buena susceptibilidad a tobramicina y fluoroquinolonas de cuarta generacin. Conclusiones: Considerando nuestros resultados, recomendaramos a nuestros pacientes tobramicina tpica como antibioprofilaxis, asociada a povidona yodada como antisptico. Una quinolona de cuarta generacin podra usarse cuando existan factores de riesgo de infeccin. Abstract in english Background. Endophtalmitis post cataract surgery is one of most feared and devastating complications resulting in serious consequences and an uncertain visual prognosis. Antimicrobial prophylaxis against endophtalmitis must be based on the best knowledge of conjuntival microbiota. Objective: To esta [...] blish microbiological basis for the best antibiotic prophylaxis to prevent endophthalmitis in cataract surgery. Materials and Methods: A descriptive, cross-sectional, prospective study. A preoperative conjunctival sample was taken from the lower fornix of 118 pacients, sowing it immediately in culture media. Identification of growing colonies and susceptibility testing were performed by manual or automated methods. Results: 106 (89.8%) of 118 preoperative cultures were positive. 159 bacteria were isolated in single or mixed flora, with 95% of Gram positive organisms. Staphylococci represented 76.1% of isolated bacteria, with 82.6% of coagulase-negative staphylococci (SCN) and 17.4% of Staphylococcus aureus. Forty two percent of SCN and 38% of S. aureus were methicillin resistan; both groups showed high susceptibility to tobramycin and fourth-generation fluoroquinolones. Conclusions: we recommend the use of topical tobramycin as pre-operative antimicrobial prophylaxis associated with povidone-iodine antisepsis. A fourth-generation quinolone is recommended when there is risk of infection.

  5. Management of cataract with macular oedema due to diabetes mellitus Type-II and hypertension with grid laser prior to surgery and intra-vitreal bevacizumab (avastin) peroperatively

    To study the visual outcome in patients subjected to cataract extraction with prior grid laser and intraoperative intravitreal bevacizumab injection. Methods: This prospective case series comprised of 38 patients subjected to phacoemulsification and in the bag intraocular lens implantation at Al-Noor Eye Hospital and Sindh Govt Lyari General Hospital Karachi from January 2007 to December 2008. All the patients had prior macular grid treatment and intra-operative injection of intra-vitreal Avastin. Diabetes mellitus duration, preoperative glycosylated haemoglobin (HbA1c) level and other systemic and local complications of diabetes were recorded. The patients were clinically assessed with bio microscopic examination preoperatively, and postoperatively on day 1, week 1, and in months 1, 2, 3 and 6 respectively. Visual acuity and state of macular oedema was clinically assessed and documented. Results: Out of thirty-eight patients, eighteen were males and 20 were females. Mean duration of diabetes was 9.92 +- 5.5 years (Range 4-16) while that of hypertension was 7.87 +- 3.66 years (Range = 2-15). HbA1c level was 8.36% +- 1.93% (range 6.3 - 12.3). Thirty-one (81.5%) patients had HbA1c level 8.0% or above indicating a poor control. At 6 months of follow up best corrected distant visual acuity of 6/6 to 6/9 was achieved in 23(60.5 %), 6/12 in 11(28.9%) and 6/24 in 4(10.5%) cases while best corrected near acuity of N/6 was achieved in 22(57.8%) N/8 in 12(31.4%) and N/12 in 4(10.5%) cases. At 6 months follow up visual acuity declined in two cases because of uncontrolled diabetes and hypertension. Conclusion: Cataract surgery in diabetic patients with macular oedema and hypertension has a good visual outcome if prior macular grid laser is performed and intra-vitreal anti VEGF is injected during surgery. (author)

  6. Preoperative visual acuity among cataract surgery patients and countries' state of development: a global study / Acuit visuelle pr-opratoire des patients subissant une opration de la cataracte et tat de dveloppement des pays: une tude mondiale / Agudeza visual preoperatoria en los pacientes sometidos a ciruga de cataratas y estado de desarrollo de los pases: un estudio global

    Shaheen P, Shah; Claire E, Gilbert; Hessom, Razavi; Elizabeth L, Turner; Robert J, Lindfield.

    2011-10-01

    Full Text Available OBJETIVO: Describir la variedad de casos quirrgicos preoperatorios en pacientes sometidos a extraccin de cataratas y examinar las asociaciones existentes entre la variedad de casos, el nivel de desarrollo del pas (de conformidad con la medicin del ndice de desarrollo humano [IDH]) y las tasas d [...] e ciruga de catarata (TCC). MTODOS: Se invit a oftalmlogos de 50 pases a que se unieran a la recin creada Red Internacional de Investigacin Ocular y se les solicit que completaran un cuestionario basado en web sobre sus hospitales oftalmolgicos. Aquellos profesionales que cumplieron lo solicitado recibieron un formulario de recopilacin de datos para el registro de datos demogrficos y clnicos de 100 pacientes consecutivos que se iban a someter a una ciruga de cataratas. Se clasific a los pases en cinco categoras de IDH y se utiliz una regresin multivariable para evaluar las asociaciones. RESULTADOS: En el ao 2008, oftalmlogos de 112 hospitales oftalmolgicos (el 54% de ellos no gubernamentales) de 50 pases proporcionaron datos sobre 11.048 cirugas de catarata durante 9 meses. Los pacientes cuya agudeza visual (AV) antes de la intervencin era Abstract in english OBJECTIVE: To describe the preoperative surgical case mix among patients undergoing cataract extraction and explore associations between case mix, country level of development (as measured by the Human Development Index, HDI) and cataract surgery rates (CSRs). METHODS: Ophthalmologists in 50 countri [...] es were invited to join the newly-established International Eye Research Network and asked to complete a web-based questionnaire about their eye hospitals. Those who complied received a data collection form for recording demographic and clinical data on 100 consecutive patients about to undergo cataract surgery. Countries were ranked into five HDI categories and multivariable regression was used to explore associations. FINDINGS: Ophthalmologists at 112 eye hospitals (54% of them nongovernmental) in 50 countries provided data on 11 048 cataract procedures over 9 months in 2008. Patients whose visual acuity (VA) before surgery was

  7. A framework for the recognition of high-level surgical tasks from video images for cataract surgeries

    Lalys, Florent; Riffaud, Laurent; Bouget, David; Jannin, Pierre

    2012-01-01

    The need for a better integration of the new generation of Computer-Assisted-Surgical (CAS) systems has been recently emphasized. One necessity to achieve this objective is to retrieve data from the Operating Room (OR) with different sensors, then to derive models from these data. Recently, the use of videos from cameras in the OR has demonstrated its efficiency. In this paper, we propose a framework to assist in the development of systems for the automatic recognition of high level surgical tasks using microscope videos analysis. We validated its use on cataract procedures. The idea is to combine state-of-the-art computer vision techniques with time series analysis. The first step of the framework consisted in the definition of several visual cues for extracting semantic information, therefore characterizing each frame of the video. Five different pieces of image-based classifiers were therefore implemented. A step of pupil segmentation was also applied for dedicated visual cue detection. Time series classification algorithms were then applied to model time-varying data. Dynamic Time Warping (DTW) and Hidden Markov Models (HMM) were tested. This association combined the advantages of all methods for better understanding of the problem. The framework was finally validated through various studies. Six binary visual cues were chosen along with 12 phases to detect, obtaining accuracies of 94%. PMID:22203700

  8. Clinical observations associated with proven and unproven cases in the ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery.

    Barry, Peter

    2012-02-01

    PURPOSE: To describe cases of postoperative endophthalmitis in the European Society of Cataract & Refractive Surgeons (ESCRS) study of the prophylaxis of endophthalmitis, compare characteristics of unproven cases and cases proven by culture or polymerase chain reaction, and compare the characteristics with those in other reported series. SETTING: Twenty-four ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, and the United Kingdom. METHODS: Univariable and multivariable logistic regression models were used to analyze data for statistical association of signs and symptoms in cases with proven or unproven endophthalmitis. Specific data describing characteristics of the cases were compared between the 2 types of cases. RESULTS: Data from 29 endophthalmitis cases were analyzed. Swollen lids and pain were statistically associated with proven cases of endophthalmitis on univariable regression analysis. Multivariable analysis indicated that swollen lids and an opaque vitreous were associated with proven cases. Five cases of endophthalmitis occurred in the cefuroxime-treated groups. No case of streptococcal infection occurred in the cefuroxime-treated groups. However, cases of infection due to streptococci showed striking differences in visual acuity and were associated with earlier onset. Characteristics in the 29 cases parallel results in previous studies, such as the Endophthalmitis Vitrectomy Study, although the addition of a control group in the ESCRS study elicited additional findings. CONCLUSION: Swollen lids, pain, and an opaque vitreous were statistically associated with proven endophthalmitis cases in the ESCRS study.

  9. Phacoemulsification in subluxated cataract.

    Praveen M

    2003-01-01

    Full Text Available Purpose: To evaluate the outcome of phacoemulsification in eyes with subluxated cataract. Materials and Methods: This retrospective study comprised 22 eyes of 20 consecutive patients with subluxated cataracts of varying aetiology operated between March 1998 and March 2001. Detailed preoperative assessment included visual acuity (VA, slitlamp examination, presence of vitreous in anterior chamber, extent of subluxation, intraocular pressure (IOP and detailed fundus examination. Phacoemulsification was done to retain the natural bag support and all patients had acrylic foldable Acrysof IOL implantation either in-the-bag or by scleral fixation. Postoperative observations included best-corrected visual acuity (BCVA, IOP, pupillary reaction and the IOL position. Results: The aetiology of the subluxation was traumatic in 11 patients and non-traumatic in 9 patients. Fifteen were males and 5 were females. Mean follow-up was 11.7 ± 9.71 months (range 4-39. The average age was 39.15 ± 16.33 (range 5 - 74. A 2-port anterior chamber vitrectomy was performed in 6 eyes (27.2%. Capsule tension ring (CTR was implanted in 15 eyes (68.18%. Twelve eyes (54.5% had in-the-bag implants, while 5 (22.72% had scleral fixation. The remaining 5 eyes (22.72% had one haptic in-the-bag and another sutured to sclera. No major intraoperative complications were noted. Twelve eyes (54.5% had clinically and geometrically well centered IOLs while 9 eyes (40.9% had geometrically decentered IOLs. One patient was lost to follow-up. Fifteen eyes (55.55% had postoperative BCVA of 6/12 - 6/6 while 2 eyes (7.40% had BCVA of 6/18. The remaining 4 eyes (14.81% had less than 6/24 BCVA due to pre-existing posterior segment pathology. Postoperative complications included rise in IOP in 1 eye (4.54%, pupillary capture of the IOL optic in 2 eyes (9.09%; the same 2 eyes (9.09% required redialing of IOL. One eye (4.54% had to undergo refixation (one haptic was fixed to sclera year after cataract surgery. Postoperative retinal detachment was noticed in one patient after a month of phacoemulsification. Conclusion: In subluxated cataracts it is essential to have appropriate parameters depending on the grade of cataract. This contributes to a safe and predictable outcome in subluxated cataract surgery.

  10. Robotic Colorectal Surgery: A Systematic Review

    Sami AlAsari; Byung Soh Min

    2012-01-01

    Aim. Robotic colorectal surgery may be a way to overcome the limitations of laparoscopic surgery. It is an emerging field; so, we aim in this paper to provide a comprehensive and data analysis of the available literature on the use of robotic technology in colorectal surgery. Method. A comprehensive systematic search of electronic databases was completed for the period from 2000 to 2011. Studies reporting outcomes of robotic colorectal surgery were identified and analyzed. Results. 41 studies...

  11. Pregnancy after Bariatric Surgery: A Review

    Eugene Oteng-Ntim; Hezelgrave, N. L.

    2011-01-01

    Maternal obesity is a major cause of obstetric morbidity and mortality. With surgical procedures to facilitate weight loss becoming more widely available and demanded and increasing number of women becoming pregnant after undergoing bariatric surgery, it is important and timely to consider the outcome of pregnancy following bariatric surgery. This paper aims to synthesize the current evidence regarding pregnancy outcomes after bariatric surgery. It concludes that bariatric surgery appears to ...

  12. Cataract removal

    ... A small cut (incision) is made in the eye. The lens is removed in one of the following ways, ... The normal lens of the eye is clear (transparent). As a cataract develops, the lens becomes cloudy. This blocks light from entering your eye. ...

  13. Fibrosis in the lens. Sprouty regulation of TGF?-signaling prevents lens EMT leading to cataract.

    Lovicu, F J; Shin, E H; McAvoy, J W

    2016-01-01

    Cataract is a common age-related condition that is caused by progressive clouding of the normally clear lens. Cataract can be effectively treated by surgery; however, like any surgery, there can be complications and the development of a secondary cataract, known as posterior capsule opacification (PCO), is the most common. PCO is caused by aberrant growth of lens epithelial cells that are left behind in the capsular bag after surgical removal of the fiber mass. An epithelial-to-mesenchymal transition (EMT) is central to fibrotic PCO and forms of fibrotic cataract, including anterior/posterior polar cataracts. Transforming growth factor ? (TGF?) has been shown to induce lens EMT and consequently research has focused on identifying ways of blocking its action. Intriguingly, recent studies in animal models have shown that EMT and cataract developed when a class of negative-feedback regulators, Sprouty (Spry)1 and Spry2, were conditionally deleted from the lens. Members of the Spry family act as general antagonists of the receptor tyrosine kinase (RTK)-mediated MAPK signaling pathway that is involved in many physiological and developmental processes. As the ERK/MAPK signaling pathway is a well established target of Spry proteins, and overexpression of Spry can block aberrant TGF?-Smad signaling responsible for EMT and anterior subcapsular cataract, this indicates a role for the ERK/MAPK pathway in TGF?-induced EMT. Given this and other supporting evidence, a case is made for focusing on RTK antagonists, such as Spry, for cataract prevention. In addition, and looking to the future, this review also looks at possibilities for supplanting EMT with normal fiber differentiation and thereby promoting lens regenerative processes after cataract surgery. Whilst it is now known that the epithelial to fiber differentiation process is driven by FGF, little is known about factors that coordinate the precise assembly of fibers into a functional lens. However, recent research provides key insights into an FGF-activated mechanism intrinsic to the lens that involves interactions between the Wnt-Frizzled and Jagged/Notch signaling pathways. This reciprocal epithelial-fiber cell interaction appears to be critical for the assembly and maintenance of the highly ordered three-dimensional architecture that is central to lens function. This information is fundamental to defining the specific conditions and stimuli needed to recapitulate developmental programs and promote regeneration of lens structure and function after cataract surgery. PMID:26003864

  14. The effect of multimedia interventions on the informed consent process for cataract surgery in rural South India

    Abraar Karan

    2014-01-01

    Full Text Available Context: The provision of ocular surgical interventions for poorer, less educated populations is increasing as a result of increased globalization and outreach. However, these populations still have trouble understanding surgical concepts and are not always fully informed decision makers. Aims: We aimed to test the effect that a multimedia addition to a traditional verbal informed consent would have on patient comprehension of relatively difficult cataract surgical concepts. Settings and Design: We conducted a randomized controlled trial with relatively uneducated patients reporting to a private surgical hospital in Chennai, India. 47 patients were placed into the intervention group and 50 patients were placed into the control group. Materials and Methods: The intervention group was presented with a scripted verbal informed consent as well as a 3-fold pamphlet and a presentation with a 3-dimensional model of the eye. The control group was only presented with a scripted verbal informed consent. The two groups were tested using an 11 item "True/False/I don′t know" quiz directly before the informed consent, directly after the informed consent, and one-day postoperatively. Statistical Analysis Used: Scores on the quiz were compared across groups and time-points using paired t-tests. Results: Patients in the both groups showed a significant improvement in scores between pre- and post-informed consent quizzes (P value on the order of 10 -6 and the improvement in scores was significantly greater in the intervention group than the control group (P value on the order of 10 -16 . There was no significant difference observed in either group with regards to the change in scores between post-informed consent and post-operative quizzes. Conclusion: Multimedia aids in addition to a standard informed consent process are effective in improving patient comprehension even for patients with low literacy and limited knowledge of surgical interventions.

  15. Spectacle independence and subjective satisfaction of ReSTOR® multifocal intraocular lens after cataract or presbyopia surgery in two European countries

    Béatrice Cochener

    2010-02-01

    Full Text Available Béatrice Cochener1, Luis Fernández-Vega2, Jose F Alfonso2, Frédérique Maurel3, Juliette Meunier4, Gilles Berdeaux5,61Centre Hospitalier de Brest, Brest, France; 2Instituto Oftalmologico Fernandez Vega, Oviedo, Spain; 3IMS Health, Health Economics Department, Puteaux, France; 4Mapi Values, Lyon, France; 5Alcon France, Health Economics Department, Rueil-Malmaison, France; 6Conservatoire National des Arts et Métiers, Paris, FrancePurpose: To determine the percentage of patients implanted bilaterally with ReSTOR® requiring spectacles at 18 months, the patient satisfaction, and factors that predict spectacles independence.Methods: The medical and surgical data were collected from patient records. The ‘Freedom from Spectacles Value Scale’ (FGVS was used to rank their experiences via telephone interview. A Bayesian network was used to predict postoperative spectacles use.Results: 304 patients (65.6 years were included. Postoperative visual acuity was ≥0.8 in 93.3% of patients for near vision and in 88.6% of patients for distance vision. After surgery, 87.2% of the patients were spectacles free. 88.2% of the patients rated their vision as being better following the surgery and 93.1% thought that surgery resulted in a positive change. FGVS mean scores (5 the most favorable rating were: ‘Practical Advantages’ 3.8, ‘Psychological Advantages’ 3.8, ‘Evaluation of the Result’ 4.5, ‘Feelings’ 4.4, and ‘Global Judgement’ 4.4. Patients who stated that spectacles wear was particularly bothersome and those who thought that their appearance was more favorable without spectacles were 3 times more likely not to wear spectacles postoperatively.Conclusion: ReSTOR® provides patients with good distance and near vision, a high rate of spectacles independence, and a high degree of patient satisfaction.Keywords: cataract surgery, multifocal intraocular lens, patient satisfaction, spectacles independence

  16. Cirugía de catarata en pacientes vitrectomizados con aceite de silicona Results of the cataract surgery in patients undergoing vitrectomy with silicone oil

    Zucell Ana Veitia Rovirosa

    2012-06-01

    Full Text Available Objetivo: Describir los resultados de la cirugía de catarata en pacientes vitrectomizados con aceite de silicona. Métodos: Se realizó un estudio descriptivo y prospectivo en 50 ojos de 49 pacientes vitrectomizados con aceite de silicona que necesitaron cirugía de catarata, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de septiembre de 2008 a noviembre de 2009. Se analizó el componente esférico esperado y obtenido (con aceite de silicona y sin este, las diferencias queratométricas, el astigmatismo resultante, los cambios morfológicos y morfométricos del endotelio corneal, la mejor agudeza visual sin corrección y corregida y las complicaciones intraoperatorias y posoperatorias. Los resultados se expresaron en frecuencias absolutas y relativas, media aritmética y desviación estándar. Resultados: Predominó el sexo masculino entre 51 y 60 años de edad. El aceite de silicona produjo una hipercorrección en el componente esférico obtenido promedio de 4,08 dioptrías que disminuyó hasta rangos de emetropía esperada cuando se extrajo. No hubo diferencias queratométricas posoperatorias significativas y el astigmatismo resultante fue mínimo (0,31 dioptrías. La mejor agudeza visual sin corrección y con esta, mejoró después de la cirugía. Hubo una pérdida mínima de células endoteliales (6,4 % y la variabilidad del pleomorfismo y polimegatismo estuvo dentro de los rangos clasificados en el preoperatorio. La opacidad de la cápsula posterior (62 % fue la complicación más frecuente. Conclusiones: La biometría óptica coherente y las fórmulas de cuarta generación permiten obtener una buena predictibilidad en el cálculo del lente intraocular en casos especiales como los vitrectomizados con aceite de silicona.Objective: To describe the results of cataract surgery results in patients who had undergone vitrectomy with silicone oil. Methods: A prospective and descriptive study was performed in 50 eyes from 49 patients who had previously undergone vitrectomy with silicone oil, and later had required cataract surgery at “Ramón Pando Ferrer”, Cuban Institute of Ophthalmology from September 2008 to November 2009. Several variables were analyzed such as the expected and obtained spherical component with and without silicone oil, the keratometric differences and the resulting astigmatism, the morphological and morphometric changes in the corneal endothelium, the best uncorrected and corrected visual acuity and transoperative and postoperative complications. The results were provided in absolute and relative frequencies, arithmetic means and standard deviation. Results: : The male group predominated as well as the 51 - 60y age group. The silicone oil caused hypercorrection in average spherical component of 4.08 D, which was reduced to the expected emmetropia ranges when the silicone oil was removed. There were no significant postoperative differences in keratometry and the resultant astigmatism was minimal (O.31 D. All the patients improved their best uncorrected and corrected visual acuity after surgery. There was minimal loss of endothelial cells (6.4 % and the variability of pleomorphism and polymegatism remained within the preoperative classified range. The posterior capsule opacity was the most common complication (62 %. Conclusion: Optical coherence biometry and fourth-generation formulas allow obtaining good predictability in the calculation of intraocular lens in special cases such as the ones that undergo vitrectomy with silicon oil.

