WorldWideScience

Sample records for cataract surgery review

  1. Cataract Surgery

    Medline Plus

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

  2. Femtosecond Laser-Assisted Cataract Surgery: A Current Review

    OpenAIRE

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

    2011-01-01

    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-t...

  3. Cataract Surgery

    Medline Plus

    Full Text Available ... Paul Wood: Yeah, especially at night was bad -- lights and stuff at night. Announcer: People with cataracts ... Announcer: The cloudy lens is removed so that light can once more pass through to the back ...

  4. Cataract Surgery

    Medline Plus

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

  5. Femtosecond cataract surgery: A review of current literature and the experience from an initial installation

    OpenAIRE

    Hodge, Chris; Bali, Shveta Jindal; Lawless, Michael; Chan, Colin; Roberts, Timothy; Ng, David; Chen, Simon; Hughes, Paul; Sutton, Gerard

    2011-01-01

    Cataract surgery remains the most widely performed intraocular procedure throughout the world. Safety and accuracy of the procedure are paramount and techniques should remain under constant review. Recently, the introduction of the femtosecond laser to assist cataract surgery has provided ophthalmologists with an exciting tool that may further improve outcomes. We review the existing literature and discuss the installation and initial experience of a femtosecond laser into our practice.

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

    OpenAIRE

    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 ...

  7. Surgery for Congenital Cataract

    Directory of Open Access Journals (Sweden)

    David Yorston FRCS FRCOphth

    2004-01-01

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

  8. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    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

  9. Cataract surgery in uveitis

    Directory of Open Access Journals (Sweden)

    Hazari Ajit

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Immediate versus Delayed Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Malvankar-Mehta, Monali S.; Chen, Yufeng Nancy; Patel, Sangita; Leung, Angela Pui-Kei; Merchea, Man Mohan; Hodge, William G.

    2015-01-01

    Background Immediately sequential bilateral cataract surgery (ISBCS), the cataract surgery that is performed in both eyes simultaneously, is gaining popularity worldwide compared to the traditional treatment paradigm: delayed sequential bilateral cataract surgery (DSBCS), the surgery that is performed in each eye on a different day as a completely separate operation. ISBCS provides advantages to patients and patients’ families in the form of fewer hospital visits. Additionally, patients enjoy rapid rehabilitation, lack of anisometropia - potentially reducing accidents and falls, and avoid suboptimal visual function in daily life. The hospital may benefit due to lower cost. Objective To perform a systematic review and meta-analysis to evaluate ISBCS and DSBCS. Data Sources Databases including MEDLINE, EMBASE, BIOSIS, CINAHL, Health Economic Evaluations Database (HEED), ISI Web of Science (Thomson-Reuters) and the Cochrane Library were searched. Participants Not applicable. Methods Literature was systematically reviewed using EPPI-Reviewer 4 gateway. Meta-analysis was conducted using STATA v. 13.0. Standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated and heterogeneity was assessed using I2 statistics. Fixed-effect and random-effect models were computed based on heterogeneity. Meta-analysis was done by instrument used to calculate utility score. Results In total, 9,133 records were retrieved from multiple databases and an additional 128 records were identified through grey literature search. Eleven articles with 3,657 subjects were included for analysis. Our meta-analysis results indicated significant improvement in post-operative utility score using TTO, EQ5D, HUI3, VF-7, and VF-14 and a non-significant improvement using Catquest questionnaire for both surgeries. For ISBCS versus DSBCS, utility-specific fixed-effect model provided an overall SMD of the utility score using the TTO method as 0.12 (95% CI: -0.15, 0.40), EQ5D as 0.14 (95% CI: -0.14, 0.41), HUI3 as 0.12 (95% CI: -0.15, 0.40), VF-7 as -0.02 (95% CI: -0.15, 0.10), and Catquest Questionnaire as 1.45 (95% CI: -0.88, 2.01). The results for utility score, which were measured using various instruments, indicated non-significant improvement in the utility due to DSBCS compared to ISBCS. However, a significant improvement in post-operative utility score was seen using Catquest questionnaire for ISBCS compared to DSBCS. The included studies using VF-14 instrument were highly heterogeneous (I2 = 97.1%). Results provided SMD of -0.25 (95% CI:-1.06, 0.57) using VF-14 indicating non-significant improvement in the utility due to DSBCS compared to ISBCS surgery. Best corrected visual acuity (BCVA) significantly improved after both surgeries (overall SMD of BCVA due to ISBCS was -1.79 (95% CI: -2.45, -1.14) and due to DSBCS was -1.53 (95% CI: -2.25, -0.81)). A non-significant improvement was seen in BCVA due to ISBCS when compared to DSBCS (SMD = -0.18; 95% CI: -0.37, 0.01). Conclusion Both surgeries, ISBCS and DSBCS significantly improve patients’ quality of life and visual acuity. Further, ISBCS may deliver certain additional benefits at the individual and societal levels as well. PMID:26121673