  17. Astigmatism in candidates of Cataract surgery and its relationship with corneal optical power, axial length, sex and patient age

    Siatiri H

    2000-08-01

    Full Text Available This study was conducted to define the prevalence and types of corneal astigmatism in relation with corneal optical power, axial length, sex and patient age. 641 cataract patients were included in a descriptive study. Complete eye examinations were included in a descriptive study. Complete eye examinations were performed. The data were analysed by standard procedures including analysis of variance, chi square test and multiple linear regression models. With the rule, astigmatism was 55.6% in younger cases and against the rule astigmatism was 55.6% in younger cases and against the rule astigmatism was 43.7% in older cases (P<0.0001. Against the rule astigmatism was 55.8% in older males and 34.6% in older females (P<0.0001.There was 0.023d decrease in kpol for each year increase in age 1 (P<0.0001. Axial length in males was 23.35±1.79 mm (P<0.05 for second degree model to show relationship between astigmatism and axial length R2 was 0.019 and 0.03 by increasing axial length up to 26 mm corneal power decreased, but further increase in axial length led to corneal power increase. For each diopter increase in corneal power there was 0.1 diopetr increase in net astigmatism (P<0.0001. In corneal powers less than 45.5 diopter there was no difference between direction of astigmatism, but in corneal powers more than 45.5 diopter with the rule astigmatism was dominated (P=0.01. younger cases had more with the rule astigmatism andolder cases had more against the rule astigmatism. Against the rule astigmatism was more common in older males than in older females. With the rule astigmatism ratio shifted to ATR astigmastism ratio with age but there was no change in against the rule astigmatism ratio with age. Males had 0.22 mm axial length more than females. There was significant relationship between axial length and net astigmatism. Abnormal size eyes had more astigmatism.Emmetropization mechanism of cornea did not work for eyes longer than 26 mm. Myopia was related to total astigmatism.Second degree model was more fitted to show relationship between astigmatism and axial length.

  18. Laparoscopic surgery for ulcerative colitis: a review of the literature.

    Hata, Keisuke; Kazama, Shinsuke; Nozawa, Hiroaki; Kawai, Kazushige; Kiyomatsu, Tomomichi; Tanaka, Junichiro; Tanaka, Toshiaki; Nishikawa, Takeshi; Yamaguchi, Hironori; Ishihara, Soichiro; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

    2015-08-01

    Despite the development of new therapies, including anti-TNF alpha antibodies and immunosuppressants, a substantial proportion of patients with ulcerative colitis (UC) still require surgery. Restorative proctocolectomy with ileal-pouch anal anastomosis is the standard surgical treatment of choice for UC. With the advent of laparoscopic techniques for colorectal surgery, ileal-pouch anal anastomosis has also been performed laparoscopically. This paper reviews the history and current trends in laparoscopic surgery for UC. The accumulation of experience and improvement of laparoscopic devices have shifted the paradigm of UC surgery towards laparoscopic surgery over the past decade. Although laparoscopic surgery requires a longer operation, it provides significantly better short and long-term outcomes. The short-term benefits of laparoscopic surgery over open surgery include shorter hospital stays and fasting times, as well as better cosmesis. The long-term benefits of laparoscopy include better fecundity in young females. Some surgeons favor laparoscopic surgery even for severe acute colitis. More efforts are being made to develop newer laparoscopic methods, such as reduced port surgery, including single incision laparoscopic surgery and robotic surgery. PMID:25346254

  19. Robotic Surgery in Otolaryngology and Head and Neck Surgery: A Review

    Reza Rahbar; Brian Rosman; Karen Watters; Hiep T. Nguyen; Ferraz, Alberto R.; Oliveira, Caio M.

    2012-01-01

    Recent advancements in robotics technology have allowed more complex surgical procedures to be performed using minimally invasive approaches. In this article, we reviewed the role of robotic assistance in Otolaryngology and Head and Neck Surgery. We highlight the advantages of robot-assisted surgery and its clinical application in this field.

  20. Radiation cataract

    Until very recently, ocular exposure guidelines were based on the assumption that radiation cataract is a deterministic event requiring threshold doses generally greater than 2 Gy. This view was, in part, based on older studies which generally had short follow-up periods, failed to take into account increasing latency as dose decreased, had relatively few subjects with doses below a few Gy, and were not designed to detect early lens changes. Newer findings, including those in populations exposed to much lower radiation doses and in subjects as diverse as astronauts, medical workers, atomic bomb survivors, accidentally exposed individuals, and those undergoing diagnostic or radiotherapeutic procedures, strongly suggest dose-related lens opacification at significantly lower doses. These observations resulted in a recent re-evaluation of current lens occupational exposure guidelines, and a proposed lowering of the presumptive radiation cataract threshold to 0.5 Gy/year and the occupational lens exposure limit to 20 mSv/year, regardless of whether received as an acute, protracted, or chronic exposure. Experimental animal studies support these conclusions and suggest a role for genotoxicity in the development of radiation cataract. Recent findings of a low or even zero threshold for radiation-induced lens opacification are likely to influence current research efforts and directions concerning the cellular and molecular mechanisms underlying this pathology. Furthermore, new guidelines are likely to have significant implications for occupational and/or accidental exposure, and the need for occupational eye protection (e.g. in fields such as interventional medicine).

  1. Bariatric surgery in elderly patients: a systematic review

    Giordano S; Victorzon M

    2015-01-01

    Salvatore Giordano,1 Mikael Victorzon2,3 1Department of Plastic and General Surgery, Turku University Hospital, Turku, 2Department of Gastrointestinal Surgery, Vaasa Central Hospital, Vaasa, 3University of Turku, Turku, Finland Abstract: Controversy exists regarding the effectiveness and safety of bariatric/metabolic surgery in elderly patients. We performed a systematic review on this issue in patients aged 60 years or older. MEDLINE, Cochrane Library, Embase, Scopus, and Google ...

  2. Avaliação do desempenho da tecnologia NeoSoniX TM em cirurgias de catarata Performance evaluation of NeoSoniX TM technology in cataract surgery

    Leonardo Akaishi

    2006-06-01

    Full Text Available OBJETIVOS: As técnicas e resultados da cirurgia de catarata melhoraram drasticamente com o avanço tecnológico. Um dos motivos para melhoria seria a menor utilização de ultra-som com novos aparelhos de facoemulsificação. O objetivo deste estudo é confirmar na prática a vantagem teórica da caneta NeoSoniX TM. MÉTODOS: Foi realizada uma análise na qual os autores compararam resultados dos parâmetros registrados pelo aparelho de facoemulsificação Legacy durante 300 cirurgias de catarata realizadas com caneta de ultra-som (handpiece convencional e 100 com a caneta NeoSoniX TM. Todas as cirurgias foram realizadas pelo mesmo cirurgião, com a mesma técnica cirúrgica. A escolha da "handpiece" foi aleatória, sendo comparadas, em relação ao grau de dureza das cataratas, os parâmetros de tempo do ultra-som, quantidade de solução salina balanceada e porcentagem de "average power" utilizadas durante as cirurgias. RESULTADOS: Foi realizada análise retrospectiva numa série cronológica de casos, mostrando que em qualquer que seja o grau de dureza da catarata, o tempo de utilização do ultra-som com a caneta NeoSoniX foi inferior ao da caneta convencional (pPURPOSE: The techniques and results of cataract surgery have improved dramatically with technological advancements. One of the reasons for this improvement would be the reduced use of ultrasound with the new phacoemulsification devices. The objective of this study is to confirm the theoretical advantage of the NeoSoniX handpiece. METHODS: The authors compared the results of the parameters recorded by the Legacy phacoemulsification system during 300 cataract surgeries performed with the use of the conventional ultrasound handpiece and 100 performed with the innovative NeosonixTM. All surgeries were performed by the same senior surgeon, using the same surgical technique. The choice of handpiece was random. The handpieces were compared considering cataract grade of hardness, in relation to parameters of ultrasound time, amount of balanced saline solution, and percentage of average power used during surgery. RESULTS: The analysis performed retrospectively on a chronological series of cases showed that the time of ultrasound used with the NeoSoniX handpiece was inferior to that with the conventional handpiece, for any cataract grade of hardness (p<0.000001. The volume of balanced saline solution used during surgical procedures was smaller, favoring the NeoSoniX technology (p<0.000001. In relation to the percentage of ultrasound energy used with the different technologies, an inferior value was found in the group who underwent surgery with the use of the NeoSoniX handpiece (p<0.000001. CONCLUSIONS: Based on the information provided by these surgeries, we may claim that there was a significant superiority when using the NeoSoniX handpiece in comparison to the conventional Legacy machine handpiece in cataract surgeries, regardless of cataract grade.

  3. Uso de C3F8 no descolamento da membrana de Descemet pós-facectomia C3F8 use in Descemet detachment after cataract surgery

    Abrahão da Rocha Lucena

    2006-06-01

    Full Text Available INTRODUÇÃO: O descolamento da membrana de Descemet é complicação rara, mas devastadora após facectomia. Algumas alternativas têm sido usadas para reposição da Descemet: bolha de ar, sutura com transfixação da córnea, viscoelástico associado com bolha de ar e gás SF6 ou C3F8. O transplante de córnea é o último recurso utilizado. OBJETIVO: Avaliar os resultados anatômicos e funcionais, do descolamento iatrogênico da membrana de Descemet, com uso de C3F8 (16% na câmara anterior em seis olhos pós-facectomia. MÉTODOS: Após colocação de 0,5 ml do gás em câmara anterior avaliou-se localização justa-estromal da membrana de Descemet em lâmpada de fenda. Os olhos com deslocamento superior/central eram orientados a ficar em decúbito elevado por dois dias e no caso do deslocamento inferior solicitamos decúbito dorsal com leve supraversão. RESULTADOS: A média de idade foi de 71,3 ± 9,3 anos, sendo quatro do sexo feminino e dois do sexo masculino. Todos os olhos tiveram sucesso com a colocação do C3F8, havendo aumento da pressão intra-ocular em um caso. O edema corneano regrediu a partir do segundo dia com resolução completa até o quarto dia. A acuidade visual melhorou em todos os casos logo após regressão do edema, sendo reavaliada quarenta e cinco dias depois. CONCLUSÃO: A introdução unicamente do gás C3F8 não expansivo para colar a membrana de Descemet é citado pela primeira vez na literatura brasileira. O restabelecimento da acuidade visual é rápida, o método é seguro, efetivo e de fácil execução, sendo realizado sob anestesia tópica.INTRODUCTION: Descemet's membrane detachment is a rare but serious complication following cataract surgery. Extensive detachments that affect the visual axis may result in poor vision and require penetrating corneal grafts. Some alternatives have been used to reattach Descemet's membrane: air bubble, transcorneal sutures and intracameral viscoelastic gel plus SF6 or C3F8 gas. PURPOSE: To describe the use of non-expanding (16% intracameral C3F8 to reattach Descemet's membrane, in six patients, following cataract surgery. METHODS: The patient's mean age was 71.3 ± 9.3. Four of the patients were females and two masculine. Immediately afters the gas injection the patient was submitted to slit-lamp evaluation to verify the position of Descemet's membrane. The patients who had eyes with central or superior detachments were told to sit upright for two days. The patients whose eyes had inferior detachments were asked to lie on their back. RESULTS: All patients had successful reattachment of Descemet's membrane after the gas injection. We observed increase in intraocular pressure in one case. The corneal edema regressed after the second day with total resolution by the fourth day. Visual acuity improved in all cases after regression of the edema and remained stable after forty-five days. CONCLUSION: The use of non-expanding C3F8 alone for reattaching Descemet's membrane is reported for the first time in the Brazilian literature. Improvement in visual acuity is fast, the method is safe, effective and easily performed under topical anesthesia.

  4. Comparisons of Objective Sleep Quality Between Elderly Individuals With and Without Cataract Surgery: A Cross-Sectional Study of the HEIJO-KYO Cohort

    Kenji Obayashi

    2015-08-01

    Full Text Available Background: Cataract surgery (CS drastically increases the capacity for light reception to the retina. Several previous studies have suggested the beneficial effect of CS on subjectively measured sleep quality; however, the association between CS and objectively measured sleep quality remains uncertain. Methods: To evaluate the association between CS and objectively measured sleep quality in home settings, we conducted a cross-sectional study in 1037 elderly individuals (mean age, 71.9 years. We evaluated actigraphically measured sleep quality, urinary 6-sulfatoxymelatonin excretion, and ambulatory light levels, in addition to CS status. Results: The CS group (n = 174 showed significantly higher sleep efficiency and shorter wake after sleep onset than the no CS group (n = 863, even after adjustment for age, gender, body mass index, current smoking status, alcohol consumption, hypertension, diabetes, sleep medication, bedtime, rising time, daytime physical activity, daytime and nighttime light exposure, and urinary 6-sulfatoxymelatonin excretion (sleep efficiency: 85.8% in the CS group vs 84.4% in the no CS group, P = 0.042; wake after sleep onset: 45.7 min vs 50.6 min, respectively, P = 0.033. In contrast, urinary 6-sulfatoxymelatonin excretion, sleep onset latency, total sleep time, and sleep-mid time did not differ significantly between the CS and no CS groups. Conclusions: Among a community-dwelling elderly population, CS is significantly associated with objectively measured sleep quality, but urinary levels of melatonin metabolite do not differ between individuals with and without CS. These associations are independent of daily light exposure profiles.

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

    Claudete I. Locatelli

    2003-07-01

    Full Text Available 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%. Coagulase-negative staphylococci isolates revealed high resistance to penicillin G followed by tetracycline, chloramphenicol and aminoglicosides. However, these isolates displayed great susceptibility to vancomycin, cephalothin and ofloxacin. Except for penicillin G, Staphylococcus aureus was very sensitive to the antimicrobial agents including oxacillin. Among Gram-negatives, Proteus mirabilis was prevalent and presented high resistance to tetracycline and chloramphenicol. Enterococcus isolates were vancomycin sensitive.A partir de material ocular coletado de 46 pacientes submetidos à cirurgia de catarata foram realizados isolamento, identificação e teste de susceptibilidade de microrganismos frente a antimicrobianos, utilizando-se suabes e lentes intraoculares (LIO. Foram obtidos 76 isolados e identificados 7 tipos de microrganismos. Estafilococos coagulase-negativos (CNS foram os microrganismos mais freqüentemente detectados de suabes (71,4% dos casos, lentes de PMMA (81,3% e lentes de silicone (77,8%. Isolados de CNS apresentaram elevada resistência à penicilina G, seguida por tetraciclina, cloranfenicol e aminoglicosídeos. No entanto, estes isolados mostraram grande sensibilidade à vancomicina, cefalotina e ofloxacina. Com exceção da penicilina G, os isolados de Staphylococcus aureus foram bastante sensíveis aos agentes antimicrobianos, incluindo a oxacilina. Entre as gram-negativas, Proteus mirabilis foi a bactéria mais freqüente e também se mostrou bastante resistente à tetraciclina e ao cloranfenicol. Os isolados de Enterococcus se mostraram sensíveis à vancomicina.

  6. The impact of market oriented reforms on choice and information: a case study of cataract surgery in outer London and Stockholm.

    Fotaki, M

    1999-05-01

    In the early 1990s, a set of market-oriented reforms was introduced into health care systems of the UK and Sweden, two exemplary cases of reliance on planned budgeting and integrated provision of services. In the pursuit of increased efficiency, several County Councils in Sweden have followed the public competition model, while in the UK internal market reforms were introduced. It was expected that the separation of functions of planners and purchasers from those of providers, which were to be freely chosen by the former, would achieve higher allocative efficiency but also enhance users' satisfaction with care. This paper uses cataract surgery as a case study to trace the impact of competition among providers on choice and information. Qualitative research methods were employed to record the perception of changes in their type and amount as it was given to both purchasers and patients. A set of open ended and standardised questionnaires was designed to elicit the views of all actors involved and to measure the likely transformations. Four study sites from Outer London were selected representing the diversity of responses, and the only existing large provider of eye services to Stockholm County Council was used. The analysis of the data showed that the quasi-market reforms have resulted in a change of attitude of providers. Some improvements in the amount and type of information given to purchasers and patients could also be detected, although as far as direct users were concerned, the demand has not been fully satisfied. However, the impact on choice available to patients and purchasers alike seemed to be adverse, an effect that was particularly strong in the UK case. PMID:10369441

  7. Profilaxia e tratamento do edema macular cistoide aps cirurgia de catarata / Prophylaxis and treatment of cystoid macular edema after cataract surgery

    Pedro C., Carricondo; Maria Fernanda, Abalem; Cleide Guimares, Machado; Newton, Kara-Junior.

    2015-04-01

    Full Text Available O edema macular cistoide uma das principais causas de baixa de viso aps cirurgia de catarata. O processo inflamatrio parece ser o principal fator causal do edema. So considerados fatores de risco complicaes cirrgicas, doenas retinianas prvias, diabetes, uvetes e uso de colrios de prosta [...] glandinas. O diagnstico feito clinicamente, mas a angiografia fluorescenica e a tomografia de coerncia ptica tambm so ferramentas importantes para detectar o edema e auxiliar no diagnstico diferencial. Apesar da profilaxia pr-operatria no ter evidncia cientfica, ela preconizada especialmente nos casos com fatores de risco. O tratamento inicial realizado com associao de corticoide e anti-inflamatrio no hormonais tpicos. Os casos crnicos e refratrios tm diversas alternativas de tratamento, sendo o uso de triancinolona e antiangiognicos intravtreos as mais utilizadas. Este artigo se prope a discutir diversos aspectos do edema macular cistoide pseudofcico. Abstract in english Macular cystoid edema is one of the major causes of decreased vision after cataract surgery. The inflammatory process appears to be the main causal factor of the edema. The major risk factors are: surgical complications, previous retinal diseases, diabetes, uveitis and use of prostaglandins drops. T [...] he diagnosis is clinically, but fluorescein angiography and optical coherence tomography are also important to detect swelling and assist in differential diagnosis. Although pre-operative prophylaxis do not have scientific evidence, it is recommended especially in cases with risk factors. The initial treatment includes a combination of both topic corticosteroid and nonsteroidal anti-inflammatory. Chronic and refractory cases can be managed with alternatives treatment, such as intravitreal triamcinolone and anti-angiogenic. This article aims to discuss various aspects of pseudophakic macular cystoid edema.

  8. Historical review of the thyroid gland surgery

    Ignjatovi? Mile D.

    2003-01-01

    Full Text Available Thyroid gland surgery passed through history from the suggestions for prohibition, during middle of XIX century due to unacceptable mortality even for mediaeval conditions, to highest level of surgical art later, as W. Halsted sad. First thyreoidectomy was done by Albucasis (El Zahrawi in 925 A.D, and after him by Roger from Salerno. While Pierre-Joseph Desault in 1791 has done first operation on thyroid gland that can fulfill todays criteria, Theodor Billroth gave scientific grounds of thyroid surgery. Genius attitude and surgical talent of Theodor Kocher raised thyroid surgery on scientific level, brought surgical skills on the top of surgical art pyramid, and brought him personally to the Nobel Prize in 1909. Very important contribution to development of thyroid surgery gave its giants: Johann von Mikulicz, William Halsted, Charles Mayo, George W. Crile and Frank Lahey. Thomas P. Dunhill, F. A. Coller, A. M. Boyden, and many others did important contribution, too. Development of thyroid surgery was constant to nowadays, with tendention for multidisciplinary approach in specialized centers. Thyroid surgery in Serbia followed this world trends, in spite of great problems in this area during history.

  9. Cataract research using electronic health records

    Waudby Carol J

    2011-11-01

    Full Text Available Abstract Background The eMERGE (electronic MEdical Records and Genomics network, funded by the National Human Genome Research Institute, is a national consortium formed to develop, disseminate, and apply approaches to research that combine DNA biorepositories with electronic health record (EHR systems for large-scale, high-throughput genetic research. Marshfield Clinic is one of five sites in the eMERGE network and primarily studied: 1 age-related cataract and 2 HDL-cholesterol levels. The purpose of this paper is to describe the approach to electronic evaluation of the epidemiology of cataract using the EHR for a large biobank and to assess previously identified epidemiologic risk factors in cases identified by electronic algorithms. Methods Electronic algorithms were used to select individuals with cataracts in the Personalized Medicine Research Project database. These were analyzed for cataract prevalence, age at cataract, and previously identified risk factors. Results Cataract diagnoses and surgeries, though not type of cataract, were successfully identified using electronic algorithms. Age specific prevalence of both cataract (22% compared to 17.2% and cataract surgery (11% compared to 5.1% were higher when compared to the Eye Diseases Prevalence Research Group. The risk factors of age, gender, diabetes, and steroid use were confirmed. Conclusions Using electronic health records can be a viable and efficient tool to identify cataracts for research. However, using retrospective data from this source can be confounded by historical limits on data availability, differences in the utilization of healthcare, and changes in exposures over time.

  10. Developments in flexible endoscopic surgery: a review

    Feussner H

    2014-12-01

    Full Text Available Hubertus Feussner,1 Valentin Becker,2 Margit Bauer,1 Michael Kranzfelder,1 Rebekka Schirren,1 Tim Lth,3 Alexander Meining,2 Dirk Wilhelm1 1Department of Surgery, 22nd Medical Department, 3Institute of Microtechnology and Medical Device Technology, Klinikum rechts der Isar, Technische Universitt Mnchen, Germany Abstract: Flexible endoscopy is increasingly developing into a therapeutic instead of a purely diagnostic discipline. Improved visualization makes early lesions easily detectable and allows us to decide ad hoc on the required treatment. Deep enteroscopy allows the exploration of even the small bowel for long a "white spot" for gastrointestinal endoscopy and to perform direct treatment. Endoscopic submucosal dissection is a considerable step forward in oncologically correct endoscopic treatment of (early malignant lesions. Though still technically challenging, it is increasingly facilitated by new manipulation techniques and tools that are being steadily optimized. Closure of wall defects and hemostasis could be improved significantly. Even the anatomy beyond the gastrointestinal wall is being explored by the therapeutic use of endoluminal ultrasound. Endosonographic-guided surgery is not only a suitable fallback solution if conventional endoscopic retrograde cholangiopancreatography fails, but even makes necrosectomy procedures, abscess drainage, and neurolysis feasible for the endoscopist. Newly developed endoscopic approaches aim at formerly distinctive surgical domains like gastroesophageal reflux disease, appendicitis, and cholecystitis. Combined endoscopic/laparoscopic interventional techniques could become the harbingers of natural orifice transluminal endoscopic surgery, whereas pure natural orifice transluminal endoscopic surgery is currently still in its beginnings. Keywords: flexible endoscopic surgery, endoscopic ultrasound, advanced techniques, natural orifice transluminal endoscopic surgery

  11. A comprehensive review of Cataract (Kaphaja Linganasha) and its Surgical Treatment in Ayurvedic Literature

    Dhiman, K. S; Dhiman, Kamini; Puri, Samita; Ahuja, Deepak

    2010-01-01

    Ayurveda the science of life, since its origin is serving the mankind throughout in health & disease state of life. Shalakyatantra, one of its specialized branch deals with the science of Ophthalmology, Otorhinolaryngology, Orodental surgery & Head; was contributed and developed by Rajrishi Nimi, the King of Videha, who was a colleague of Atreya, Punarvasu, Dhanwantri, Bharadwaja, Kashyapa etc. The available literature related to this speciality is reproduced from original text of Nimitantra ...

  12. Visual outcomes of bilateral congenital and developmental cataracts in young children in south India and causes of poor outcome

    Rohit C Khanna

    2013-01-01

    Full Text Available Context: Bilateral pediatric cataracts are important cause of visual impairment in children. Aim: To study the outcome of bilateral pediatric cataract surgery in young children. Setting and Design: Retrospective case series in a tertiary center. Materials and Methods: Records of pediatric cataracts operated between January 2001 and December 2003, with a minimum follow-up of 3 months, were reviewed retrospectively. Statistical Methods: Independent sample t-test, Fisher?s exact test, and logistic regression using SPSS (Statistical Package for Social Science, Chicago, USA version 12. Results: 215/257 (83.7% patients had a minimum follow-up of 3 months. The mean age of presentation to the hospital was 53 months (range: 0-168 months. Congenital cataract was present in 107 patients (58.2% and developmental cataract in 77 patients (41.8%. The mean age at surgery was 55.2 months (range: 1-168 months. Out of 430 eyes, 269 (62.6% had an intraocular lens implanted. The mean duration of follow-up was 13.1 months (range: 3-38 months. Pre-operatively, 102 patients (47.3% had visual acuity 6/18. The most common early post-operative complication was fibrinous uveitis in 57 eyes (13.3% and the most common delayed post-operative complication was posterior capsular opacification in 118 eyes (27.4%. The most important prognostic factor for poor outcome was congenital cataract (odds ratio [OR]: 26.3; 95% confidence interval [CI], 4.4-158.5 and total cataract (OR: 4.8; 95% CI, 1.3-17. Conclusion: Nearly half of the eyes had visual acuity >6/18. The outcome was poorer in congenital cataracts, especially those operated after >1 year of age.

  13. Final visual outcome following re exploration of cataracts performed by trainee surgeons in India

    Mehul A Shah

    2011-01-01

    Full Text Available Objective: To investigate the outcome of secondary intraocular lens implantation, compare final visual outcome between different categories of surgeon, and evaluate care provided by teaching hospitals to patients with capsular complications. Materials and Methods: Setting: Teaching hospital. Design: Retrospective study. Subjects were recruited by examination of electronic medical records. All patients operated for corrective surgery following capsular complications during cataract surgery were included. All patient medical records were reviewed, and data were collected for 359 eyes. Main outcome measures: Visual acuity and major complications. All collected data were entered into Microsoft Excel and analyzed by SPSS 17 software using cross tabulation and Chi-squared tests. Results: Surgical intervention made a significant difference to the final visual outcome (P < 0.001. The category of the trainee had a significant effect on the final visual outcome (P = 0.021. Conclusion: Capsular complications during cataract surgery should be surgically treated to improve outcome.

  14. Pregnancy after bariatric surgery - a review of benefits and risks

    Kjær, Mette Karie Mandrup; Nilas, Lisbeth

    2013-01-01

    Background. When other weight loss attempts have failed, bariatric surgery offers a successful alternative against obesity. Since operations are performed during women´s reproductive years, the number of pregnant women with prior bariatric surgery is increasing. Bariatric surgery results in...... restriction of food intake and/or malabsorption leading to weight loss, but may induce a risk for malnutrition and pregnancy complications. Method. Systematically conducted review addressing pregnancy after bariatric surgery using the PubMed and Cochrane databases. Main Outcome Measures. Birthweight......, gestational age, birth defects, preeclampsia, gestational diabetes mellitus, and mode of delivery. Results. We included 17 articles in English, comparing pregnancies in women with prior bariatric surgery to pregnancies in a control group without this. There was considerable heterogeneity in study design and...

  15. Efeitos da latanoprosta sobre a espessura foveal em olhos submetidos cirurgia de catarata Influence of topical latanoprost on foveal thickness in eyes that underwent uneventful cataract surgery

    Enyr Saran Arcieri

    2008-10-01

    Full Text Available OBJETIVO: Avaliar prospectivamente com o uso da tomografia de coerncia ptica se o uso tpico de latanoprosta induz alteraes retinianas em pacientes submetidos cirurgia de catarata. MTODOS: Estudo clnico randomizado, com observador mascarado e um ms de durao. Pacientes pseudofcicos foram tratados com latanoprosta (n=10 ou lubrificante ocular uma vez ao dia (grupo controle - placebo (n=10. Metade dos pacientes de cada grupo possua capsulotomia posterior (Nd:YAG laser. Avaliamos o status da barreira hemato-retiniana pela medida da espessura retiniana na fvea com a tomografia de coerncia ptica. Exames de tomografia de coerncia ptica e medida da acuidade visual foram realizados antes do incio do estudo e com 15 e 30 dias de tratamento. RESULTADOS: No foi observada alterao significante na mdia da espessura foveal do grupo controle (p>0,0610. Houve aumento significante na mdia da espessura foveal nos pacientes tratados com latanoprosta (pPURPOSE: To study prospectively using optical coherence tomography whether topical latanoprost induces retinal disorders in patients that underwent cataract surgery. METHODS: Randomized, masked-observer, one-month clinical trial. Pseudophakic patients were treated with latanoprost (n=10 or lubricant drop q.d. (control group (n=10. Half of the patients of each group presented ruptured posterior capsule (Nd:YAG laser. We evaluated the blood-retinal barrier status assessed by optical coherence tomography measurement of retinal thickness in the fovea. Before the beginning of the study and after 15 and 30 days of treatment, optical coherence tomography images were taken, and the visual acuity examination was performed. RESULTS: There was no statistically significant increase in mean foveal thickness when patients instilled placebo (P>0.0610. A statistically significant increase in retinal thickness in the fovea was observed when patients instilled latanoprost (P<0.0004. No changes were observed in visual acuity in both groups. Mean retinal thickness in the fovea was significantly higher in the latanoprost group (P<0.0007. The mean foveal thickness in latanoprost treated eyes with ruptured posterior capsule was statistically greater when compared with that of intact posterior capsule (P<0.0461. When comparing only the patients with that of intact posterior capsule, there was a statistically significant difference in foveal thickness between patients treated with latanoprost (236.4 29.4 mm and placebo (197.8 19.3 mm only at 30 days of treatment. CONCLUSIONS: Latanoprost may lead to disruption of the blood-retinal barrier in pseudophakic patients, and is more probable to occur in patients with ruptured posterior capsule.

  16. Pharmacological Risk Factors for Delirium after Cardiac Surgery: A Review

    Tse, Lurdes; Schwarz, Stephan KW; Bowering, John B; Moore, Randell L; Burns, Kyle D; Richford, Carole M; Osborn, Jill A; Barr, Alasdair M.

    2012-01-01

    Purpose: The objective of this review is to evaluate the literature on medications associated with delirium after cardiac surgery and potential prophylactic agents for preventing it. Source: Articles were searched in MEDLINE, Cumulative Index to Nursing and Allied Health, and EMBASE with the MeSH headings: delirium, cardiac surgical procedures, and risk factors, and the keywords: delirium, cardiac surgery, risk factors, and drugs. Principle inclusion criteria include having patient samples re...

  17. Facts and Myths about Cataracts

    Facts & Myths About Cataracts MYTH: Only older Americans develop cataracts FACT: While cataracts affects nearly 20.5 million Americans age 40 and older, cataracts can occur among young adults or children. Risk ...

  18. Preoperative automatic visual behavioural analysis as a tool for intraocular lens choice in cataract surgery / Anlise comportamental visual automtica pr-operatria como ferramenta para escolha de lente intraocular em cirurgia de catarata

    Heloisa Neumann, Nogueira; Mnica, Alves; Paulo, Schor.

    2015-04-01

    Full Text Available Objetivo: A catarata a principal causa de cegueira e acomete 18 milhes de pessoas no mundo, com maior incidncia na populao acima de 50 anos. A baixa acuidade visual causada pela catarata gera um impacto negativo na qualidade de vida de pacientes. O tratamento atual feito por meio de cirurgi [...] a com a substituio do cristalino opacificado por uma lente intraocular (LIO) que pode ser monofocal ou multifocal. No entanto, a escolha da lente intraocular deve ser cuidadosamente realizada para garantir maior satisfao dos pacientes Assim, o estudo do comportamento visual desses pacientes pode ser uma ferramenta importante para definir qual o melhor tipo de lente intraocular a ser implantada. O presente estudo props a avaliao de uma ferramenta adicional anamnese na a escolha da lente intraocular. Mtodo: Com o uso de uma cmera programada para realizar o registro automtico de fotos, foi documentanda a rotina visual do paciente, a fim de se obterem maiores informaes sobre a frequncia com que o mesmo utiliza a viso para longe, meia distncia ou para perto. Resultados: Os resultados indicaram uma estimativa em porcentagem dessa frequncia, sugerindo que a anlise dos registros fotogrficos da rotina visual de um paciente portador de catarata pode ser de grande ajuda no entendimento do seu comportamento visual e para a escolha da estratgia de reabilitao visual aps a cirurgia de catarata e, inclusive, despertar o interesse pela confeco de lentes intraoculares personalizadas de acordo com as necessidades de cada paciente. Abstract in english Purpose: Cataract is the main cause of blindness, affecting 18 million people worldwide, with the highest incidence in the population above 50 years of age. Low visual acuity caused by cataract may have a negative impact on patient quality of life. The current treatment is surgery in order to repla [...] ce the natural lens with an artificial intraocular lens (IOL), which can be mono- or multifocal. However, due to potential side effects, IOLs must be carefully chosen to ensure higher patient satisfaction. Thus, studies on the visual behavior of these patients may be an important tool to determine the best type of IOL implantation. This study proposed an anamnestic add-on for optimizing the choice of IOL. Methods: We used a camera that automatically takes pictures, documenting the patients visual routine in order to obtain additional information about the frequency of distant, intermediate, and near sights. Results: The results indicated an estimated frequency percentage, suggesting that visual analysis of routine photographic records of a patient with cataract may be useful for understanding behavioural gaze and for choosing visual management strategy after cataract surgery, simultaneously stimulating interest for customized IOL manufacturing according to individual needs.

  19. Capsulorhexis contraction after cataract surgery

    Corydon, Charlotte; Lindholt, Michael; Knudsen, Ellen B; Graakjaer, Jesper; Corydon, Thomas J; Dam-Johansen, Mikael

    2007-01-01

    PURPOSE: To evaluate the reduction in the anterior capsule opening after phacoemulsification, continuous curvilinear capsulorhexis, and implantation of 1 of 2 acrylic intraocular lenses (IOLs). SETTING: Department of Ophthalmology, Vejle Hospital, Vejle, Denmark. METHODS: Eighty-four patients (84...

  20. Visual recovery and predictors of visual prognosis after managing traumatic cataracts in 555 patients

    Mehul Shah

    2011-01-01

    Full Text Available The aim was to evaluate the visual recovery after managing traumatic cataracts and determine the predictors of a better visual prognosis. This was a prospective study. We enrolled patients with specific inclusion criteria, examined their eyes to review the comorbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were reexamined 6 weeks postoperatively. We divided the cases of traumatic cataract into two groups, the "open globe" (Group 1 and "closed globe" (Group 2 groups, according to the ocular trauma based on the Birmingham Eye Trauma Terminology System (BETTS and compared the determinants of visual acuity. Our cohort of 555 eyes with traumatic cataracts included 394 eyes in Group 1 and 161 in Group 2. Six weeks postoperatively, the visual acuity in the operated eye was >20/60 in 193 (48% and 49 (29% eyes in Groups 1 and 2, respectively (P = 0.002, ANOVA. At follow-up, >20/60 vision was significantly higher in Group 1 than in Group 2 (OR = 1.61; 95% CI, 0.85-3.02. Overall 242 (43.5% eyes gained a final visual acuity of >20/60. Open globe injury has a favorable prognosis for satisfactory (>20/60 visual recovery after the management of traumatic cataracts.

  1. Cataract incidence after total-body irradiation

    Purpose: The aim of this retrospective study was to evaluate cataract incidence in a homogeneously-treated group of patients after total-body irradiation (TBI) followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Methods and Materials: Between 1982 and 1994, a total of 260 patients received either autologous bone marrow or blood stem cell transplantation for hematological malignancy at the University of Heidelberg. Two hundred nine of these patients received TBI in our hospital. Radiotherapy was applied as hyperfractionated TBI, with a median dose of 14.4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 h. Photons with an energy of 23 MeV were used with a dose rate of 7-18 cGy/min. Ninety-six of the 209 irradiated patients were still alive in 1996; 86 of these patients (52 men, 33 women) answered a questionnaire and could be examined ophthalmologically. The median age at time of TBI was 38.5 years, with a range of 15-59 years. Results: The median follow-up is now 5.8 years, with a range of 1.7-13 years. Cataract occurred in 28/85 patients (32.9%) after a median of 47 months (1-104 months). In 6 of 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to TBI had been performed more often in the group of patients developing cataract (14.3%) versus 10.7% in the group of patients without cataract. However, there was no statistical difference (Chi-square, p > 0.05). Conclusion: Cataract is a common side effect of TBI. Cataract incidence found in our patients is comparable to results of other centers using a fractionated regimen for TBI. To assess the incidence of cataract after TBI, a long-term follow-up is required

  2. Nutritional modulation of cataract

    Cataract, or lens opacification, remains a major cause of blindness worldwide. Cataracts reduce vision in over eighty million people, causing blindness in eighteen million people. The number afflicted by cataract will increase dramatically as the proportion of the elderly global population increase...

  3. A Review of Psychosocial Outcomes for Patients Seeking Cosmetic Surgery

    Honigman, Roberta J.; Phillips, Katharine A.; Castle, David J

    2004-01-01

    The authors reviewed the literature on psychological and psychosocial outcomes for individuals undergoing cosmetic surgery, to address whether elective cosmetic procedures improve psychological well-being and psychosocial functioning and whether there are identifiable predictors of an unsatisfactory psychological outcome. They conducted a search of appropriate computerized databases for studies that evaluated psychological and psychosocial status both before and after elective cosmetic surger...

  4. Single-port laparoscopic rectal surgery - a systematic review

    Lolle, Ida; Rosenstock, Steffen; Bulut, Orhan

    2014-01-01

    INTRODUCTION: Single-port laparoscopic surgery (SPLS) for colonic disease has been widely described, whereas data for SPLS rectal resection are sparse. This review aimed to evaluate the feasibility, safety and complication profile of SPLS for rectal diseases. METHODS: A systematic literature search...

  5. Epidemiology of 411140 cataract operations performed in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012

    Solborg Bjerrum, Sren; Mikkelsen, Kim Lyngby; la Cour, Morten

    2015-01-01

    PURPOSE: To study the epidemiology and mortality in patients who had cataract surgery in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012 and to assess the validity of the Danish cataract registries. METHODS: Register- and chart-based study. RESULTS: A total of 411...... 140 cataract operations were performed in 243 856 patients. Patients who had cataract surgery in public hospitals had an overall statistically significantly 62% higher mortality compared to patients who had cataract surgery in private hospitals/clinics. The decrease in mean age at first eye cataract...... surgery in private hospitals/clinics was statistically significantly greater compared to the decrease in mean age at first eye cataract surgery in public hospitals (p < 0.001). The median time interval between first and second eye cataract surgery decreased statistically significantly during the study...

  6. Current surgery of retinal detachment recurrence. Review

    V. D. Zakharov

    2014-07-01

    Full Text Available this review presents a detailed analysis and an experience of surgical treatment of retinal detachment recurrence associated with light silicone oil tamponade of vitreous cavity. Approaches and variants of treatment were described in the historical aspect and till now. there are considered general and particular issues in case of retinal detachment recurrence appearance, expediency and volume of intraoperative manipulations, time of operation and choice of temporary substitute of vitreous body for a purpose of postoperative tamponade of vitreous cavity.

  7. Oculoplastic surgery in Madagascar: a review

    JH Norris; Gale RP; Nkumbe, H; OC Backhouse; Bernadin, P; BY Chang

    2009-01-01

    The aim of this study was to review the oculoplastic practices in Madagascar, including the nature of presenting disease and the surgical procedures performed. The study formed part of the initial phase of a training link between Madagascar and Leeds University Teaching Hospitals Trust. We hoped to identify areas of practice that required more specific surgical training. To our knowledge, this is one of the first studies looking specifically at oculoplastic disease prevalence in Madagascar or...

  8. Oculoplastic surgery in Madagascar: a review

    JH Norris

    2009-06-01

    Full Text Available The aim of this study was to review the oculoplastic practices in Madagascar, including the nature of presenting disease and the surgical procedures performed. The study formed part of the initial phase of a training link between Madagascar and Leeds University Teaching Hospitals Trust. We hoped to identify areas of practice that required more specific surgical training. To our knowledge, this is one of the first studies looking specifically at oculoplastic disease prevalence in Madagascar or any African country.

  9. A COMPARATIVE STUDY OF EARLY POST OPERATIVE CORNEAL COMPLICATIONS OF MANUAL SMALL INCISION CATARACT SURGERY BY FOUR TECHNIQUES OF NUCLEUS EXPRESSION

    Ananth Bhandary; Sathyendranath B; Pradeep; Jasna Rabia

    2015-01-01

    AIM: To study the early post - operative corneal complications arising from the 4 techniques of nucleus expression. To study the resultant post - operative visual acuity from the 4 techniques of nucleus expression . MATERIALS AND METHODS: 100 patients with senile cataract were selected fr om those attending ophthalmology OPD, M. S. Ramaiah Medical College and those attending camps. They were divided by simple random sampling into 4 groups ...

  10. Review of contemporary role of robotics in bariatric surgery

    Vivek Bindal

    2015-01-01

    Full Text Available With the rise in a number of bariatric procedures, surgeons are facing more complex and technically demanding surgical situations. Robotic digital platforms potentially provide a solution to better address these challenges. This review examines the published literature on the outcomes and complications of bariatric surgery using a robotic platform. Use of robotics to perform adjustable gastric banding, sleeve gastrectomy, roux-en-y gastric bypass (RYGB, biliopancreatic diversion with duodenal switch and revisional bariatric procedures (RBP is assessed. A search on PubMed was performed for the most relevant articles in robotic bariatric surgery. A total of 23 articles was selected and reviewed in this article. The review showed that the use of robotics led to similar or lower complication rate in bariatric surgery when compared with laparoscopy. Two studies found a significantly lower leak rate for robotic gastric bypass when compared to laparoscopic method. The learning curve for RYGB seems to be shorter for robotic technique. Three studies revealed a significantly shorter operative time, while four studies found a longer operative time for robotic technique of gastric bypass. As for the outcomes of RBP, one study found a lower complication rate in robotic arm versus laparoscopic and open arms. Most authors stated that the use of robotics provides superior visualisation, more degrees of freedom and better ergonomics. The application of robotics in bariatric surgery seems to be a safe and feasible option. Use of robotics may provide specific advantages in some situations, and overcome limitations of laparoscopic surgery. Large and well-designed randomised clinical trials with long follow-up are needed to further define the role of digital platforms in bariatric surgery.

  11. Robotic surgery in trauma and orthopaedics: a systematic review.

    Karthik, K; Colegate-Stone, T; Dasgupta, P; Tavakkolizadeh, A; Sinha, J

    2015-03-01

    The use of robots in orthopaedic surgery is an emerging field that is gaining momentum. It has the potential for significant improvements in surgical planning, accuracy of component implantation and patient safety. Advocates of robot-assisted systems describe better patient outcomes through improved pre-operative planning and enhanced execution of surgery. However, costs, limited availability, a lack of evidence regarding the efficiency and safety of such systems and an absence of long-term high-impact studies have restricted the widespread implementation of these systems. We have reviewed the literature on the efficacy, safety and current understanding of the use of robotics in orthopaedics. PMID:25737510

  12. Impact of Cataract Surgery on the Psychological State of the Elderly Repercusión de la cirugía de catarata en el estado psicológico del adulto mayor

    Aleima Rodríguez Carvajal

    2011-04-01

    Full Text Available Background: Progressively aging populations are one of the most distinctive demographic phenomena of the last decades. The elderly represent a particular risk group because typical characteristics of this stage of life, commonly associated with loss, are added to regular causes of psychopathologic disorders in today's social life. Objective: To assess the impact of cataract surgery on the psychological state of the elderly. Methods: A descriptive correlational study was conducted. The sample included 80 elder patients who attended the outpatient cataract pre-surgery consultation in the General University Hospital of Cienfuegos. They all presented some kind of affective disorder. The following psychosocial variables were analyzed: anxiety, depression, self-esteem and lifestyle. Sociodemographic variables such as age, sex, skin color, personal address, people they live with, education and occupation were also considered. Results: Predominant groups were those of females, white skinned, over 71 years old, average school level, married, living in urban residences and within a multigenerational household. Depression levels were high (30 % before surgery. After surgery they decreased in a 5 %. High levels of anxiety also decreased from 53 % to 10 %. Inadequate self-esteem before surgery (65 % decreased to 20 % after surgery. Conclusions: Cataract surgery has a favorable effect on the psychological status of the elderly.Fundamento: el progresivo envejecimiento poblacional es uno de los fenómenos demográficos más característicos de las últimas décadas, los ancianos constituyen un grupo de riesgo, pues a los factores desencadenantes de trastornos psicopatológicos propios de la sociedad actual se le asocian otros más específicos inherentes a la etapa de pérdida que constituye la ancianidad. Objetivo: valorar la repercusión de la cirugía de catarata en el estado psicológico del adulto mayor. Métodos: estudio descriptivo correlacional que incluyó 80 ancianos que acudieron a la consulta de pre operatorio de catarata del Hospital de Cienfuegos, con alguna afectación en el funcionamiento afectivo. Se analizaron variables psicosociales como ansiedad, depresión, autovaloración, estilo de vida y variables sociodemográficas como edad, sexo, color de la piel, residencia, convivencia, escolaridad y ocupación. Resultados: predominaron el sexo femenino, color de piel blanca y los mayores de 71 años, con escolaridad media, casados, de residencia urbana, que viven en el seno de una familia multigeneracional. El grado de depresión alta (30 % antes de la cirugía, bajó a 5 % después de esta; asimismo la ansiedad alta descendió de un 53 % a un 10 %; la autovaloración inadecuada antes de la operación (65 % descendió a 20 % después de ella. Conclusiones: la operación de catarata repercute favorablemente en el estado psicológico del adulto mayor.