  12. Cataract surgery in ancient Egypt.

    Science.gov (United States)

    Blomstedt, Patric

    2014-03-01

    Ophthalmology was one of the most important specialties in Egyptian medicine, and more specialists are known in this field than in any other. This specialization seems, however, to have been of a purely noninvasive nature. Even though it has been claimed that cataract surgery was performed in pharaonic Egypt, careful analysis of the sources does not support the claim. No example of cataract surgery or of any other invasive ophthalmologic procedure can be found in the original sources. PMID:24485861

  13. Cataract surgery in pseudoexfoliation syndrome.

    Science.gov (United States)

    Sangal, Neha; Chen, Teresa C

    2014-01-01

    Pseudoexfoliation (PXF) syndrome is characterized by the deposition of distinctive fibrillar material in the anterior segment of the eye. It is an age-related process that is associated with open and narrow angle glaucomas and the formation of cataracts. Not only is PXF associated with the formation of dense nuclear cataracts, it is also well known that those presenting with PXF are at a higher risk of developing complications during, and even after, cataract surgery. Complications associated with cataract surgery in PXF can occur from poor pupillary dilation, zonular weakness leading to intraoperative or postoperative lens dislocation and vitreous loss, postoperative intraocular pressure (IOP) spikes potentiating glaucomatous damage, capsular phimosis, prolonged inflammation, and postoperative corneal decompensation. The surgeon should be prepared to encounter the various potential intraoperative and postoperative complications in eyes with pseudoexfoliation syndrome during cataract surgery. In this way, the surgeon can plan his/her surgical technique to help avoid surprises during cataract surgery and be prepared to manage the potential postoperative complications that can occur in pseudoexfoliation eyes. PMID:25325866

  14. Risk of retinal detachment after pediatric cataract surgery

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Andersen, Elisabeth W

    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, excluding cataract cases caused by trauma, or acquired systemic or acquired ocular pathology, and cases with ocular anomalies associated with the development of retinal detachment. Cases of cataract were ascertained from the mandatory Danish National Patient Register, and information on retinal detachment 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%-11%) among cataract patients. In otherwise normal children having isolated cataract, the risk was 3% (95% CI: 0%-7%). A significantly higher risk of developing retinal detachment was found in children with mental retardation (23% [95% CI: 9%-35%]) or in cataract cases with other ocular or systemic anomalies (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 ocular or systemic diseases.

  15. Risk of Retinal Detachment After Pediatric Cataract Surgery

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Andersen, Elisabeth W

    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, excluding cataract cases caused by trauma, or acquired systemic or acquired ocular pathology, and cases with ocular anomalies associated with the development of retinal detachment. Cases of cataract were ascertained from the mandatory Danish National Patient Register, and information on retinal detachment 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%-11%) among cataract patients. In otherwise normal children having isolated cataract, the risk was 3% (95% CI: 0%-7%). A significantly higher risk of developing retinal detachment was found in children with mental retardation (23% [95% CI: 9%-35%]) or in cataract cases with other ocular or systemic anomalies (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 ocular or systemic diseases.

  16. Patient satisfaction with cataract surgery

    Directory of Open Access Journals (Sweden)

    Wasfi Ehab I

    2008-10-01

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

  17. Femtosecond laser in refractive and cataract surgeries

    Science.gov (United States)

    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

  18. Current developments in equine cataract surgery.

    Science.gov (United States)