  13. At the frontiers of surgery: review

    Upile, Tahwinder

    2011-02-09

    Abstract The complete surgical removal of disease is a desirable outcome particularly in oncology. Unfortunately much disease is microscopic and difficult to detect causing a liability to recurrence and worsened overall prognosis with attendant costs in terms of morbidity and mortality. It is hoped that by advances in optical diagnostic technology we could better define our surgical margin and so increase the rate of truly negative margins on the one hand and on the other hand to take out only the necessary amount of tissue and leave more unaffected non-diseased areas so preserving function of vital structures. The task has not been easy but progress is being made as exemplified by the presentations at the 2nd Scientific Meeting of the Head and Neck Optical Diagnostics Society (HNODS) in San Francisco in January 2010. We review the salient advances in the field and propose further directions of investigation.

  14. Bariatric surgery: A review of normal postoperative anatomy and complications

    Quigley, S., E-mail: shaun.quigley@bartsandthelondon.nhs.uk [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Colledge, J. [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Mukherjee, S. [Bariatric Surgery Unit, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Patel, K. [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom)

    2011-10-15

    The number of bariatric surgery procedures performed is increasing every year. Patients may be referred for radiological investigations to exclude complications not only in the early postoperative period but many months later. Radiologists who do not work in bariatric centres are therefore required to have an understanding of the complex normal anatomy and complications associated with bariatric surgery to interpret imaging studies correctly. The purpose of this article is to describe the surgical techniques and normal anatomy of the four bariatric operations performed today, review the most common problems encountered in this patient group, and to describe the imaging findings that allow the accurate diagnosis of complications. In particular, we focus on identification of the internal hernia, a grave complication of bariatric surgery often missed by radiologists.

  15. [Body dysmorphic disorder and aesthetic surgery: A systematic review].

    Kerfant, N; Henry, A-S; Ta, P; Trimaille, A; Philandrianos, C; Hu, W

    2015-12-01

    Patients suffering from body dysmorphic disorder (BDD) are preoccupied with an imagined or minor defect in appearance that causes significant distress and impairment in social and occupational functioning. Despite a rate of up to 15% of BDD patients reported in cosmetic surgery settings, there is no consensus on the best management for these patients. The main purpose of this article was to conduct a literature review on BDD and cosmetic surgery. Properly trained healthcare professionals in recognizing and diagnosing this pathology is essential for the delivery of quality psychiatric care while taking into account the high prevalence of body dysmorphic disorder patients in cosmetic surgery and the poor outcome of these patients following cosmetic procedures. PMID:26184610

  16. Outcomes of dogs presented for cataract evaluation: a retrospective study.

    Adkins, Elizabeth A; Hendrix, Diane V H

    2005-01-01

    Two hundred and forty-four dogs were evaluated for cataracts at the University of Tennessee from January 2001 to December 2002. Fifty-four canine breeds were affected. Odds ratios for cataracts were significantly higher for six purebred dogs (including the cocker spaniel, miniature schnauzer, toy poodle, Boston terrier, miniature poodle, and bichon frise) compared with mixed-breed dogs. One hundred fifty-nine dogs did not have cataract surgery. The most common reason for dogs not having surgery was retinal degeneration (n=66). PMID:15995160

  17. Time series analysis of age related cataract hospitalizations and phacoemulsification

    Moineddin Rahim

    2006-01-01

    Full Text Available Abstract Background Cataract surgery remains a commonly performed elective surgical procedure in the aging and the elderly. The purpose of this study was to utilize time series methodology to determine the temporal and seasonal variations and the strength of the seasonality in age-related (senile cataract hospitalizations and phacoemulsification surgeries. Methods A retrospective, cross-sectional time series analysis was used to assess the presence and strength of seasonal and temporal patterns of age-related cataract hospitalizations and phacoemulsification surgeries from April 1, 1991 to March 31, 2002. Hospital admission rates for senile cataract (n = 70,281 and phacoemulsification (n = 556,431 were examined to determine monthly rates of hospitalization per 100,000 population. Time series methodology was then applied to the monthly aggregates. Results During the study period, age-related cataract hospitalizations in Ontario have declined from approximately 40 per 100,000 to only one per 100,000. Meanwhile, the use of phacoemulsification procedures has risen dramatically. The study found evidence of biannual peaks in both procedures during the spring and autumn months, and summer and winter troughs. Statistical analysis revealed significant overall seasonal patterns for both age-related cataract hospitalizations and phacoemulsifications (p Conclusion This study illustrates the decline in age-related cataract hospitalizations in Ontario resulting from the shift to outpatient phacoemulsification surgery, and demonstrates the presence of biannual peaks (a characteristic indicative of seasonality, in hospitalization and phacoemulsification during the spring and autumn throughout the study period.

  18. Psychological depression and cardiac surgery: a comprehensive review.

    Tully, Phillip J

    2012-12-01

    The psychological and neurological impact of cardiac surgery has been of keen empirical interest for more than two decades although reports showing the prognostic influence of depression on adverse outcomes lag behind the evidence documented in heart failure, myocardial infarction, and unstable angina. The paucity of research to date is surprising considering that some pathophysiological mechanisms through which depression is hypothesized to affect coronary heart disease (e.g., platelet activation, the inflammatory system, dysrhythmias) are known to be substantially influenced by the use of cardiopulmonary bypass. As such, cardiac surgery may provide a suitable exemplar to better understand the psychiatric mechanisms of cardiopathogenesis. The extant literature is comprehensively reviewed with respect to the deleterious impact of depression on cardiac and neuropsychological morbidity and mortality. Research to date indicates that depression and major depressive episodes increase major cardiovascular morbidity risk after cardiac surgery. The association between depressive disorders and incident delirium is of particular relevance to cardiac surgery staff. Contemporary treatment intervention studies are also described along with suggestions for future cardiac surgery research. PMID:23441564

  19. Laparoscopic surgery: a narrative review of pharmacotherapy in pain management.

    Sjövall, Sari; Kokki, Merja; Kokki, Hannu

    2015-11-01

    Laparoscopic surgery is widespread, and an increasing number of surgeries are performed laparoscopically. Early pain after laparoscopy can be similar or even more severe than that after open surgery. Thus, proactive pain management should be provided. Pain after laparoscopic surgery is derived from multiple origins; therefore, a single agent is seldom sufficient. Pain is most effectively controlled by a multimodal, preventive analgesia approach, such as combining opioids with non-opioid analgesics and local anaesthetics. Wound and port site local anaesthetic injections decrease abdominal wall pain by 1-1.5 units on a 0-10 pain scale. Inflammatory pain and shoulder pain can be controlled by NSAIDs or corticosteroids. In some patient groups, adjuvant drugs, ketamine and α2-adrenergic agonists can be helpful, but evidence on gabapentinoids is conflicting. In the present review, the types of pain that need to be taken into account while planning pain management protocols and the wide range of analgesic options that have been assessed in laparoscopic surgery are critically assessed. Recommendations to the clinician will be made regarding how to manage acute pain and how to prevent persistent postoperative pain. It is important to identify patients at the highest risk for severe and prolonged post-operative pain, and to have a proactive strategy in place for these individuals. PMID:26493289

  20. Review of contemporary role of robotics in bariatric surgery

    Vivek Bindal; Parveen Bhatia; Usha Dudeja; Sudhir Kalhan; Mukund Khetan; Suviraj John; Sushant Wadhera

    2015-01-01

    With the rise in a number of bariatric procedures, surgeons are facing more complex and technically demanding surgical situations. Robotic digital platforms potentially provide a solution to better address these challenges. This review examines the published literature on the outcomes and complications of bariatric surgery using a robotic platform. Use of robotics to perform adjustable gastric banding, sleeve gastrectomy, roux-en-y gastric bypass (RYGB), biliopancreatic diversion with duodena...

  1. Adjacent level disease following lumbar spine surgery: A review

    Epstein, Nancy E.

    2015-01-01

    Background: Instrumented lumbar spine surgery is associated with an increased risk of adjacent segment disease (ASD). Multiple studies have explored the various risk factors contributing to ASD that include; fusion length (especially, three or more levels), sagittal malalignment, facet injury, advanced age, and prior cephalad degenerative disease. Methods: In this selective review of ASD, following predominantly instrumented fusions for lumbar degenerative disease, patients typically unde...

  2. Weight recidivism post-bariatric surgery: a systematic review.

    Karmali, Shahzeer; Brar, Balpreet; Shi, Xinzhe; Sharma, Arya M; de Gara, Christopher; Birch, Daniel W

    2013-11-01

    Obesity is considered a worldwide health problem of epidemic proportions. Bariatric surgery remains the most effective treatment for patients with severe obesity, resulting in improved obesity-related co-morbidities and increased overall life expectancy. However, weight recidivism has been observed in a subset of patients post-bariatric surgery. Weight recidivism has significant medical, societal and economic ramifications. Unfortunately, there is a very limited understanding of how to predict which bariatric surgical patients are more likely to regain weight following surgery and how to appropriately treat patients who have regained weight. The objective of this paper is to systematically review the existing literature to assess the incidence and causative factors associated with weight regain following bariatric surgery. An electronic literature search was performed of the Medline, Embase and Cochrane library databases along with the PubMed US national library from January 1950 to December 2012 to identify relevant articles. Following an initial screen of 2,204 titles, 1,437 abstracts were reviewed and 1,421 met exclusion criteria. Sixteen studies were included in this analysis: seven case series, five surveys and four non-randomized controlled trials, with a total of 4,864 patients for analysis. Weight regain in these patients appeared to be multi-factorial and overlapping. Aetiologies were categorized as patient specific (psychiatric, physical inactivity, endocrinopathies/metabolic and dietary non-compliance) and operation specific. Weight regain following bariatric surgery varies according to duration of follow-up and the bariatric surgical procedure performed. The underlying causes leading to weight regain are multi-factorial and related to patient- and procedure-specific factors. Addressing post-surgical weight regain requires a systematic approach to patient assessment focusing on contributory dietary, psychologic, medical and surgical factors. PMID:23996349

  3. Are We Monitoring the Quality of Cataract Surgery Services? A Qualitative Situation Analysis of Attitudes and Practices in a Large City in South Africa

    Haastrup, Oluwatosin O. O.; Buchan, John C.; Cassels-Brown, Andy; Cook, Colin

    2015-01-01

    Purpose: To evaluate the current quality “assurance” and “improvement” mechanisms, the knowledge, attitudes and practices of cataract surgeons in a large South African city. Methodology: A total of 17 in-depth semi-structured interviews were conducted with ophthalmologists in June 2012 at 2 tertiary institutions in the Republic of South Africa. Recruitment of the purposive sample was supplemented by snowball sampling. The study participants were 5 general ophthalmologists and 2 pediatric ophthalmologists; 4 senior and 4 junior registrars and a medical officer. Participants were interviewed by a trained qualitative interviewer. The interview lasted between 20 and 60 min. The interviews were recorded, transcribed verbatim and analyzed for thematic content. Results: Mechanisms for quality assurance were trainee logbooks and subjective senior staff observation. Clinicians were encouraged, but not obliged to self-audit. Quality improvement is incentivized by personal integrity and ambition. Poorly performing departments are inconspicuous, especially nationally, and ophthalmologists rely on the impression to gauge the quality of service provided by colleagues. Currently, word of mouth is the method for determining the better cataract surgical centers. Conclusion: The quality assurance mechanisms were dependent on insight and integrity of the individual surgeons. No structures were described that would ensure the detection of surgeons with higher than expected complication rates. Currently, audits are not enforced, and surgical outcomes are not well monitored due to concerns that this may lead to lack of openness among ophthalmologists. PMID:25949081

  4. Epidemiology and molecular genetics of congenital cataracts.

    Yi, Jun; Yun, Jun; Li, Zhi-Kui; Xu, Chang-Tai; Pan, Bo-Rong

    2011-01-01

    Congenital cataract is a crystallin severe blinding disease and genetic factors in disease development are important. Crystallin growth is under a combination of genes and their products in time and space to complete the coordination role of the guidance. Congenital cataract-related genes, included crystallin protein gene (CRYAA, CRYAB, CRYBA1/A3, CRYBA4, CRYBB1, CRYBB2, CRYBB3, CRYGC, CRYGD, CRYGS), gap junction channel protein gene (GJA1, GJA3, GJA8), membrane protein gene (GJA3, GJA8, MIP, LIM2), cytoskeletal protein gene (BF-SP2), transcription factor genes (HSF4, MAF, PITX3, PAX6), ferritin light chain gene (FTL), fibroblast growth factor (FGF) and so on. Currently, there are about 39 genetic loci isolated to which primary cataracts have been mapped, although the number is constantly increasing and depends to some extent on definition. We summarized the recent advances on epidemiology and genetic locations of congenital cataract in this review. PMID:22553694

  5. Limitantes en la cirugía de catarata desde una perspectiva científico- tecnológica Limiting factors in the surgery of cataracts from a scientific-technological perspective

    Janet González Sotero

    2011-09-01

    Full Text Available Objetivo: valorar la cirugía de catarata desde la perspectiva científico-tecnológica y su impacto social en el contexto del subdesarrollo. Método: se realizó un estudio exploratorio en el periodo comprendido de octubre a diciembre de 2010 sobre el tema. Se utilizaron los buscadores médicos: Medline, Ebesco, Hinari, Scielo y otros. Se resumió la información en vistas a la presentación del informe final de la investigación. Además, se empleó la entrevista a expertos. Desarrollo: las Ciencias Médicas constituyen un ejemplo de la interacción ciencia-tecnología-sociedad, y la Oftalmología que no ha estado ajena a estos problemas actuales, entre los que se encuentra la alta prevalencia de ceguera por catarata, cuyo tratamiento es quirúrgico, y con respecto al cual existe un gran desarrollo técnico y científico. A pesar de ello, el número de personas ciegas por esta causa es de millones, estando ubicados la mayoría de los casos no caprichosamente en los países no desarrollados. Conclusiones: las principales limitantes sociales para la cirugía de catarata son: falta de mano de obra entrenada e insumos, elevado costo de la cirugía, falta de calidad en los servicios, lejanía de los hospitales, barreras sociales y culturales, desconocimiento acerca de los servicios, miedo a los resultados negativos de la cirugía y falta de voluntad política de los gobiernos. Cuba cuenta con un programa nacional de prevención de ceguera y constituye un paradigma dentro de la Oftalmología mundial.Objective: to assess the surgery of cataracts from a scientific-technological perspective and its social impact in the underdeveloped context. Method: an exploratory study from October to December 2010 about the topic. The theme was sought out in the Bibliographic Database of Medline, Ebsco, Hinari, Scielo and others. The information was collected to write the final report of the research, as well as interviews to experts. Development: Medical Sciences constitute an example of the interaction science-technology-society and Ophthalmology has always been aware of current problems, among them the prevalence of blindness due to cataracts, which treatment is surgical, where technical and scientific developments are observed. Despite; there are millions of blind people, the majority of them from the underdeveloped countries capriciously. Conclusion: the main social limiting factors to perform the cataract surgeries are: lack of trained human resources and medical supplies, the high cost of the surgery, lack of quality in health services, remoteness of hospital facilities, social and cultural barriers, ignorance about health services, fears to negative surgery outcomes and lack of political will of the governments. Cuba has designed a national program to prevent blindness and constitutes a worldwide paradigm in Ophthalmology.

  6. Robotic surgery: review of prostate and bladder cancer.

    Sohn, William; Lee, Hak J; Ahlering, Thomas E

    2013-01-01

    Minimally invasive laparoscopic surgery has become to replace many of the open procedures in urology because of the obvious benefits in perioperative morbidity. However, because of the technical challenges and steep learning curve, the adoption of laparoscopy has been limited to only highly skilled laparoscopic surgeons. The introduction of the da Vinci surgical system (Intuitive Surgical Inc, Sunnyvale, Calif) has offered significant technical advantages over laparoscopic surgery. Because of the wide acceptance of robotic-assisted radical prostatectomy over the past decade, it has paved the way for urologists to tackle other complex operations, such as a radical cystectomy to decrease the morbidity of the operation. The goal of this article was to review the history and discuss the application and current status of the robot in both prostate and bladder cancer management. We present our technique of performing a robotic-assisted radical prostatectomy and the application of the robust prostate experience to robotic cystectomy. PMID:23528721

  7. Fluorescein-guided surgery for malignant gliomas: a review.

    Acerbi, Francesco; Cavallo, Claudio; Broggi, Morgan; Cordella, Roberto; Anghileri, Elena; Eoli, Marica; Schiariti, Marco; Broggi, Giovanni; Ferroli, Paolo

    2014-10-01

    Fluorescein is widely used as a fluorescent tracer for many applications. Its capacity to accumulate in cerebral areas where there has been blood-brain barrier damage makes it particularly suitable as a dye for the intraoperative visualization of malignant gliomas (MGs). In this report, we describe the results of a comprehensive review on the use of fluorescein in the surgical treatment of MGs. A comprehensive literature search and review for English-written articles concerning the use of fluorescein in the resection of MGs has been conducted. The search was executed through a PubMed literature search using the following keywords: malignant gliomas, glioblastomas, high-grade gliomas, YELLOW 560, total removal, dedicated filter, neurosurgery, brain tumors, intracranial tumors, and confocal microscopy. The literature search resulted in the retrieval of 412 evidence-based articles. Of these, 17 were found to be strictly related to the resection of MG with the aid of fluorescein. In addition to these 17, we have included 2 articles derived from a personal database of the corresponding author (FA). The analysis of the articles reviewed revealed three major applications of fluorescein during surgery for MGs that was documented: Fluorescein-guided resection of MGs with white-light illumination, fluorescein-guided resection of MGs with a surgical microscope equipped with a dedicated filter for fluorescein, and confocal microscopy for intraoperative histopathological analysis on MGs. The systemic review conducted on the use of fluorescein in MGs explored the applications and the different modalities in which fluorescein has been used. The data we have gathered indicates that fluorescein-guided surgery is a safe, effective, and convenient technique to achieve a high rate of total removal in MGs. Further prospective comparative trials, however, are still necessary to prove the impact of fluorescein-guided surgery on both progression-free survival and overall survival. PMID:24756415

  8. Iatrogenic neurologic deficit after lumbar spine surgery: A review.

    Ghobrial, George M; Williams, Kim A; Arnold, Paul; Fehlings, Michael; Harrop, James S

    2015-12-01

    Iatrogenic neurologic deficits after lumbar spine surgery are rare complications, but important to recognize and manage. Complications such as radiculopathy, spinal cord compression, motor deficits (i.e. foot drop with L5 radiculopathy), and new onset radiculitis, while uncommon do occur. Attempts at mitigating these complications with the use of neuromonitoring have been successful. Guidance in the literature as to the true rate of iatrogenic neurologic deficit is limited to several case studies and retrospective designed studies describing the management, prevention and treatment of these deficits. The authors review the lumbar spinal surgery literature to examine the incidence of iatrogenic neurologic deficit in the lumbar spinal surgery literature. An advanced MEDLINE search conducted on May 14th, 2015 from January 1, 2004 through May 14, 2015, using the following MeSH search terms "postoperative complications," then subterms "lumbar vertebrae," treatment outcome," "spinal fusion," and "radiculopathy" were included together with "postoperative complications" in a single search. Postoperative complications including radiculopathy, weakness, and spinal cord compression were included. The definition of iatrogenic neurologic complication was limited to post-operative radiculopathy, motor weakness or new onset pain/radiculitis. An advanced MEDLINE search conducted on May 14th, 2015 using all of the above terms together yielded 21 results. After careful evaluation, 11 manuscripts were excluded and 10 were carefully reviewed. The most common indications for surgery were degenerative spondylolisthesis, spondylosis, scoliosis, and lumbar stenosis. In 2783 patients in 12 total studies, there were 56 patients who had reported a postoperative neurologic deficit for a rate of 5.7. The rates of deficits ranged from 0.46% to 17% in the studies used. The average rate of reported neurologic complications within these papers was 9% (range 0.46-24%). Thirty patients of a total of 731 (4.1%) had a new onset neurologic injury after anterior lumber interbody fusion or lateral lumber interbody fusion. Thirty-seven out of 2052 (1.9%) patients had a neurologic injury after posterior decompression and fusion. Screw malposition was responsible for 11 deficits. Spinal surgery for lumbar degenerative disease carries a low but definite rate of neurologic deficits. Despite the introduction of neuromonitoring, these complications still occur. Interpretation of neurologic injury rates for lumbar surgery is limited by the few prospective and cohort-matched controlled studies. Likewise, most injuries were associated with the placement of instrumentation despite the type of approach. PMID:26386902

  9. Modificaciones del endotelio corneal en cirugía de catarata simultánea con vitrectomía Changes of the corneal endothelium in cataract surgery combined with vitrectomy

    Zucell Ana Veitía Rovirosa

    2012-12-01

    Full Text Available Objetivo: determinar el comportamiento del endotelio corneal en pacientes sometidos a cirugías simultáneas de vítreo y catarata. Métodos: se realizó un estudio observacional, descriptivo y prospectivo. El universo lo constituyó 15 pacientes (15 ojos sometidos a cirugías de catarata y vítreo de forma simultánea. El estudio se efectúo en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de enero a noviembre de 2010. Resultados: la mayoría de los pacientes fueron hombres entre 53 y 67 años de edad. Las principales causas de indicación quirúrgica de vitrectomía pars plana fueron el desprendimiento de retina y la hemorragia vítrea. La densidad celular promedio antes de la cirugía y después de esta mostró una pérdida de 634 células (26,8 %. La ausencia de polimegatismo y sus formas leves predominaron en el preoperatorio, hubo un incremento hacia formas moderadas y severas en el posoperatorio. El pleomorfismo se comportó de forma similar al polimegatismo. Las complicaciones posquirúrgicas fueron hipertensión ocular, síndrome tóxico del segmento anterior y uveítis anterior. Conclusiones: valorar el estado del endotelio antes de la cirugía permite trazar una estrategia quirúrgica encaminada a proteger esta importante capa corneal y establecer un pronóstico visual del paciente. De esta forma permite evaluar su comportamiento en el posoperatorio.Objective: to determine the corneal endothelium behavior in the cataract surgery and vitrectomy performed simultaneously. Methods: a prospective, descriptive and observational research was carried out in “Ramón Pando Ferrer” Cuban Institute of Ophthalmology from January to November 2010. The sample was made up of 15 eyes from 15 patients, who had undergone cataract surgery and vitrectomy simultaneously. Results: most of the patients were men aged 53 to 67 years. The main causes to indicate the pars plana vitrectomy were retinal detachment and vitreous hemorrhage. Before and after surgery, the average cellular density showed loss of 634 cells (26,8%. Mild polymegatism forms were not detected before surgery but moderate as well as severe forms were observed after surgery. Pleomorphism behaved similarly to polymegatism. Three complications were observed after surgery: ocular hypertension, toxic syndrome of the anterior segment and the anterior uveitis. Conclusions: the evaluation of the state of the corneal endothelium behavior before surgery helps drawing up a surgical strategy to protect this important corneal layer and to establish a visual prognosis of the patient as well as to evaluate the postsurgical progress.

  10. Hyperferritinaemia-cataract syndrome: Worldwide mutations and phenotype of an increasingly diagnosed genetic disorder

    Millonig Gunda

    2010-04-01

    Full Text Available Abstract The hereditary hyperferritinaemia-cataract syndrome (HHCS is characterised by an autosomal dominant cataract and high levels of serum ferritin without iron overload. The cataract develops due to L-ferritin deposits in the lens and its pulverulent aspect is pathognomonic. The syndrome is caused by mutations within the iron-responsive element of L-ferritin. These mutations prevent efficient binding of iron regulatory proteins 1 and 2 to the IRE in L-ferritin mRNA, resulting in an unleashed ferritin translation. This paper reviews all 31 mutations (27 single nucleotide transitions and four deletions that have been described since 1995. Laboratory test showing hyperferritinaemia, normal serum iron and normal transferrin saturation are indicative for HHCS after exclusion of other causes of increased ferritin levels (inflammation, malignancy, alcoholic liver disease and should prompt an ophthalmological consultation for diagnostic confirmation. Invasive diagnostics such as liver biopsy are not indicated. HHCS is an important differential diagnosis of hyperferritinaemia. Haematologists, gastroenterologists and ophthalmologists should be aware of this syndrome to spare patients from further invasive diagnosis (liver biopsy, and also from a false diagnosis of hereditary haemochromatosis followed by venesections. Patients diagnosed with HHCS should be counselled regarding the relative harmlessness of this genetic disease, with early cataract surgery as the only clinical consequence.

  11. Value of dual biometry in the detection and investigation of error in the preoperative prediction of refractive status following cataract surgery.

    Charalampidou, Sofia

    2012-02-01

    PURPOSE: To report the value of dual biometry in the detection of biometry errors. METHODS: Study 1: retrospective study of 224 consecutive cataract operations. The intraocular lens power calculation was based on immersion biometry. Study 2: immersion biometry was compared with optical coherence biometry (OCB) in terms of axial length, anterior chamber depth, keratometry readings and the recommended lens power to achieve emmetropia. Study 3: prospective study of 61 consecutive cataract operations. Both immersion and OCB were performed, but lens power calculation was based on the latter. RESULTS: Study 1: 115 (86%), 101 (75.4%), 90 (67.2%) and 50 (37.3%) of postoperative spherical equivalents were within +\\/-1.5 dioptres (D), +\\/-1.25 D, +\\/-1 D and +\\/-0.5 D of the target, respectively. Study 2: excellent agreement between axial length readings, anterior chamber depth readings and keratometry readings by immersion biometry and OCB was observed (reflected in a mean bias of -0.065 mm, -0.048 mm and +0.1803 D, respectively, in association with OCB). Agreement between the lens power recommended by each technique to achieve emmetropia was poor (mean bias of +1.16 D in association with OCB), but improved following appropriate modification of lens constants in the Accutome A-scan software (mean bias with OCB = -0.4 D). Study 3: 37 (92.5%) and 23 (57.5%) of operated eyes achieved a postoperative refraction within +\\/-1 D and +\\/-0.5 D of target, respectively. CONCLUSION: Systematic errors in biometry can exist, in the presence of acceptable postoperative refractive results. Dual biometry allows each biometric parameter to be scrutinized in isolation, and identify sources of error that may otherwise go undetected.

  12. Cataract incidence after total-body irradiation

    Purpose: Aim of this retrospective study was to evaluate cataract incidence in a homogeneous group of patients after total-body irradiation followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Method and Materials: Between 11/1982 and 6/1994 in total 260 patients received in our hospital total-body irradiation for treatment of haematological malignancy. In 1996-96 patients out of these 260 patients were still alive. 85 from these still living patients (52 men, 33 women) answered evaluable on a questionnaire and could be examined ophthalmologically. Median age of these patients was 38,5 years (15 - 59 years) at time of total-body irradiation. Radiotherapy was applied as hyperfractionated total-body irradiation with a median dose of 14,4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 hours, photons with a energy of 23 MeV were used, and the dose rate was 7 - 18 cGy/min. Results: Median follow-up is now 5,8 years (1,7 - 13 years). Cataract occurred in (28(85)) patients after a median time of 47 months (1 - 104 months). In 6 out of these 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to total-body irradiation was more often in the group of patients developing a cataract (14,3%) vs. 10,7% in the group of patients without cataract. Conclusion: Cataract is a common side effect of total-body irradiation. Cataract incidence found in our patients is comparable to results of other centres using a fractionated regimen for total-body irradiation. The hyperfractionated regimen used in our hospital does obviously not result in a even lower cataract incidence. In contrast to acute and late toxicity in other organ/organsystems, hyperfractionation of total-body irradiation does not further reduce toxicity for the eye-lens. Dose rate may have more influence on cataract incidence

  13. Influence of cataract surgery in biopsychosocial adaptation in the elderly Influencia de la cirugía de catarata en la adaptación biopsicosocial del adulto mayor

    Bárbara Suárez Rodríguez

    2010-11-01

    Full Text Available Background: The twenty-first century is characterized by a progressive aging in the population, with the subsequent demand of medical care it implies due to the polimorbility rates typical of this stage of life. Objective: to prove the positive influence of cataract surgery in biopsychosocial adaptation of elderlies. Methods: a descriptive study conducted from January to June 2008 in the General University Hospital "Dr. Aldereguía Gustavo Lima’’ in Cienfuegos. The 60 elder patients who underwent surgery cataract in that period were included. Geriatric evaluation was used as assessment instrument. It was applied before and 3 months after cataract surgery and included the Yesavage Geriatric Depression Rating Scale to measure emotional function and the Katz index for functional evaluation. The variables used are part of the preoperative geriatric assessment. Among them we can find biomedical, social, functional and psychological aspects as well as-risk benefit and anesthetic risks analysis. Results: the largest amount of patients was between 70 and 74 years old, predominantly males and white skinned. Most frequent personal pathological records were arthropathies, diabetes mellitus and hypertension. A significant relationship between initial visual acuity levels and depression rates was found; as well as limitations in performing basic daily life activities. Conclusions: with surgical intervention an improved visual acuity was achieved and a number of functional capacities were reestablished to allow a better biopsychosocial adaptation in elderlies.Fundamento: el siglo XXI se caracteriza por un aumento progresivo del envejecimiento poblacional, con la consecuente demanda de atención médica por la polimorbilidad que presenta esta etapa del ciclo vital. Objetivo: demostrar la influencia de la cirugía de catarata en la adaptación biopsicosocial del adulto mayor. Métodos: se realizó un estudio descriptivo, durante los meses de enero a junio del 2008 en el Hospital General Universitario “Dr. Gustavo Aldereguía Lima” de la provincia Cienfuegos, que incluyó a los 60 pacientes adultos mayores operados de catarata en ese periodo. Se utilizó como instrumento la evaluación geriátrica, aplicada antes de la cirugía de catarata y 3 meses después, que incluyó la escala de depresión geriátrica de Yesavage, para medir función afectiva, y el índice de Katz, para la evaluación funcional. Las variables utilizadas conforman la evaluación geriátrica preoperatoria que incluye aspectos biomédicos, sociales, funcionales, psicológicos, análisis riesgo beneficio, análisis del riesgo quirúrgico anestésico. Resultados: el mayor número de pacientes se encontró entre 70 y 74 años, predominó el sexo masculino y el color blanco de la piel. Los antecedentes patológicos personales más frecuentes fueron las artropatías, la diabetes mellitus y la hipertensión arterial. Existió una relación significativa, entre los niveles de agudeza visual inicial y los índices de depresión; así como con las limitaciones en la realización de las actividades básicas para la vida diaria. Conclusiones: con la intervención quirúrgica se logró mejorar la agudeza visual y restablecer un conjunto de capacidades funcionales que permiten una mejor adaptación biopsicosocial del adulto mayor.

  14. Failed back surgery syndrome: review and new hypotheses

    Bordoni B

    2016-01-01

    Full Text Available Bruno Bordoni,1,2 Fabiola Marelli2 1Department of Cardiology, Foundation Don Carlo Gnocchi, IRCCS, Institute of Hospitalization and Care, S Maria Nascente, Milan, 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, Italy Abstract: Failed back surgery syndrome (FBSS is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or without it radiating to the leg. The possible reasons and risk factors that would lead to FBSS can be found in distinct phases: in problems already present in the patient before a surgical approach, such as spinal instability, during surgery (for example, from a mistake by the surgeon, or in the postintervention phase in relation to infections or biomechanical alterations. This article reviews the current literature on FBSS and tries to give a new hypothesis to understand the reasons for this clinical problem. The dysfunction of the diaphragm muscle is a component that is not taken into account when trying to understand the reasons for this syndrome, as there is no existing literature on the subject. The diaphragm is involved in chronic lower back and sacroiliac pain and plays an important role in the management of pain perception. Keywords: diaphragm, fascia, chronic pain, pain, spine FBSS

  15. Failed back surgery syndrome: review and new hypotheses

    Bordoni, Bruno; Marelli, Fabiola

    2016-01-01

    Failed back surgery syndrome (FBSS) is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or without it radiating to the leg. The possible reasons and risk factors that would lead to FBSS can be found in distinct phases: in problems already present in the patient before a surgical approach, such as spinal instability, during surgery (for example, from a mistake by the surgeon), or in the postintervention phase in relation to infections or biomechanical alterations. This article reviews the current literature on FBSS and tries to give a new hypothesis to understand the reasons for this clinical problem. The dysfunction of the diaphragm muscle is a component that is not taken into account when trying to understand the reasons for this syndrome, as there is no existing literature on the subject. The diaphragm is involved in chronic lower back and sacroiliac pain and plays an important role in the management of pain perception. PMID:26834497

  16. Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review

    Molinari, Robert W.; Saleh, Ahmed; Molinari, Robert; Hermsmeyer, Jeff; Dettori, Joseph R.

    2015-01-01

    Study Design Systematic review. Clinical Questions (1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrumentation in spine surgery. Studies including recombinant human bone morphogenetic protein 2 as adjunct therapy and those with follow-up of less than 2 years were excluded. Results Ten randomized controlled trials met the inclusion criteria: five compared unilateral with bilateral instrumentation using open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF), one used open posterolateral fusion, and four used minimally invasive TLIF/PLIF. There were no significant differences between unilateral and bilateral screw instrumentation with respect to nonunion, low back or leg pain scores, Oswestry Disability Index, reoperation, or complications. Conclusions The existing literature does not identify significant differences in clinical outcomes, union rates, and complications when unilateral instrumentation is used for degenerative pathologic conditions in the lumbar spine. The majority of published reports involve single-level lumbar unilateral instrumentation. PMID:26131385

  17. Otologic surgeries in National Ear Care Centre, Kaduna, Nigeria: A 5 years review

    Grema Umar Sambo; Aminu Bakari; Musa Thomas Samdi; Garba Mohammed Mainasara; Joseph Yohanna; Abdullahi Musa Kirfi

    2015-01-01

    Background: Otologic surgeries that endure are based on a detailed knowledge of anatomy, physiology, and pathology of the temporal bone. Ear surgeries are challenging to most otolaryngologists practicing in Nigeria. The aim was to present a 5 years review of indications, types, complications, success, and limitations of the ear surgeries at the study center. Materials and Methods: A 5 years retrospective review of all the otologic surgeries are done under general and local anesthesia from Jul...

  18. Small-incision cataract extraction combined trabeculectomy for primary angle-closure glaucoma with cataract

    Yu-Feng Wu

    2014-09-01

    Full Text Available AIM: To observe the curative effect of treating small-incision cataract extraction by intraocular lens implantation combined with trabeculectomy for primary angle-closure glaucoma with cataract. METHODS: Totally 44 cases(52 eyesof primary angle-closure glaucoma combined with cataract were selected to undergo the combined surgery, in order to observe the patients' pre- and postoperative eyesights, intraocular pressures and the postoperative complications.RESULTS: The postoperative eyesight was improved significantly as compared with the preoperative eyesight. The intraocular pressure was declined dramatically. The result was of statistical significance(P0.05. All the 52 cases' surgeries were performed by the same surgeon. The surgeries were processed smoothly, with 6 postoperative eyes of anterior chamber inflammation cell response, 3 eyes of anterior chamber fibrinoid exudate, 2 eyes of shallow anterior chamber through mydriasis and treatment with glucocorticoids and non-steroidal eyedrops before absorption, and no complications like malignant glaucoma, cyclodialysis, etc. were reported through mydriasis and pressure bandaging before recovery.CONCLUSION: Treating the primary angle-closure glaucoma combined with cataract through the combined surgery has high reliability and desirable curative effect. The surgical method is simple to learn and applicable for promotion on the basic level.

  19. Atomic bomb cataracts

    Eye disturbance caused by atomic bomb radiation can be divided into three groups: direct injury immediately after exposure, eye lesions associated with radiation syndrome, and delayed disturbance. The crystalline lens of the eye is the most radiosensitive. Atomic bomb cataract has been investigated in a number of studies. The first section of this chapter discusses radiation cataract in terms of the incidence and characteristics. The second section deals with atomic bomb cataract, which can be diagnosed based on the four criteria: (1) opacity of the crystalline lens, (2) a history of proximal exposure, (3) lack of eye disease complicating cataract, and (4) non-exposure to radiation other than atomic bombing. The prevalence of cataract and severity of opacity are found to correlate with exposure doses and age at the time of exposure. Furthermore, it is found to correlate with distance from the hypocenter, the condition of shielding, epilation, and the presence or absence or degree of radiation syndrome. (N.K.)

  20. Prevalence of visual impairment, blindness, ocular disorders and cataract surgery outcomes in low-income elderly from a metropolitan region of São Paulo - Brazil Prevalência de cegueira, deficiência visual e alterações oculares numa população idosa e de baixa renda na cidade de São Paulo

    Arnaud Araújo Filho; Solange Rios Salomão; Adriana Berezovsky; Rafael Werneck Cinoto; Paulo Henrique Ávila Morales; Francisco Roberto Gonçalves Santos; Rubens Belfort Jr.

    2008-01-01

    PURPOSE: To determine prevalence and causes of visual impairment, blindness, ocular disorders and cataract surgery outcomes in a low-income elderly population from a metropolitan area in the city of São Paulo, Brazil. METHODS: Observational study where 801 individuals of 60 years and older underwent presented and best corrected visual acuity measurements as well as ophthalmologic examination. Definition of blindness and visual impairment followed studies conducted in Nepal, China and India. R...

  1. Ambulatory surgery with chloroprocaine spinal anesthesia: a review

    Ghisi D

    2015-11-01

    Full Text Available Daniela Ghisi, Stefano Bonarelli Department of Anaesthesia and Postoperative Intensive Care, Istituto Ortopedico Rizzoli, Bologna, Italy Abstract: Spinal anesthesia is a reliable and safe technique for procedures of the lower extremities. Nevertheless, some of its characteristics may limit its use for ambulatory surgery, including delayed ambulation, risk of urinary retention, and pain after block regression. The current availability of short-acting local anesthetics has renewed interest for this technique also in the context of short- and ultra-short procedures. Chloroprocaine (CP is an amino-ester local anesthetic with a very short half-life. It was introduced and has been successfully used for spinal anesthesia since 1952. Sodium bisulfite was then added as a preservative after 1956. The drug was then abandoned in the 1980s for several reports of neurological deficits in patients receiving accidentally high doses of intrathecal CP during epidural labor analgesia. Animal studies have proven the safety of the preservative-free formulation, which has been extensively evaluated in volunteer studies as well as in clinical practice with a favorable profile in terms of both safety and efficacy. In comparison with bupivacaine, 2-chloroprocaine (2-CP showed faster offset times to end of anesthesia, unassisted ambulation, and discharge from hospital. These findings suggests that 2-CP may be a suitable alternative to low doses of long-acting local anesthetics in ambulatory surgery. Its safety profile also suggests that 2-CP could be a valid substitute for intrathecal short- and intermediate-acting local anesthetics, such as lidocaine and mepivacaine – often causes of transient neurological symptoms. In this context, literature suggests a dose ranging between 30 and 60 mg of 2-CP for procedures lasting 60 minutes or less, while 10 mg is considered the no-effect dose. The present review describes recent evidence about 2-CP as an anesthetic agent for spinal anesthesia in ambulatory surgery. Keywords: outpatient surgery, spinal anesthesia, 2-chloroprocaine

  2. Desperdício de exames complementares na avaliação pré-operatória em cirurgias de catarata Waste of medical tests in preoperative evaluation for cataract surgery

    Carlos Eduardo Leite Arieta

    2004-02-01

    Full Text Available O objetivo deste experimento clínico foi determinar a freqüência dos exames considerados dispensáveis numa rotina pré-operatória de facectomias e avaliar os gastos com eles. Se o paciente foi sorteado para testes-seletivos, solicitou-se que nenhum teste fosse executado, a menos que o paciente apresentasse um novo problema médico, ou piora de uma doença preexistente, a qual requeresse os testes independentemente da realização da cirurgia. Para pacientes sorteados para testes-rotineiros, foram solicitados: eletrocardiograma, dosagem de hemoglobina e glicemia de jejum. Foram calculados os gastos com exames considerados desnecessários. A amostra de 1.025 pacientes incluiu 513 sorteados para testes seletivos e 512 para testes rotineiros. A freqüência de eventos adversos intra-operatórios foi semelhante nos dois grupos (p = 0,923. O grupo de testes seletivos realizou de 60,7% menos exames que o de testes rotineiros. Os resultados sugerem que a requisição seletiva de exames pré-operatórios em facectomias, além de não prejudicar o paciente do ponto de vista de complicações clínicas intra-operatórias, possibilita expressiva economia de recursos quando comparada à atual rotina.The objective of this clinical trial was to determine the frequency of medical tests considered unnecessary in routine preoperative evaluation for cataract surgery. Unnecessary costs with these tests were also evaluated. For patients assigned to the selective testing group, it was requested that no preoperative testing be performed unless the patient presented a new or worsening medical problem warranting medical evaluation with testing. For patients assigned to the routine testing group, three tests were requested: a 12-lead electrocardiogram, complete blood count, and serum glucose level. The costs of tests considered unnecessary were calculated. The sample of 1,025 patients consisted of 512 assigned to the routine testing group and 513 to the selective testing group. Cumulative rate of medical events was similar in the two groups (p = 0.923. The selective group underwent 60.7% fewer tests. The results suggest that selective preoperative testing in cataract surgery does not harm patients in terms of peri-operative clinical complications and also represents a significant cost reduction compared to routine testing.

  3. Cx43, ZO-1, alpha-catenin and beta-catenin in cataractous lens epithelial cells

    Anshul I Arora; Kaid Johar; Devarshi U Gajjar; Darshini A Ganatra; Forum B Kayastha; Anuradha K Pal; Alpesh R Patel; Rajkumar S; Abhay R Vasavada

    2012-12-01

    Specimens of the anterior lens capsule with an attached monolayer of lens epithelial cells (LECs) were obtained from patients (=52) undergoing cataract surgery. Specimens were divided into three groups based on the type of cataract: nuclear cataract, cortical cataract and posterior subcapsular cataract (PSC). Clear lenses (=11) obtained from donor eyes were used as controls. Expression was studied by immunofluorescence, real-time PCR and Western blot. Statistical analysis was done using the student’s -test. Immunofluorescence results showed punctate localization of Cx43 at the cell boundaries in controls, nuclear cataract and PSC groups. In the cortical cataract group, cytoplasmic pools of Cx43 without any localization at the cell boundaries were observed. Real-time PCR results showed significant up-regulation of Cx43 in nuclear and cortical cataract groups. Western blot results revealed significant increase in protein levels of Cx43 and significant decrease of ZO-1 in all three cataract groups. Protein levels of alpha-catenin were decreased significantly in nuclear and cortical cataract group. There was no significant change in expression of beta-catenin in the cataractous groups. Our findings suggest that ZO-1 and alpha-catenin are important for gap junctions containing Cx43 in the LECs. Alterations in cell junction proteins may play a role during formation of different types of cataract.