    McMullen, R J; Utter, M E

    2010-03-01

    The purpose of this review is to discuss the evolution of equine cataract surgery over the past 50 years to its current stage. Equine cataract surgery is performed similarly compared with the techniques used in human ophthalmology and in other veterinary species. However, enough differences exist to make surgical lens removal and intraocular lens implantation in the horse an intrinsically unique endeavour. Due to the size of the adult equine globe, the introduction of species-specific instrumentation has provided the cornerstone to many of the changes made regarding surgical technique over the last 15-20 years. The continuing development of an equine specific, foldable intraocular lens implant (IOL) has provided much needed data supporting the use of such lenses in the horse to improve upon the post operative visual outcome. Finally, the methods utilised to assess visual capacity and the effects of intraocular lens implantation on the globe (e.g. ocular ultrasonography, electroretinography and streak retinoscopy) are gradually becoming more important in preoperative patient assessment and IOL development in the horse. It is the hope of the authors that a broader group of equine veterinarians will become aware of the many changes that have taken place in equine cataract surgery over the last half-century. Although aspiration was implemented nearly 40 years ago in foals for the treatment of congenital cataracts, phacofragmentation (phacoemulsification) techniques have only recently become routine in mature horses undergoing lens extraction. PMID:20939165

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

    Directory of Open Access Journals (Sweden)

    Linertová R

    2014-08-01

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

  20. New technology update: femtosecond laser in cataract surgery

    OpenAIRE

    Zz, Nagy

    2014-01-01

    Zoltan Z NagyDepartment of Ophthalmology, Semmelweis University, Budapest, HungaryAbstract: Femtosecond lasers represent a new frontier in cataract surgery. Since their ­introduction and first human treatment in 2008, a lot of new developments have been achieved. In this review article, the physical principle of femtolasers is discussed, together with the indications and side effects of the method in cataract surgery. The most important clinical results are also presented regarding c...

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

    Directory of Open Access Journals (Sweden)

    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

  2. Large choroidal melanoma diagnosed after cataract surgery.

    Science.gov (United States)

    Nentwich, Martin M; Mackert, Marc J; Hintschich, Christoph; Messmer, Elisabeth M

    2012-10-01

    A dense cataract prevents detailed fundus examination which may lead to delayed diagnosis of undiscovered intraocular pathology before cataract surgery. We report two cases where large choroidal melanomas were diagnosed after cataract surgery and/or Nd:Yag laser capsulotomy. In the first case, a dense cataract prevented proper examination of the fundus of an 84-year-old female. A brownish choroidal lesion was seen after cataract surgery and diagnosed as postoperative choroidal detachment. As this lesion persisted over months, the patient was sent to our hospital for evaluation where a diagnosis of choroidal melanoma with extrascleral growth was made and an enucleation with implantation of a dermis-fat graft was performed without complication 10 days later. In the second case, a 58-year-old female patient had Nd:Yag laser treatment 2 years after cataract surgery had been performed. During fundus examination 1 day after treatment, the ophthalmologist noticed a choroidal lesion which he suspected to be a reaction to the laser treatment and referred the patient to our hospital where a diagnosis of a mushroom-shaped choroidal melanoma with serous retinal detachment was made. These cases show that preoperative evaluation of the posterior segment prior to cataract surgery or other therapeutic interventions is essential in order to identify any pathology. In case of a dense cataract, additional imaging such as ultrasound sonography is recommended in order to exclude intraocular lesions and to visualize the optic disc in suspected glaucoma. PMID:22610449

  3. Simulation-based certification for cataract surgery

    DEFF Research Database (Denmark)

    Thomsen, Ann Sofia Skou; Kiilgaard, Jens Folke

    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: Total module score on seven of 13 modules showed significant discriminative ability between the novices and experienced cataract surgeons. The intermodule reliability coefficient was 0.76 (p < 0.001). A pass/fail level was defined from the total score on these seven modules using the contrasting-groups method. The test had an overall ability to discriminate between novices and experienced cataract surgeons, as 21 of 26 novices (81%) versus one of 11 experienced surgeons (9%) did not pass the test. The vitreoretinal surgeons scored significantly higher than the novices (p = 0.006), but not significantly lower than the experienced cataract surgeons (p = 0.32). CONCLUSION: We have established a performance test, consisting of seven modules on the EyeSi(™) simulator, which possess evidence of validity. The test is a useful and reliable tool for assessment of both cataract surgical and general microsurgical skills in vitro.

  4. Secondary glaucoma after pediatric cataract surgery

    Directory of Open Access Journals (Sweden)

    Yasin Çinar

    2013-04-01

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

  5. Intraocular lens employed for cataract surgery

    Science.gov (United States)

    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.