  4. Meeting the need for childhood cataract surgical services in Madagascar

    Henry E Nkumbe

    2011-01-01

    Full Text Available Background: Cataract has emerged as the most important cause of blindness in children worldwide, and has been one of the priorities of VISION 2020, the global initiative to eliminate avoidable blindness by 2020. More than 2500 children are estimated to be blind from cataract in Madagascar. The aim of this study was to investigate the burden and causes of pediatric cataract in a busy eye clinic in Madagascar and measure service delivery. Materials and Methods: This was a retrospective case series of all children aged 15 and below, receiving cataract surgery at the busiest eye clinic in Southern Madagascar. Data on all children operated on at the eye clinic between September 1999 and July 2009 were retrieved from theatre logs and patient charts. Results: One hundred and fourteen eyes of 86 children were operated on during the study period, with congenital cataract being the diagnosis in 53.5% of the children. For the catchment area of 5.8 million inhabitants 2.7% of incident cases of non-traumatic pediatric cataracts had surgery, with a mean CCSR per year for the entire catchment area of 1.1/million population. Conclusions: The Southern part of Madagascar is underserved for pediatric cataract surgical services, hence the need for a childhood blindness program.

  5. Cataract Extraction in High Myopic Eyes

    Wan-Chen Ku

    2002-05-01

    Full Text Available Background: According to the high prevalence of myopia in Taiwan, we analyze theadopted cataract extractions, identify predicting factors for postoperativevision, and to assess the incidence of retinal complications after Nd: YAGlaser capsulotomy in high myopic eyes.Methods: One hundred and twenty-five eyes, which the axial lengths were longer than26 mm, following cataract extraction were enrolled. Surgeries adoptedincluded phacoemulsification with intraocular lens implantation, extracapsularcataract extraction with intraocular lens implantation, phacoemulsification,and extracapsular cataract extraction. Logistic regression was utilizedto assess predictive factors for postoperative vision.Results: Postoperative vision of 41 eyes (32.8% of the 125 high myopic eyesimproved at least 4 lines of Snellen acuity. Thirty-two eyes (25.6%achieved good postoperative vision (BCVA≥20/40, and 26 eyes (20.8%demonstrated poor postoperative vision (BCVA<20/200. Younger age andshorter axial length were appreciated for better visual outcome ( p < 0.05.Nd: YAG laser capsulotomy is required for posterior capsular opacity. Threein 125 eyes (2.4% developed retinal complications and 2 of them had retinaldetachment subsequently within one month after Nd: YAG laser capsulotomy.Conclusion: Most high myopic patients achieved visual improvement after cataract surgeries.Age and axial length are the predictive factors in high myopicpatients. It is crucial to examine retina prior to Nd: YAG laser capsulotomyto prevent retinal complication.

  6. Diffusion Tractography in Deep Brain Stimulation Surgery: A Review

    Calabrese, Evan

    2016-01-01

    Deep brain stimulation (DBS) is believed to exert its therapeutic effects through modulation of brain circuitry, yet conventional preoperative planning does not allow direct targeting or visualization of white matter pathways. Diffusion MRI tractography (DT) is virtually the only non-invasive method of visualizing structural connectivity in the brain, leading many to suggest its use to guide DBS targeting. DT-guided DBS not only has the potential to allow direct white matter targeting for established applications [e.g., Parkinson’s disease (PD), essential tremor (ET), dystonia], but may also aid in the discovery of new therapeutic targets for a variety of other neurologic and psychiatric diseases. Despite these exciting opportunities, DT lacks standardization and rigorous anatomic validation, raising significant concern for the use of such data in stereotactic brain surgery. This review covers the technical details, proposed methods, and initial clinical data for the use of DT in DBS surgery. Rather than focusing on specific disease applications, this review focuses on methods that can be applied to virtually any DBS target. PMID:27199677

  7. Aspheric Intraocular Lenses Implantation for Cataract Patients with Extreme Myopia

    Yanwen Fang; Yi Lu; Aizhu Miao; Yi Luo

    2014-01-01

    Objective. To evaluate the postoperative visual quality of cataract patients with extreme myopia after implantation of aspheric intraocular lenses (IOLs). Methods. Thirty-three eyes were enrolled in this prospectivestudy. Eighteen eyes with an axial length longer than 28 mm were included in the extreme myopia group, and the other 15 eyes were included in the nonextreme myopia group. Phacoemulsification and aspheric IOL implantation were performed. Six months after cataract surgery, best-corre...

  8. Experience with Childhood Cataract

    Shekhar Sharma, Satish Gupta, Vijaya Wali

    2004-04-01

    Full Text Available This study shows management profile of 71 eyes of 52 children below the age of 10 years havingcongenital/developmental cataract. They were operated upon for cataract with intraocular lensimplantation after establishing their possible aetiology. However, aetiology of cataract could beestablished only in 46.15% cases. Vitreous thrust (8.45%, iritis (15.49% and posterior capsularopacification (25.35% were the most common per-operative, immediate post-operative and latepost-operative problems encountered respectively. After one year of follow up 52.11% eyes regainedvisual acuity better than 6/24 after full correction and amblyopia therapy.

  9. An instrument for assessment of subjective visual disability in cataract patients

    Pesudovs, K; Coster, D

    1998-01-01

    AIMS/BACKGROUND—The construction and validation of an instrument for the assessment of subjective visual disability in the cataract patient is described. This instrument is specifically designed for measuring the outcome of cataract surgery with respect to visual disability.
METHODS—Visually related activities thought to be affected by cataract were considered for the questionnaire. These were reduced by pilot study and principal components analysis to 18 items. A patient's assessment of his/...

  10. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

    Michael Mazzeffi

    2015-01-01

    Full Text Available Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review.

  11. Mediastinitis in cardiac surgery: A review of the literature

    Kunal S

    2012-01-01

    Full Text Available Background: Postoperative mediastinitis is a serious complication in cardiac surgery that substantially increases morbidity and mortality. Aim: This study reviews the various prophylactic and therapeutic measures. Material and Method: Literature searches were done to identify relevant studies. Results: Various possible causes and risk factors were identified and prophylaxis in the form of strict sterility in the operating room, preoperative skin disinfection, nonabrasive preoperative hair removal, antibiotic prophylaxis, and non-traumatic surgical intervention with sparing use of electrocautery. These along with wide range of wound-healing strategies have been established for the treatment of post-sternotomy mediastinitis. Conventional treatment are surgical revision with open dressings or closed irrigation, or reconstruction with vascularized soft tissue flap and novel treatment such as vacuum-assisted closure and their overall effect on Morbidity, Hospital stay, Cost and Mortality. Conclusion: Despite advances, there is substantial risk of postoperative mediastinitis. Presently there is no general consensus regarding the appropriate surgical approach to mediastinitis.

  12. Biomaterials and Implants in Cardiac and Vascular Surgery - Review

    Stanis?awska A.

    2014-10-01

    Full Text Available Currently, on prosthesis in cardiac blood vessels and heart valves are used materials of animal or synthetic origin. For animal materials include, among others pericardial sac in which is the heart. Materials such as this (natural are characterized by a remarkable biocompatibility within the human body, but their main disadvantage is the relatively low durability. In turn, synthetic materials, which include the austenitic chromium-nickel-molybdenum steels, alloys with a shape memory (nickel-titanium, or polymeric materials, such as lactic acid, are characterized by high stability in an environment of bodily fluids, wherein the insufficiently high biocompatibility with the organism human requires from patients using after implantation, anticoagulants which prevent anti-platelet deposition on the surface of the prosthesis. The present work is a review of biomaterials using in implantology and implants using in cardiac and vascular surgery.

  13. Robotic surgery in oral and maxillofacial, craniofacial and head and neck surgery: a systematic review of the literature.

    De Ceulaer, J; De Clercq, C; Swennen, G R J

    2012-11-01

    A systematic review of the literature concerning robotic surgery in oral and maxillofacial (OMF), craniofacial and head and neck surgery was performed. The objective was to give a clear overview of the different anatomical areas of research in the field of OMF, craniofacial and head and neck surgery, in all its fields (pre-clinical and clinical). The present indications are outlined and the critical reader is invited to assess the value of this new technology by highlighting different relevant parameters. A PubMed and Cochrane library search yielded 838 papers published between 1994 and 2011. After screening the abstracts, 202 articles were considered clinically or technically relevant and were included. These full papers were screened in detail and classified as articles on synopsis (n=41), educational aspects (n=3), technical/practical aspects (n=11) and clinical papers (n=147). Regarding clinical feasibility this systematic review revealed the following main indications: transoral robotic surgery (TORS) for upper digestive and respiratory tract lesions; TORS for skull base surgery; and TORS for trans-axillary thyroid and endocrine surgery. Regarding functional outcome, this systematic review revealed a promising reduction of morbidity in patients with cancer of the upper digastric and respiratory tract. PMID:22910368

  14. Antibiotic prophylaxis for transurethral urological surgeries: Systematic review

    Basim S Alsaywid

    2013-01-01

    Full Text Available The use of antibiotic prophylaxis to prevent urinary tract infection and bacteremia (sepsis following endoscopic urologic procedures is a controversial topic. Evidence in the literature revealed that urological instrumentation is associated with increased incidence of urinary tract infection and bacteremia. The aim of this review is to evaluate the effectiveness of antibiotic prophylaxis in reducing the risk of urinary tract infection in patients who had transurethral urological surgeries. We have selected all RCTs of adult population who underwent all different types of transurethral urological surgery, including cystoscopy, transurethral resection of prostate and transurethral resection of bladder tumor, and received prophylactic antibiotics or placebo/no treatment. At first, more than 3000 references were identified and reviewed; of which 42 studies with a total of 7496 patients were included in the final analysis. All those trials were analyzing antibiotic prophylaxis versus placebo/no treatment, and they were significantly favoring antibiotic use in reducing all outcomes, including bacteriuria (RR 0.36, 95% CI 0.29 to 0.46, P < 0.0001 with moderate heterogeneity detected (I 2 48%, symptomatic UTI (RR 0.38, 95% CI 0.28 to 0.51, P < 0.0001 with no significant heterogeneity was detected (I 2 = 17%, bacteremia (RR 0.43, 95% CI 0.23 to 0.82, P < 0.0001 with no noted heterogeneity (I 2 = 0%, and fever ≥38.5 Celsius (RR 0.41, 95% CI 0.23 to 0.73, P = 0.003; also, there was no noted heterogeneity (I 2 = 0%. However, using antibiotic prophylaxis did not reduce the incidence of low grade temperature (RR 0.82, 95% CI 0.61 to 1.11, P = 0.20 or in moderate grade temperature (RR 1.03, 95% CI 0.71 to 1.48, P = 0.89. Antibiotic prophylaxis appears to be an effective intervention in preventing urinary tract infections and its sequels following transurethral urological surgeries in patients with preoperative sterile urine.

  15. Lumbar spine surgery positioning complications: a systematic review.

    Shriver, Michael F; Zeer, Valerie; Alentado, Vincent J; Mroz, Thomas E; Benzel, Edward C; Steinmetz, Michael P

    2015-10-01

    OBJECT There are a variety of surgical positions that provide optimal exposure of the dorsal lumbar spine. These include the prone, kneeling, knee-chest, knee-elbow, and lateral decubitus positions. All are positions that facilitate exposure of the spine. Each position, however, is associated with an array of unique complications that result from excessive pressure applied to the torso or extremities. The authors reviewed clinical studies reporting complications that arose from positioning of the patient during dorsal exposures of the lumbar spine. METHODS MEDLINE, Scopus, and Web of Science database searches were performed to find clinical studies reporting complications associated with positioning during lumbar spine surgery. For articles meeting inclusion criteria, the following information was obtained: publication year, study design, sample size, age, operative time, type of surgery, surgical position, frame or table type, complications associated with positioning, time to first observed complication, long-term outcomes, and evidence-based recommendations for complication avoidance. RESULTS Of 3898 articles retrieved from MEDLINE, Scopus, and Web of Science, 34 met inclusion criteria. Twenty-four studies reported complications associated with use of the prone position, and 7 studies investigated complications after knee-chest positioning. Complications associated with the knee-elbow, lateral decubitus, and supine positions were each reported by a single study. Vision loss was the most commonly reported complication for both prone and knee-chest positioning. Several other complications were reported, including conjunctival swelling, Ischemic orbital compartment syndrome, nerve palsies, thromboembolic complications, pressure sores, lower extremity compartment syndrome, and shoulder dislocation, highlighting the assortment of possible complications following different surgical positions. For prone-position studies, there was a relationship between increased operation time and position complications. Only 3 prone-position studies reported complications following procedures of less than 120 minutes, 7 studies reported complications following mean operative times of 121-240 minutes, and 9 additional studies reported complications following mean operative times greater than 240 minutes. This relationship was not observed for knee-chest and other surgical positions. CONCLUSIONS This work presents a systematic review of positioning-related complications following prone, knee-chest, and other positions used for lumbar spine surgery. Numerous evidence-based recommendations for avoidance of these potentially severe complications associated with intraoperative positioning are discussed. This investigation may serve as a framework to educate the surgical team and decrease rates of intraoperative positioning complications. PMID:26424340

  16. Systematic review of the surgery-first approach in orthognathic surgery

    Chiung Shing Huang

    2014-08-01

    Full Text Available The surgery-first approach in orthognathic surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment. Available evidence on the surgery-first approach should be appraised to support its use in orthognathic surgery. A MEDLINE search using the keywords "surgery first" and "orthognathic surgery" was conducted to select studies using the surgery-first approach. We also manually searched the reference list of the selected keywords to include articles not selected by the MEDLINE search. The search identified 18 articles related to the surgery-first approach. There was no randomized controlled clinical trial. Four papers were excluded as the content was only personal opinion or basic scientific research. Three studies were retrospective cohort studies in nature. The other 11 studies were case reports. For skeletal Class III surgical correction, the final long-term outcomes for maxillofacial and dental relationship were not significantly different between the surgery-first approach and the orthodontics-first approach in transverse (e.g., intercanine or intermolar width dimension, vertical (e.g., anterior open bite, lower anterior facial height dimension, and sagittal (e.g., anterior-posterior position of pogonion and lower incisors dimension. Total treatment duration was substantially shorter in cases of surgery-first approach use. In conclusion, most published studies related to the surgery-first approach were mainly on orthognathic correction of skeletal Class III malocclusion. Both the surgery-first approach and orthodontics-first approach had similar long-term outcomes in dentofacial relationship. However, the surgery-first approach had shorter treatment time.

  17. Cataract blindness: challenges for the 21st century

    Brian Garry

    2001-01-01

    Full Text Available Cataract prevalence increases with age. As the world?s population ages, cataract-induced visual dysfunction and blindness is on the increase. This is a significant global problem. The challenges are to prevent or delay cataract formation, and treat that which does occur. Genetic and environmental factors contribute to cataract formation. However, reducing ocular exposure to UV-B radiation and stopping smoking are the only interventions that can reduce factors that affect the risk of cataract. The cure for cataract is surgery, but this is not equally available to all, and the surgery which is available does not produce equal outcomes. Readily available surgical services capable of delivering good vision rehabilitation must be acceptable and accessible to all in need, no matter what their circumstances. To establish and sustain these services requires comprehensive strategies that go beyond a narrow focus on surgical technique. There must be changes in government priorities, population education, and an integrated approach to surgical and management training. This approach must include supply of start-up capital equipment, establishment of surgical audit, resupply of consumables, and cost-recovery mechanisms. Considerable innovation is required. Nowhere is this more evident than in the pursuit of secure funding for ongoing services.

  18. Minimally invasive single-site surgery for the digestive system: A technological review

    Dhumane Parag

    2011-01-01

    Full Text Available Minimally Invasive Single Site (MISS surgery is a better terminology to explain the novel concept of scarless surgery, which is increasingly making its way into clinical practice. But, there are some difficulties. We review the existing technologies for MISS surgery with regards to single-port devices, endoscope and camera, instruments, retractors and also the future perspectives for the evolution of MISS surgery. While we need to move ahead cautiously and wait for the development of appropriate technology, we believe that the "Ultimate form of Minimally Invasive Surgery" will be a hybrid form of MISS surgery and Natural Orifice Transluminal Endoscopic Surgery, complimented by technological innovations from the fields of robotics and computer-assisted surgery.

  19. Cataract in Latin America: findings from nine recent surveys La catarata en Amrica Latina: resultados de nueve encuestas recientes

    Hans Limburg

    2009-05-01

    Full Text Available OBJECTIVES: To review recent data on blindness and low vision due to cataract in Latin America. METHODS: Presentation of findings from population-based prevalence surveys conducted between 1999 and 2006 in nine Latin American countries covering 30 544 people aged 50 years and older. RESULTS: Prevalence of cataract blindness in people 50 years and older ranged from 0.5% in Buenos Aires to 2.3% in four provinces of Guatemala. Low vision from cataract ranged from 0.9% in Buenos Aires to 10.7% in Piura and Tumbes Districts in Peru. Cataract surgical coverage (CSC was good in Campinas, Brazil; low in Paraguay, Peru, and Guatemala; and moderate in the other areas. Good visual outcome after cataract surgery nearly conformed to World Health Organization (WHO guidelines in Buenos Aires (more than 80% of operated eyes able to see 20/60 or better, but ranged from 60% to 79% in most of the other settings, and was less than 60% in Guatemala and Peru. "Unaware that treatment is possible," "contraindications," "cannot afford," and "fear of operation" were the most common explanations for failure to come forward for surgery. CONCLUSIONS: In Campinas, Brazil, cataract is fairly well controlled. In Buenos Aires, the visual outcomes after cataract surgery nearly meet WHO standards. In most countries in Latin America, however, cataract intervention needs to be intensified and visual outcome improved. Reducing the costs of cataract surgery and providing effective health education and adequate program management are essential to combat the expected increase in visual impairment due to cataract in the region.OBJETIVO: Hacer una revisin de los datos recientes sobre ceguera y visin reducida por catarata en Amrica Latina. MTODO: Presentacin de los resultados de estudios de prevalencia de base poblacional realizados entre 1999 y 2006 en nueve pases latinoamericanos, que abarcaron 30 544 personas de 50 aos o ms. RESULTADOS: La prevalencia de ceguera por catarata en personas de 50 aos o ms estuvo entre 0,5% en Buenos Aires, Argentina, y 2,3% en cuatro provincias de Guatemala. La visin reducida por catarata vari entre 0,9% en Buenos Aires y 10,7% en los distritos de Piura y Tumbes, Per. La cobertura de ciruga de catarata fue buena en Campinas, Brasil; baja en Paraguay, Per y Guatemala; y media en el resto de las reas. Los resultados positivos de la ciruga de catarata estuvieron muy cerca de los estndares de la Organizacin Mundial de la Salud (OMS en Buenos Aires (ms de 80% de los ojos operados con visin de 20/60 o mejor, pero vari entre 60% y 79% en la mayora de los otros lugares y fue inferior a 60% en Guatemala y Per. Las explicaciones expuestas ms frecuentemente para no someterse a esta operacin fueron "no saber que el tratamiento es posible", "contraindicaciones", "no poder pagarlo" y "temor a la operacin". CONCLUSIONES: En Campinas, la catarata est bastante bien controlada. En Buenos Aires, la visin despus de la ciruga de catarata se acerca a los estndares de la OMS. No obstante, en la mayora de los pases de Amrica Latina las intervenciones contra la catarata deben intensificarse y sus resultados deben mejorar. Es esencial reducir el costo de la ciruga de catarata y brindar una educacin sanitaria eficaz y programas adecuados para combatir el esperado aumento en los trastornos de la visin por catarata en la Regin.

  20. Cataract extraction with erisophake.

    ALEXANDER, H B

    1951-01-01

    Today the erisophake offers the most successful means for the intracapsular extraction of cataracts. The advantages of this method are that no counterpressure is required so that the incidence of vitreous loss is reduced; the vacuum cup provides a firmer grasp of the lens with less danger of rupture of the lens capsule; and the vacuum cup can be used for the delivery of practically all types of cataract in the adult, including intumescent and Morgagnian cataracts as well as lenses with exfoliating and friable capsules. While the forceps method of intracapsular extraction is generally successful in not more than 70 to 75 per cent of cases, the erisophake may offer success in 90 per cent of cases. PMID:14792378

  1. Radiation and cataract

    When this paper was about to go to press, the International Commission on Radiological Protection released a statement recommending a change in the threshold dose for the eye lens and dose limits for eye for occupationally exposed persons. It is clear that the earlier published threshold for radiation cataract is no longer valid. Epidemiological studies among Chernobyl clean-up workers, A bomb survivors, astronauts, residents of contaminated buildings, radiological technicians and recent surveys of staff in interventional rooms indicate that there is an increased incidence of lens opacities at doses below 1 Gy. Nevertheless, eye lens dosimetry is at a primitive stage and needs to be developed further. Despite uncertainties concerning dose threshold and dosimetry, it is possible to significantly reduce the risk of radiation cataract through the use of appropriate eye protection. By increasing awareness among those at risk and better adoption and increased usage of protective measures, radiation cataract can become preventable despite lowering of dose limits. (authors)

  2. Oral surgery in patients under antithrombotic therapy. Narrative review.

    Anggelo Carrizo

    2015-02-01

    Full Text Available ABSTRACT Aging population and increase of cardiovascular diseases have raised the number of patients receiving antithrombotic therapy in elective or emergency dental care, including surgical procedures. The aim of this article is to review the evidence and clinical guidelines published in the past five years for dental management of patients on antithrombotic therapy. The American Antithrombotic Therapy Guideline - 2012 - generally recommends not to suspend antiplatelet or anticoagulant treatment in dental procedures since they are considered to have low bleeding risk and easy resolution. In the dental area there is ample published evidence regarding oral surgical procedures management, especially by maxillofacial surgeons. Low number of complications associated with extractions or other minor surgeries of the oral cavity, without suspending antithrombotic drugs and only taking some minimum safeguards, such as healing by first intention or the use of some local hemostatic agents, have been shown. Overall, patients under chronic antithrombotic therapy should maintain their medications when undergoing low and medium complexity dental procedures, since complications are minor and easy to handle. Due to the interactions between them, particular care should be taken with patients using more than one drug.

  3. The Indication of Surgical Treatment and Visual Rehabilitation in the Congenital Cataracts

    Uğur Keklikçi

    2005-01-01

    Congenital cataracts constitute an important part of blindness in childhood. It’s a curable disease which is one of the most common causes of blindness in childhood. Main treatment is surgical operation. Timing of surgery, appropriate and rapid post sur- gery visual rehabilitation have a major effect on prognosis. Surgery should be perfor-med as soon as possible after the diagnosis in order to prevent amblyopia.Visual rehabi- litation of congenital cataract includes optical correction and am...

  4. ADJUSTABLE SUTURE STRABISMUS SURGERY: A REVIEW OF 850 CASES

    M.E. Latronico

    2012-05-01

    Full Text Available Purpose. The aim of the study is to investigate the relationship between the different kinds of squint and the adjustament re- quired in post-op. Methods. Our personal case histories concerns 850 patients that underwent adjustable suture strabismus surgery during the last ten years, examinated in our Department of Ophtalmology over the period 2000-2009. The same surgeon (G.L. performed adjustable suture strabismus surgery as routine duties, whether on horizontal or vertical rectus muscles, but never on oblique muscles. Adjustments were always performed in the 24 postoperative hours. With regard to the relationship between previous surgeries, and requested regulation: 669 cases not underwent previous sur- gery; 181 cases peviously underwent surgery one or more times. results. First we seek for the statistical significant difference between the various results found, computing X2, ? and the rel- ative risk. We can conclude by saying that who made a vertical muscle squint surgery presents a relative risk of 3 times greater to take hypocorrection rather than hypercorrection and that who made before squint surgery presents a relative risk of 2,72 times greater to take regulation. Conclusions. We predicted this result because it confirms that the use of adjustable suture is the more frequent as the muscle fibrosis is the more significant. And the fibrosis is an usual outcome of previous squint surgery.

  5. Connexin mutants and cataracts

    EricCBeyer

    2013-04-01

    Full Text Available The lens is a multicellular, but avascular tissue that must stay transparent to allow normal transmission of light and focusing of it on the retina. Damage to lens cells and/or proteins can cause cataracts, opacities that disrupt these processes. The normal survival of the lens is facilitated by an extensive network of gap junctions formed predominantly of connexin46 and connexin50. Mutations of the genes that encode these connexins (GJA3 and GJA8 have been identified and linked to inheritance of cataracts in human families and mouse lines. In vitro expression studies of several of these mutants have shown that they exhibit abnormalities that may lead to disease. Many of the mutants reduce or modify intercellular communication due to channel alterations (including loss of function or altered gating or due to impaired cellular trafficking which reduces the number of gap junction channels within the plasma membrane. However, the abnormalities detected in studies of other mutants suggest that they cause cataracts through other mechanisms including gain of hemichannel function (leading to cell injury and death and formation of cytoplasmic accumulations (that may act as light scattering particles. These observations and the anticipated results of ongoing studies should elucidate the mechanisms of cataract development due to mutations of lens connexins and abnormalities of other lens proteins. They may also contribute to our understanding of the mechanisms of disease due to connexin mutations in other tissues.

  6. Post-vitreoretinal surgery strabismus-a review.

    Chaudhry, N L; Durnian, J M

    2012-03-01

    Vitreoretinal surgery has long been recognized as a significant cause of secondary strabismus. These cases can be difficult to manage due to the previous surgery and the altered status of the visual function. External scleral buckling procedures are most commonly associated with its development; however recent research shows that pars plana vitrectomy procedures also have a risk of causing the condition. Many factors may play a role in the development of the strabismus: mechanical, extraocular muscle changes, local anesthetic administration, and sensory alteration. Treatment options include occlusion, prisms, botulinum toxin, and surgery. Vitreoretinal surgeons should be aware of the distinct of strabismus development following surgery. With increased recognition, the condition can be managed more effectively. PMID:22390329

  7. Robotic Surgery in Gynecology: An Updated Systematic Review

    Sanjay Rao; Lori Weinberg; Escobar, Pedro F.

    2011-01-01

    The introduction of da Vinci Robotic Surgery to the field of Gynecology has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. In general gynecology and reproductive gynecology, the robot is being increasingly used for procedures such as hysterectomies, myomectomies, adnexal surgery, and tubal anastomosis. Among urogynecology the robot is being utilized for sacrocolopexies. In the field of gy...

  8. Failed back surgery syndrome: review and new hypotheses

    Bordoni B; Marelli F

    2016-01-01

    Bruno Bordoni,1,2 Fabiola Marelli2 1Department of Cardiology, Foundation Don Carlo Gnocchi, IRCCS, Institute of Hospitalization and Care, S Maria Nascente, Milan, 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, Ancona, Italy Abstract: Failed back surgery syndrome (FBSS) is a term used to define an unsatisfactory outcome of a patient who underwent spinal surgery, irrespective of type or intervention area, with persistent pain in the lumbosacral region with or ...

  9. Otologic surgeries in National Ear Care Centre, Kaduna, Nigeria: A 5 years review

    Grema Umar Sambo

    2015-01-01

    Full Text Available Background: Otologic surgeries that endure are based on a detailed knowledge of anatomy, physiology, and pathology of the temporal bone. Ear surgeries are challenging to most otolaryngologists practicing in Nigeria. The aim was to present a 5 years review of indications, types, complications, success, and limitations of the ear surgeries at the study center. Materials and Methods: A 5 years retrospective review of all the otologic surgeries are done under general and local anesthesia from July, 2009 to July, 2014. Results: There were 1067 patients who had ear, nose, and throat surgeries within the period under review, out of which 68 were ear surgeries. Prevalence was 6.37%, there were 25 (37% males and 43 (63% females, male: female 1:1.7. Age ranged from 1 to 58 years, mean age 21 ± 6 years. Chronic suppurative otitis media was the most common diagnosis 39 (57.4% and indication for tympanoplasty 31 (46.6%. Meatocanaloplasty was the least with 2 (2.9%, mastoidectomy 7 (10.3%, myringotomy and grommet insertion 11 (16.2%, excisional biopsy 7 (10.3%, foreign body removal 4 (5.90%, tympanomastoidectomy 3 (4.40%, and pinnaplasty 3 (4.40%. Forty-one (60.3% achieved resolution of symptoms while 8 (11.8% had persistence of symptoms. One (1.5% had revision surgery. The success rate is about 60.3% within the period under review. Postoperative complications (facial nerve paralysis, persistence discharge from the mastoid cavity, worsened deafness, postauricular fistula were seen in 14 (20.6%. While 4 (5.9% were lost to follow-up. Conclusion: Ear surgeries are still underdeveloped when compared to nose and throat surgeries in our center. Complication (chronic suppurative otitis media was the most common indication for ear surgery. Provision of adequate training facilities, especially in the field of otology and review of the training curriculum for otorhinolaryngology residency in Nigeria is indispensable.

  10. Eye surgery in the elderly

    Raczyńska D

    2016-04-01

    Full Text Available Dorota Raczyńska, Leopold Glasner, Ewelina Serkies-Minuth, Magdalena A Wujtewicz, Kamila Mitrosz Department of Ophthalmology, Medical University of Gdansk, Gdansk, Poland Abstract: Extending life expectancy is a human achievement. It does however entail problems. Ophthalmic treatments are widely recognized as having a low risk of general complications. A classic example is cataract surgery, considered to be one of the safest and most frequently performed surgical procedures in the world. However, advanced age brings with it risks that should be considered before surgery. Eye operations, as with procedures on other organs, are largely dependent on the quality of surgical tissues. Therefore, the elderly are at increased risk of complications. Improved general health and postoperative follow-up with the use of noninvasive technologies such as optical coherence tomography translate into lower intraoperative risk and better postoperative prognosis. In this review, we discuss the impact of general health on operational prognosis, therapeutic problems, and technical difficulties which a surgeon and anesthesiologist may encounter in the process. We also consider new technology and strategies specifically aimed at treating eye conditions in the elderly. Keywords: eye surgery, eye aging, anesthesiology in ophthalmology, cataract, glaucoma, vitrectomy, age-related macular degeneration

  11. Preliminary clinical outcomes from the Peruvian National Cataract Elimination Plan Resultados clnicos preliminares del Plan Nacional de Lucha contra la Ceguera por Catarata del Per

    Stryjewski, Tomasz P.; Daniel Bitrn Benadretti; Sihai Dave Zhao; Susannah Rowe; Mitnick, Carole D.

    2010-01-01

    OBJECTIVE: To evaluate the clinical outcomes of a publicly funded cataract elimination program. METHODS: Outcomes of all patients (186) who received extracapsular cataract extraction (ECCE) surgery free of charge at the Instituto Regional de Oftalmologa in northern Peru in the first year (August 2008 to July 2009) of the Peruvian National Cataract Elimination Plan were compared retrospectively with the outcomes of all patients (68) who paid in the highest charge tier for ECCE surgery during ...

  12. Pain Management in Ambulatory SurgeryA Review

    Jan G. Jakobsson

    2014-07-01

    Full Text Available Day surgery, coming to and leaving the hospital on the same day as surgery as well as ambulatory surgery, leaving hospital within twenty-three hours is increasingly being adopted. There are several potential benefits associated with the avoidance of in-hospital care. Early discharge demands a rapid recovery and low incidence and intensity of surgery and anaesthesia related side-effects; such as pain, nausea and fatigue. Patients must be fit enough and symptom intensity so low that self-care is feasible in order to secure quality of care. Preventive multi-modal analgesia has become the gold standard. Administering paracetamol, NSIADs prior to start of surgery and decreasing the noxious influx by the use of local anaesthetics by peripheral block or infiltration in surgical field prior to incision and at wound closure in combination with intra-operative fast acting opioid analgesics, e.g., remifentanil, have become standard of care. Single preoperative 0.1 mg/kg dose dexamethasone has a combined action, anti-emetic and provides enhanced analgesia. Additional ?-2-agonists and/or gabapentin or pregabalin may be used in addition to facilitate the pain management if patients are at risk for more pronounced pain. Paracetamol, NSAIDs and rescue oral opioid is the basic concept for self-care during the first 35 days after common day/ambulatory surgical procedures.

  13. Methods to improve rehabilitation of patients following breast cancer surgery: a review of systematic reviews

    Loh SY

    2015-03-01

    Full Text Available Siew Yim Loh, Aisya Nadia Musa Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, 'therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’. Study selection: Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review. Data extraction: Included review year, study aim, total number of participants included, and results. Data synthesis: Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods for addressing the domains of psychosocial, cognitive, and occupational outcomes. Conclusion: There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients’ self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years. Keywords: breast cancer surgery, rehabilitation methods, symptom-management, quality of life, lifestyle redesign, self-management

  14. Cataracts - what to ask your doctor

    You are having a procedure to remove a cataract. A cataract occurs when the lens of the eye becomes cloudy and starts to block vision. Removing the cataract can help improve your vision. Below are some ...

  15. Persistent fetal vasculature: ocular features, management of cataract and outcomes

    Marcia Beatriz Tartarella

    2013-06-01

    Full Text Available PURPOSES: To describe ocular features, management of cataract and functional outcomes in patients with persistent fetal vasculature. METHODS: Retrospective, descriptive case series of patients with persistent fetal vasculature. Data were recorded from the Congenital Cataract Section of Federal University of São Paulo, Brazil from 2001 to 2012. All patients were evaluated for sex, age at diagnosis, systemic findings, laterality, age at surgery, and initial and final follow-up visual acuities. Follow-up and complications after cataract surgery were recorded. Ultrasound was performed in all cases and ocular eco-Doppler was performed in most. RESULTS: The study comprised 53 eyes from 46 patients. Age at diagnosis ranged from 5 days of life to 10 years-old (mean 22.7 months. Twenty-seven patients were male (58.7%. Persistent fetal vasculature was bilateral in 7 patients (15.2%. Forty-two eyes (79.2% had combined (anterior and posterior forms PFV presentation, 5 eyes (9.4% had only anterior persistent fetal vasculature presentation and 6 eyes (11.3% had posterior persistent fetal vasculature presentation. Thirty-eight eyes (71.7% were submitted to cataract surgery. Lensectomy combined with anterior vitrectomy was performed in 18 eyes (47.4%. Phacoaspiration with intraocular lens implantation was performed in 15 eyes (39.5%, and without lens implantation in 5 eyes (13.2%. Mean follow-up after surgery was 44 months. Postoperative complications were posterior synechiae (3 cases, retinal detachment (2 cases, phthisis (3 cases, posterior capsular opacification (8 cases, inflammatory pupillary membrane (5 cases, glaucoma (4 cases, intraocular lens implantation displacement (1 case and vitreous hemorrhage (2 cases. Complications were identified in 19 (50% of the 38 operated eyes. Visual acuity improved after cataract surgery in 83% of the eyes. CONCLUSIONS: Patients with persistent fetal vasculature have variable clinical presentation. There is an association of persistent fetal vasculature with congenital cataract. Severe complications are related to cataract surgery in patients with persistent fetal vasculature, but 83% of the operated eyes improved visual acuity.

  16. Cataracts in uranium miners

    The question was studied of whether or not uranium miners with a long history of work underground develop alterations of the eye lens as a result of a long-term chronic exposure to gamma radiation. Investigated were the area of opacities and the occurrence of alterations of the lens posterior pole in a group of 800 uranium miners (i.e., 1,600 eyes) with work underground longer than 10 years. As against controls, no statistical differences were found in the lens transparency. Significant differences were also not found in the extent of cataracts and the occurrence of posterior pole alterations, nor in the rate of an increased occurrence of cataracts due to age. (L.O.)

  17. Keratoplasty and cataract extraction

    Panda Anita; Kumar T

    1991-01-01

    Fifty eyes were evaluated following penetrating keratoplasty and cataract extraction. Twenty five of them had intracapsular lens extraction while the remaining 25 had intercapsular method of extracapsular lens extraction. Both operative and post operative complications were more in group I. Visual outcome and graft clarity were also better in eyes of group II. Combined keratoplasty and intercapsular method of extracapsular lens extraction was recommended in eyes having both corneal and lentic...

  18. Keratoplasty and cataract extraction

    Panda Anita

    1991-01-01

    Full Text Available Fifty eyes were evaluated following penetrating keratoplasty and cataract extraction. Twenty five of them had intracapsular lens extraction while the remaining 25 had intercapsular method of extracapsular lens extraction. Both operative and post operative complications were more in group I. Visual outcome and graft clarity were also better in eyes of group II. Combined keratoplasty and intercapsular method of extracapsular lens extraction was recommended in eyes having both corneal and lenticular pathology.

  19. Surgical therapy of congenital cataract and its postoperative visual function recovery

    Yan-Ting Su

    2013-11-01

    Full Text Available Congenital cataract is an important cause of lifelong visual impairment in children. Its treatment is different from that of senile cataract since visual functions of the affected children are still under development. However, consensus has not be made in surgical management of congenital cataract, especially in the surgical approach,intraocular lens selection and postoperative refractive correction. This study reviews researches on the surgical therapy and its postoperative visual function recovery conducted in recent years.

  20. Cataract and ionizing radiation

    The radiation-induced cataract has been up to now considered as a quite rare pathology, needing high-dose radiations (beyond a dose threshold roughly estimated at 2 Grays to the lens) consisting mainly in head tumour radiotherapy complications. Several new studies on different exposed populations such as astronauts, japanese atomic bomb survivors, people undergoing X-ray examinations, Chernobyl accident 'liquidators' as well as data from animal experiments, suggest that dose threshold for detectable opacities as well as for clinical posterior sub-capsular cataract occurring, might be far lower than those previously assumed. Even the existence of a dose threshold is no longer an absolute certitude insofar as radiation-induced cataract pathogenesis might consist not really in a deterministic effect (direct tissue harmful effect, killing or seriously injuring a critical population of cells) as believed until now, but rather in a stochastic effect (genomic damage in target-cells, altered cell division, abnormal lens fiber cell differentiation). More practically, these new data may lead us to reconsider radioprotection of specifically exposed populations: mainly patients and workers. Regarding workers, labour legislation (lens equivalent dose limit of 150 mSv during 12 consecutive months) might be, in the medium term, reassessed downwards. (author)

  1. Radiation-induced cataract

    Dose assessments for cataract threshold doses are available based on epidemiological studies of radiotherapy patients, survivors of the nuclear bombing of Hiroshima and Nagasaki, and of persons with occupational exposure to radiation. According to these, short-term application of low-level LET radiation of a dose ranging between 0.5 and 2.0 Gy may suffice to cause a cataract in the course of a few months or years which results in inpairment of vision (UNSCEAR, 1982). In fractionated irradiation, cataractogenic threshold dose increases to 4 Sv at treatment times between 3 weeks and 3 months, and to more than 5 Sv at more than 3 months (ICRP 41). Densely ionizing radiation must be assumed to have threshold doses between 2 and 20 Sv. An ICRP assessment (ICRP Publ. No. 41, 1984) gives a threshold dose of more than 8 Sv for a vision-impairing cataract if these was protracted irradiation at a low-level dose rate. Concerning radiation protection, a maximum lens dose of 150 mSv per annum was recommended which should not be exceeded. This indicates a maximum of 7.5 Sv of exposure throughout a period of 50 years of working life. (orig./HP)

  2. Cytoprotective mechanism of action of curcumin against cataract.

    Raman, Thiagarajan; Ramar, Manikandan; Arumugam, Munusamy; Nabavi, Seyed Mohammad; Varsha, Mosur Kumaraswamy Nagarajan Sai

    2016-06-01

    This review discusses the relationship between oxidative stress and cataract formation, molecular mechanism of curcumin action and potential benefits of treatment with the antioxidant curcumin. The first section deals with curcumin and endogenous antioxidants. The second section focuses on the action of curcumin on lipid peroxidation. Calcium homeostasis and curcumin will be discussed in the third section. The fourth section discusses the role of crystallin proteins that are responsible for maintaining lens transparency and the role of curcumin in regulating crystallin expression. The interaction of curcumin with transcription factors will be dealt in the fifth section. The final section will focus on the effect of curcumin on aldose reductase, which is associated with hyperglycemia and cataract. One of the strongest antioxidants is curcumin which has been shown to be very effective against cataract. This compound is better than other antioxidants in preventing cataract but its limited bioavailability can be addressed by employing nanotechnology. PMID:26894964

  3. Incisões relaxantes limbares durante a cirurgia de catarata: resultados após seguimento de um ano Limbal relaxing incisions during cataract surgery: one-year follow-up

    João Carlos Arraes

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a variação do astigmatismo entre o pré-operatório, 1º mês e 12º mês pós-operatórios dos pacientes submetidos à cirurgia de catarata, com realização de incisões relaxantes limbares para redução do astigmatismo pré-operatório. MÉTODOS: Foram avaliados 16 pacientes submetidos a cirurgia de catarata pela técnica de facoemulsificação através de incisão escleral tunelizada de 5,5 mm, na Fundação Altino Ventura, no período entre abril e julho de 2002, na qual foram realizados incisões relaxantes no limbo (IRL, seguindo o nomograma modificado de Gills (1D - 1 IRL de 6 mm; 1-2D - 2 IRL de 6 mm; 2-3D - 2 IRL de 8 mm, nos meridianos corneanos mais curvos determinados por topografia corneana pré-operatória. RESULTADOS: Ocorreu redução significante do astigmatismo pré-operatório no 1º mês pós-operatório, no grupo de 2 incisões relaxantes no limbo de 6 mm (57% do astigmatismo topográfico e 87% do refracional e o de 2 incisões relaxantes no limbo de 8 mm (50% do astigmatismo topográfico e 65% do refracional, mantendo-se sem alteração significante este astigmatismo até o 12º mês pós-operatório. O grupo de 1 incisão relaxante no limbo de 6 mm não alcançou redução significante do astigmatismo, no entanto, não houve alteração significante até o 12º mês pós-operatório. Não foram observadas, ainda, complicações pós-operatórias como "glare", aniseiconia, diplopia, desconforto, infecção da ferida e afinamento ou ectasia corneana. CONCLUSÃO: A realização de 2 incisões relaxantes no limbo de 8 e 6 mm, para correção de astigmatismo pré-operatório de 2 a 3 e 1 a 2 dioptrias, respectivamente, mostraram-se eficazes, seguras e com efeito estável ao longo do primeiro ano de acompanhamento pós-operatório. A realização de 1 incisão relaxante no limbo de 6 mm para redução de 1 dioptria de astigmatismo pré-operatório não se mostrou eficaz, no entanto, não levou a complicações pós-operatórias significativas.PURPOSE: To evaluate astigmatism variation between preoperative, 1st and 12th postoperative month of patients who underwent cataract surgery with limbal relaxing incisions (LRI aiming to reduce the preoperative astigmatism. METHODS: Sixteen patients who underwent cataract surgery by the phacoemulsification technique with a 5.5 mm escleral incision, at the Altino Ventura Foudation, between April and July of 2002. The limbal relaxing incisions were performed according to Gills' modified nomogram (1D - 1 LRI of 6 mm; 1-2D - 2 LRI of 6 mm; 2-3D - 2 LRI of 8 mm. They were done in the most curved meridians, determined by preoperative corneal topography. RESULTS: Significant reduction in preoperative astigmatism was observed in the 1st postoperative month in 2 limbal relaxing incisions of the 6 mm group (57% topographic astigmatism and 87% refractional and in 2 limbal relaxing incisions of the 8 mm group (50% topographic astigmatism and 65% refractional, maintaining the reduction with no significant alteration until the 12th postoperative month. The 1 limbal relaxing incision of the 6 mm group did not yield significant astigmatism reduction, but there was no significant alteration until de 12th postoperative month. There were also no complications such as postoperative discomfort, glare, aniseiconia, diplopia, incision infection and corneal thinning or ectasia. CONCLUSION: Two limbal relaxing incisions of 8 and 6 mm aiming to correct preoperative astigmatism of 2 to 3D and 1 to 2D, respectively, were safe and effective with a stable effect in the first postoperative follow-up year. The 1 limbal relaxing incision of 6 mm aiming to reduce 1 diopter of preoperative astigmatism was not effective, but it did not induce any significant postoperative complications.