  6. Evaluation of povidone-iodine applications in cataract surgery

    Directory of Open Access Journals (Sweden)

    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.

  7. New technology update: femtosecond laser in cataract surgery

    Directory of Open Access Journals (Sweden)

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

  8. Cost-utility of routine cataract surgery

    Directory of Open Access Journals (Sweden)

    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.

  9. Role of sphincterotomy in extracapsular cataract surgery.

    OpenAIRE

    Cole, M D; Brown, R; Ridgway, A. E.

    1986-01-01

    Forty patients subjected to extracapsular cataract extraction with posterior chamber intraocular lens implantation in whom a sphincterotomy was required are reported on. This method was used to counter the problems created by a small pupil during surgery. The technique is described and results evaluated.

  10. Spontaneous corneal perforation post cataract surgery

    OpenAIRE

    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...

  11. Cataract surgery following KAMRA presbyopic implant

    Directory of Open Access Journals (Sweden)

    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

  12. Axial length variability in cataract surgery

    International Nuclear Information System (INIS)

    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)

  13. High-fidelity cataract surgery simulation and third world blindness.

    Science.gov (United States)

    Singh, Ajay; Strauss, Glenn H

    2015-04-01

    The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-based surgical training simulator as the centerpiece of a scalable, comprehensive training system for manual small-incision cataract surgery. PMID:24996918

  14. High-Fidelity Cataract Surgery Simulation and Third World Blindness

    Science.gov (United States)

    Singh, Ajay

    2015-01-01

    The burden of global cataract blindness continues to rise, because the number of surgical ophthalmologists is insufficient, and they are unevenly distributed. There is an urgent need to train surgeons quickly and comprehensively in high-quality, low-cost cataract removal techniques. The authors suggest manual small-incision cataract surgery as a safe alternative to phacoemulsification cataract surgery in the developing world. They discuss the development of a novel, full-immersion, physics-based surgical training simulator as the centerpiece of a scalable, comprehensive training system for manual small-incision cataract surgery. PMID:24996918

  15. Control of astigmatism in cataract surgery.

    OpenAIRE

    Brown, N. A.; Sparrow, J. M.

    1988-01-01

    A study is reported on cataract surgery, with intraocular lens implant, with measurement of the preoperative astigmatism and of the postoperative astigmatism over 28 weeks. Nine interrupted 10/0 nylon sutures are used to close a limbal section. Preoperative astigmatism is compensated for in the method of suturing by the placement of additional sutures. Postoperatively sutures are cut in line with the plus cylinder axis in eyes showing excessive astigmatism with the rule. Final postoperative a...

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

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    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

  17. Recent advances in femtosecond laser-assisted cataract surgery

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    Zhao-Jie Chu

    2013-07-01

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

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

    OpenAIRE

    Rs, Joshi

    2013-01-01

    Rajesh Subhash JoshiDepartment of Ophthalmology, Vasatrao Naik Government Medical College, Yavatmal, IndiaAim: To find out the incidence of primary posterior capsular opacification (PCO) in rural patients with a hypermature senile cataract undergoing cataract surgery.Settings: Tertiary eye care center in central India.Design: Prospective, observational, noncomparative study.Materials and methods: Two-hundred eyes of 200 patients presenting with a hypermature cataract underwent manual small in...

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

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    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.

  20. Observation on the efficacy of complicated small pupil cataract surgeries

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    Zhi Lei

    2013-07-01

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

  1. Ocufen and pupillary dilation during cataract surgery.

    Science.gov (United States)

    Drews, R C; Katsev, D A

    1989-07-01

    A random, masked prospective study was performed on 100 patients having elective extracapsular cataract extraction to evaluate the ability of Ocufen (flurbiprofen) to maintain dilation of the pupil. All the patients received a standard dilating regimen; half also received Ocufen drops. Surgery was recorded with a video camera attached to the operating microscope. Magnification was kept constant. Pupil diameters were measured on a calibrated video screen at four different stages of the operation: at the beginning, post-capsulotomy, post-nucleus delivery, and at the end. The age, sex, and iris color of each patient were recorded. Preoperative pupillary diameters were not statistically different between the control and Ocufen groups. The Ocufen-treated group maintained pupillary dilation better on the average and had a much smaller incidence of pupil constriction greater than 2 mm. PMID:2778693

  2. Risk of retinal detachment following cataract extraction: results from the International Cataract Surgery Outcomes Study.