  4. The impact of bariatric surgery on quality of life: a systematic review and meta-analysis.

    Lindekilde, N; Gladstone, B P; Lbeck, M; Nielsen, J; Clausen, L; Vach, W; Jones, A

    2015-08-01

    This study aims to review the obesity literature in order to assess the impact of bariatric surgery on quality of life and the between-study variation by examining the standardized mean magnitude of effect in change in the levels of quality of life. The following databases EMBASE, PubMed, PsycINFO, CINAHL, the Cochrane Library and Web of Science were systematically searched for studies examining change in quality of life in adults receiving bariatric surgery for obesity. Seventy-two studies were included with a total of 9,433 participants treated for obesity with bariatric surgery. The average impact of bariatric surgery on quality of life corresponded to an effect size of 0.88 (95% CI: 0.80-0.96), indicating that bariatric surgery has a significant positive influence on quality of life in general. The impact varied considerably across studies with bariatric surgery showing a significantly greater positive influence on physical quality of life compared to mental quality of life. Bariatric surgery is effective in improving quality of life, especially when looking at physical well-being. Greater focus on the psychological well-being of the person undergoing surgery for obesity may lead to a better post-surgery prognosis for more people. PMID:26094664

  5. Review of Postoperative Delirium in Geriatric Patients Undergoing Hip Surgery.

    Rizk, Paul; Morris, William; Oladeji, Philip; Huo, Michael

    2016-06-01

    Postoperative delirium is a serious complication following hip surgery in elderly patients that can adversely affect outcomes in both hip fracture and arthroplasty surgery. Recently, the incidence of hip fracture in the Medicare population was estimated at approximately 500 000 patients per year, with the majority treated surgically. The annual volume of total hip arthroplasty is nearly 450 000 patients and is projected to increase over the next 15 to 20 years. Subsequently, the incidence of postoperative delirium will rise. The incidence of postoperative delirium after hip surgery in the elderly patients ranges between 4% and 53%, and it is identified as the most common surgical complication of older patients. The most common risk factors include advanced age, hip fracture surgery (vs elective hip surgery), and preoperative delirium/cognitive impairment. Exact pathophysiology has not been fully defined. It is hypothesized that imbalances in cortical neurotransmitters or inflammatory cytokine pathway mechanisms contribute to delirium. Development of postoperative delirium is associated with longer hospital stay, increased medical complications, and poorer short-term functional outcome. Patients who develop postoperative delirium are also at increased risk for cognitive decline beyond the acute phase. Following acute care, postoperative delirium is associated with the need for a higher level of care, an additional cost. Management of postoperative delirium centers on prevention and early recognition. Medical prophylaxis has been demonstrated to have limited utility. Utilization of delirium detection methods contributed to early recognition. The most effective means of prevention involved a multidisciplinary team focused on adequate hydration, optimization of analgesia, reduction in polypharmacy, aggressive physiotherapy, and early recognition of the delirium symptoms. PMID:27239384

  6. Efeito da facectomia no posicionamento palpebral superior: comparação entre as técnicas de facoemulsificação e a extracapsular Changes in the position of the upper eyelid after cataract surgery: a comparison between phacoemulsification and extracapsular techniques

    Roberto Pinto Coelho

    2003-10-01

    Full Text Available OBJETIVO: Comparar o efeito de duas técnicas de facectomia (facoemulsificação e extracapsular no posicionamento da pálpebra superior. MÉTODOS: Foi analisado o posicionamento palpebral de dois grupos de pacientes submetidos à cirurgia de catarata: facoemulsificação e extracapsular. As imagens foram digitalizadas (antes e 30 dias após a cirurgia e processadas com o programa NIH 1.62. O posicionamento palpebral foi medido em relação a uma linha horizontal que unia os cantos medial e lateral da fenda palpebral, passando pelo centro da pupila. RESULTADOS: O posicionamento palpebral foi afetado de maneira diferente segundo a técnica utilizada. Na facoemulsificação a diferença média entre a posição palpebral superior pós e pré-operatória foi de -0,54 mm. Na extracapsular esta diferença aumentou para -1,41 mm. O teste t de Student (amostras pareadas mostrou que as médias das diferenças entre os dois grupos são significativamente diferentes (p=0,0068. CONCLUSÃO: A técnica de cirurgia de facoemulsificação induziu menor variação do posicionamento palpebral em relação à cirurgia extracapsular no pós-operatório recente.PURPOSE: To compare changes in the upper eyelid position after cataract surgery with phacoemulsification and extracapsular techniques. METHODS: The upper eyelid position was measured in two groups of patients before and 30 days after cataract surgery performed with phacoemulsification and extracapsular techniques. Palpebral fissure images (before and after the cataract surgery were digitized and then processed using the NIH 1.62 software. Eyelid position was measured relative to a horizontal line passing through the pupil center and connecting both canthi of the palpebral fissure. RESULTS: The palpebral position was differently affected according to the techniques. In phacoemulsification the mean difference between eyelids position before and after surgery was -0.54 mm. In the extracapsular technique this difference increased to -1.41 mm.The paired Student t test showed that the difference between two means was significant (p=0.0068. CONCLUSION: The phacoemulsification technique induces less variation in the upper eyelid position than the extracapsular technique in the recent postoperative period.

  7. Cataract, functioning and co-morbidity: a cross-sectional study in family practice.

    van de Lisdonk, E H; Furer, J W; Kroonen, A P; Marijnissen, A G

    1992-09-01

    Cataract is a slowly developing eye disease, the prevalence of which rises with age. Although patients often adapt to the diminished visual acuity accompanying the development of cataracts, their functional health may be impaired by poor vision. An index for visual functioning was derived from the literature. As older people often have additional chronic diseases, vision, visual functioning index and chronic co-morbidity were measured. Functional health was measured with different validated instruments. Eighty cataract patients participated in this study and were visited at home. Results showed statistically significant correlations between vision and co-morbidity on the one hand and visual functioning and functional health on the other. As in most participants vision was only slightly impaired, these results might even be more pronounced in patients with mature cataract. We conclude that indications for cataract surgery might not only be derived from visual acuity, but also from visual functioning and functional health. PMID:1459382

  8. Dementia after DBS Surgery: A Case Report and Literature Review

    Balaz, M.; Rektorova, I.; Hummelova, Z.

    2011-01-01

    We report the case history of a 75-year-old woman with Parkinson's disease who developed severe cognitive problems after deep brain stimulation (DBS) of the bilateral subthalamic nuclei (STN). After a brief cognitive improvement, the patient gradually deteriorated until she developed full-blown dementia. We discuss the case with respect to the cognitive effects of STN DBS and the possible risk factors of dementia after STN DBS surgery.

  9. A review of the problematic adhesion prophylaxis in gynaecological surgery

    Hirschelmann, Anja; Tchartchian, Garri; Wallwiener, Markus; Hackethal, Andreas; De Wilde, Rudy Leon

    2011-01-01

    Background Adhesions lead to considerable patient morbidity and are a mounting burden on surgeons and the health care system alike. Although adhesion formation is the most frequent complication in abdominal and pelvic surgery, many surgeons are still not aware of the extent of the problem. To provide the best care for their patients, surgeons should consistently inform themselves of anti-adhesion strategies and include these methods in their daily routine. Methods Searches were conducted in P...

  10. Vasospasm after transsphenoidal pituitary surgery: A case report and review of the literature

    Kasliwal Manish

    2008-01-01

    Full Text Available Vasospasm, so commonly described after aneurysmal rupture, is very rare after surgery for brain tumors. Its occurrence after transsphenoidal surgery is extremely uncommon with only three cases reported as per the authors′ review of the literature. The authors report a case of pituitary macroadenoma in a 34-year-old female who underwent transsphenoidal tumor decompression and developed angiographically documented vasospasm during the course of her illness. The rarity of the occurrence of vasospasm after transsphenoidal surgery makes its management very challenging, frequently leading to a delay in diagnosis and a poor outcome. The key to successful management is a high index of suspicion and early proactive management.

  11. Pacemaker Dependency after Cardiac Surgery: A Systematic Review of Current Evidence

    Curtis M. Steyers; Khera, Rohan; Bhave, Prashant

    2015-01-01

    Background Severe postoperative conduction disturbances requiring permanent pacemaker implantation frequently occur following cardiac surgery. Little is known about the long-term pacing requirements and risk factors for pacemaker dependency in this population. Methods We performed a systematic review of the literature addressing rates and predictors of pacemaker dependency in patients requiring permanent pacemaker implantation after cardiac surgery. Using a comprehensive search of the Medline...

  12. Prevalence of visual impairment, blindness, ocular disorders and cataract surgery outcomes in low-income elderly from a metropolitan region of São Paulo - Brazil Prevalência de cegueira, deficiência visual e alterações oculares numa população idosa e de baixa renda na cidade de São Paulo

    Arnaud Araújo Filho

    2008-04-01

    Full Text Available PURPOSE: To determine prevalence and causes of visual impairment, blindness, ocular disorders and cataract surgery outcomes in a low-income elderly population from a metropolitan area in the city of São Paulo, Brazil. METHODS: Observational study where 801 individuals of 60 years and older underwent presented and best corrected visual acuity measurements as well as ophthalmologic examination. Definition of blindness and visual impairment followed studies conducted in Nepal, China and India. RESULTS: The prevalence of presented and best-corrected visual acuity worse than 20/400 in both eyes was 1.38% (95% CI: 0.69% - 2.45% and 1.25% (95% CI: 0.60% - 2.29%. Prevalence of visual impairment considering presented and best-corrected visual acuity was, respectively, 24.16% (95% CI: 21.22% - 27.28% and 12.77% (95% CI: 10.53% - 15.28%. Cataract was the main cause of blindness (30.00% and visual impairment (54.90%. A total of 54 participants (6.74% had previous cataract surgery and, with best-corrected visual acuity, 35.12% showed visual acuity better than 20/60 in both eyes. Rates of visual impairment and blindness in this low-income elderly population were high. There was a considerable decrease in prevalence after optical correction emphasizing the importance of uncorrected refractive errors. CONCLUSION: Cataract was the main cause of blindness; poor visual outcomes in eyes previously operated for cataract reinforce the need to seek good quality cataract services and to provide careful postoperative follow-up.OBJETIVO: Determinar a prevalência e causas de deficiência visual, cegueira além dos resultados de cirurgia de catarata numa população idosa de baixa renda de São Miguel Paulista, distrito da cidade de São Paulo. MÉTODOS: Estudo observacional no qual a acuidade visual apresentada e com a melhor correção óptica foi medida em 801 indivíduos com 60 anos ou mais anos, bem como realizado exame oftalmológico. Definição de cegueira e deficiência visual seguiu estudos prévios realizados no Nepal, China e Índia. RESULTADOS: As prevalências de acuidade visual apresentada e com a melhor correção óptica pior do que 20/400 em ambos os olhos foram 1,38% (intervalo de confiança de 95%: 0,69% - 2,45% e 1,25% (intervalo de confiança de 95%: 0,60% - 2,29%. As de deficiência visual considerando a acuidade visual apresentada e com a melhor correção óptica foram, respectivamente, 24,16% (intervalo de confiança de 95%: 21,22% - 27,28% e 12,77% (intervalo de confiança de 95%: 10,53% - 15,28%. Catarata foi a principal causa de cegueira (30,00% e deficiência visual (54,90%. Cirurgia prévia de catarata foi realizada em 54 participantes (6,74% e 35,12% mostraram acuidade visual com a melhor correção óptica melhor do que 20/60 em ambos os olhos. Houve considerável diminuição nas prevalências de deficiência visual e cegueira após a correção óptica. CONCLUSÃO: Catarata foi a principal causa de cegueira. Os resultados visuais ruins nos olhos operados reforçam a necessidade de serviços de boa qualidade e de seguimento pós-operatório cuidadoso.

  13. Catarata peditrica ps-trauma Traumatic pediatric cataract

    Fernando Antonio de M. Leal

    2004-04-01

    Full Text Available OBJETIVO: Estudar a catarata peditrica ps-trauma, com relao ao tipo de trauma, o tempo decorrido entre este e a cirurgia e a correlao entre a acuidade visual obtida com o tratamento realizado. MTODOS: Estudo retrospectivo de pacientes atendidos no servio de Catarata Congnita da Universidade Federal de So Paulo, no perodo de agosto de 1988 a dezembro de 2001, com diagnstico de catarata peditrica ps-trauma. RESULTADOS: Foram revisados 66 pronturios de pacientes com diagnstico de catarata peditrica aps trauma, correspondendo a uma incidncia de 4,80% do total de casos atendidos no servio. Com relao ao sexo, 47 (71,22% eram do sexo masculino e 19 (28,78% do sexo feminino. Do total de casos de trauma, 35 (53,03% foram contusos, 21 (31,82% penetrantes e 10 (15,15% no classificados. O tempo mdio decorrido entre o trauma e a cirurgia foi de 7 anos e seis meses. As principais complicaes ps-operatrias descritas foram seqelas de uvetes em 13 pacientes (21,12% e opacificao de cpsula posterior em 10 (15,15%. Em 30 olhos foi possvel obtermos as acuidades visuais inicial e final; deste total, 1 olho (3,33% possua AV inicial superior ou igual a 20/60 com melhor correo e 12 (40% olhos AV final superior ou igual a 20/60 com melhor correo. Os pacientes foram acompanhados em mdia por 2 anos. CONCLUSO: A melhora da acuidade visual foi estatisticamen-te significante (teste de Wilcoxon pPURPOSE: To study the pediatric cataract after trauma, it's relation to the kind of the trauma, the time elapsed between trauma and surgery and the correlation between corrected visual acuity and treatment. METHODS: We reviewed the medical records of all patients who presented diagnosis of traumatic cataract between August 1988 and December 2001 at the Congenital Cataract Service of Federal University of So Paulo. RESULTS: Sixty-six patients with diagnosis of pediatric cataract after trauma were studied, corresponding to an incidence of 4.80% of the total of cases attended in the service. Forty-seven (71.22% were male and 19 (28.78% were female. Forty-five (53.03% sustained a blunt trauma, 21 (31.82% a penetrating one, and 10 (15.15% were not classified. The mean time between the injury and the surgery was 7 years and 6 months. The main described postoperative complications were uveitis sequels in 13 patients (21.12% and posterior capsule opacification in 10 (15.15%. The initial and final visual acuity were obtained in 30 eyes. The mean follow-up was of two years, ranging from 1 to 96 months. CONCLUSION: The improvement of visual acuity was statistically significant (Wilcoxon test p < 0.001, being more intense in the eyes submitted to surgical treatment (p < 0.001 than in the eyes submitted to clinical treatment.

  14. Priorización de pacientes en lista de espera para cirugía de cataratas: diferencias en las preferencias entre ciudadanos Prioritizing patients on waiting list for cataract surgery: preference differences among citizens

    Laura Sampietro-Colom

    2006-10-01

    Full Text Available Objetivos: Estimar y comparar las preferencias de los ciudadanos sobre la priorización de pacientes en lista de espera para cirugía de cataratas. Método: Análisis de conjunto. Identificación y selección de criterios de priorización: 4 grupos focales/nominales de población general, pacientes/familiares, profesionales relacionados, y especialistas de Catalunya (n = 36. Estimación de las preferencias (puntuaciones de los criterios: entrevista a una muestra representativa de los 4 grupos (n = 771 y aplicación del modelo del rank-ordered logit. Las diferencias se estudiaron mediante análisis separado por grupo y su comparación. Resultados: Los criterios seleccionados y su importancia relativa fueron: incapacidad visual (45%, limitación de las actividades (15%, limitación para trabajar (14%, tener alguna persona que le cuide (11%, ser cuidador (8% y probabilidad de recuperación (7%. Existieron diferencias entre grupos en la puntuación de los criterios. La población general y los pacientes/familiares valoraron más la incapacidad visual que los otros grupos (p 0,9, la ordenación final de éstos en la lista de espera podía variar hasta 27 posiciones al aplicar las preferencias obtenidas de un grupo o de otro. Conclusiones: Se consideró relevantes los criterios clínicos y los sociales. La existencia de diferencias sobre cómo deberían priorizarse los pacientes en espera recomienda tener en cuenta las preferencias de todas las partes afectadas.Objectives: To estimate and compare citizen preferences regarding patient prioritization for cataract surgery. Method: A conjoint analysis was performed. Priority criteria were identified and selected using 4 focus/nominal groups consisting of the general public, patients/relatives, allied health-professionals and specialists from Catalonia (n = 36. Preferences elicitation (score of criteria: representative sample survey of the above mentioned groups (n = 771 and rank-ordered logit model application. Differences were assessed by group analysis and their comparison. Results: The criteria selected and their relative importance were: visual impairment (45%, difficulty in performing activities of daily living (ADL (15%, limitation of ability to work (14%, being looked after by someone (11%, being a caregiver (8%, and recovery probability (7%. Differences in scores were observed among groups. Visual impairment was scored more highly by the general public and patients/relatives than by other groups (p 0.9. However, the final order of patients on the waiting list could differ by up to 27 positions when different group scores were applied. Conclusions: Social and clinical criteria were considered important. The observed differences among citizens regarding how to prioritize patients on the waiting lists indicates the need to take into account the preferences of all groups of citizens.

  15. The Prevalence of Body Dysmorphic Disorder in Patients Undergoing Cosmetic Surgery: a Systematic Review.

    Panayi, Andreana

    2015-09-01

    Body dysmorphic disorder (BDD) is a somatoform disorder characterised by a distressing obsession with an imagined or slight appearance defect, which can significantly impair normal day-to-day functioning. Patients with BDD often first present, and are hence diagnosed, in cosmetic surgery settings. Several studies have investigated the prevalence rate of BDD in the general population or have done so for patients referring to cosmetic medical centers. To date, however, no review has been undertaken to compare the prevalence in the general community versus in a cosmetic surgery setting. Despite the lack of such a review it is a commonly held belief that BDD is more common in patients seeking cosmetic surgery. The current study aims to review the available literature in order to investigate whether BDD is indeed more prevalent in patients requesting cosmetic surgery, and if that is the case, to provide possible reasons for the difference in prevalence. In addition this review provides evidence on the effectiveness of cosmetic surgery as a treatment of BDD. PMID:26417812

  16. Ubiquitin Carboxyl-Terminal Esterase LI (UCHLI) SI8Y Polymorphism in Patients with Cataracts

    Rudolph, Thiemo; Sjölander, Annica; Palmér, Mona Seibt; Minthon, Lennart; Wallin, Anders; Andreasen, Niels; Tasa, Gunnar; Juronen, Erkki; Blennow, Kaj; Zetterberg, Henrik; Zetterberg, Madeleine

    2011-01-01

    Background: Cataract is characterized by light-scattering protein aggregates. The ubiquitin-proteasome system has been proposed a role in proteolytic removal of these protein aggregates. Ubiquitin carboxyl-terminal esterase L1 (UCHL1) is a de-ubiquitinating enzyme with important functions in recycling of ubiquitin. A protective role of the p.S18Y polymorphism of the UCHL1 gene has been shown in Parkinson's disease. The current study aimed to examine possible effects on cataract formation. Methods: Patients with cataract (n = 493) and controls (n = 142) were analyzed for the UCHL1 p.S18Y polymorphism using dynamic allele-specific hybridization. Results: Significant differences were observed in allele and genotype frequencies of the p.S18Y polymorphism between controls and cataract patients, where a positive UCHL1 allele A carrier status was associated with the cataract diagnosis (adjusted OR 1.7 [95% CI = 1.1-2.6] p = 0.02). No significant differences were seen in genotype distribution when stratifying for type of cataract. Nor did the mean age at cataract surgery differ between genotypes. Conclusion: The current study does not support a protective role for the UCHL1 S18Y polymorphism in cataract development, but may instead suggest a disease-promoting effect. PMID:21268678

  17. Clinical analysis of surgical treatment in patients with senile cataract and hematologic disease

    Wan-Hui Wang

    2013-11-01

    Full Text Available AIM: To evaluate the clinical efficacy of cataract extraction and intraocular lens implantation in patients with senile cataract and hematologic disease. METHODS: Forty patients(58 eyeswith senile cataract and hematologic disease underwent cataract extraction and intraocular lens implantation. Preoperative assessment included blood coagulation testing, leukocyte classification, and bone marrow examination. Appropriate preoperative treatments were administered to patients with senile cataract and thrombocytopenia, leukopenia, anemia, and/or pancytopenia(identified through blood testing. Thirty patients with senile cataract and normal routine bloodwork findings, with ages similar to those of patients in the study group, were randomly recruited as a control group. Postoperative corrected visual acuity and intraoperative and postoperative complications were recorded. The causes of hematologic disease in patients in the study group were recorded. Blood clotting data were compared between groups using t-tests. RESULTS: Plasma prothrombin time and activated partial thromboplastin time did not differ significantly between the study and control groups(P=0.379 and P=0.945, respectively. Surgery improved corrected visual acuity in all patients(>0.4 in 56 〖96.55%〗 eyes. No postoperative infection, bleeding or fever occurred. The etiology of hematological disease was unknown in some patients; most patients had diabetes mellitus, hypertension, cirrhosis, and/or kidney disease. CONCLUSION: With adequate perioperative treatment, patients with senile cataract and hematological disease can safely undergo cataract operation and intraocular lens implantation, with good outcomes.

  18. Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

    HenningBayNielsen

    2014-03-01

    Full Text Available Near-infrared spectroscopy (NIRS is used to monitor