    OpenAIRE

    Norregaard, J. C.; Thoning, H.; Andersen, T. F.; Bernth-petersen, P.; Javitt, J. C.; Anderson, G. F.

    1996-01-01

    AIMS: To estimate the risk of retinal detachment (RD) following cataract extraction in Denmark, and to compare the risk with that following cataract extraction in the USA, and with that in a sample of Danish patients who did not have ocular surgery. METHODS: A sample was created from the administrative Danish Hospital Register and included 19,252 patients who underwent first eye cataract surgery between 1985 and 1987, and who were 50 years of age or older. The patients were then followed for ...

  3. Gains from cataract surgery: visual function and quality of life.

    OpenAIRE

    Desai, P; REIDY, A.; Minassian, D. C.; Vafidis, G.; Bolger, J

    1996-01-01

    AIMS: To describe the impact of cataract surgery in terms of visual function (functioning in everyday life with respect to vision dependent activities) and health related quality of life. METHODS: An observational, longitudinal study of patients undergoing cataract surgery was carried out at three district general hospitals in outer London districts of North Thames Region with follow up at 4 and 12 months postoperatively for a clinical assessment and a standardised administered interview. Pat...

  4. Pulsed electron avalanche knife: new technology for cataract surgery

    Science.gov (United States)

    Priglinger, Siegfried G; Palanker, Daniel; Alge, Claudia S; Kreutzer, Thomas C; Haritoglou, Christos; Grueterich, Martin; Kampik, Anselm

    2007-01-01

    Background The pulsed electron avalanche knife (PEAK?fc) is a new pulsed electrosurgical device that allows for precise, “cold” and traction?free tissue dissection. Aim To evaluate the surgical applicability, safety and potential complications of PEAK?fc in complicated cataract surgery. Methods The study included five children with congenital cataracts, two patients with advanced senile cataracts, six adults with mature cataracts, three of them with posterior iris synechia, three patients with post?traumatic cataracts with zonulolysis, one patient with intumescent traumatic cataract and three patients with massive anterior capsule opacification. Anterior and posterior capsulotomies, iris synechiolysis, dissection of anterior capsule opacification and fibrotic scar tissue were performed. PEAK?fc was set at voltages of 500–700?V, pulse duration of 0.1?m and repetition rate of 40–100?Hz. Results Anterior and posterior capsulotomies were successfully and safely performed in all eyes. The edges of capsulotomies appeared sharp, showing only limited collateral damage. PEAK?fc worked best by just gently touching the capsule, thereby avoiding tractional forces or pressure on the lens capsule. Posterior iris synechiae could be released and anterior capsule opacification was dissected without complications. Conclusions PEAK?fc is a very helpful cutting device for complicated cases of cataract surgery, especially for mature and congenital cataracts, traumatic zonulolysis or anterior segment complications after intraocular inflammation. PMID:17229798

  5. Risk of endophthalmitis after cataract extraction: results from the International Cataract Surgery Outcomes study

    OpenAIRE

    Norregaard, J. C.; Thoning, H.; Bernth-petersen, P.; Andersen, T. F.; Javitt, J.; Anderson, G.

    1997-01-01

    AIM—To estimate risk of infectious endophthalmitis after cataract extraction in Denmark and to compare results with the risk of this complication in the USA?METHODS—In the national Danish administrative hospital register, 19 426 patients were identified who underwent first eye cataract surgery from 1985 to 1987 and who were 50 years of age or older. Of these, 61 patients had postoperative endophthalmitis.?RESULTS—A 12 month cumulative risk of rehospitalisation for endophthalmi...

  6. Investigation of cataract surgery in Leshan, Sichuan Province

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    Yu Han

    2014-08-01

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

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

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    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.

  8. Cataract surgery in Knobloch syndrome: a case report

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    Bongiovanni CS

    2011-06-01

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

  9. Clinical observation of complicated cataract after glaucoma surgery

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    Xue-Yan Wang

    2014-09-01

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

  10. Complicated extracapsular cataract surgery in pseudoexfoliation syndrome: a case report.

    OpenAIRE

    Kirkpatrick, J. N.; Harrad, R. A.

    1992-01-01

    Crystalline lens dislocation and zonular dialysis during intraocular surgery are recognised features of the pseudoexfoliation syndrome (PES). A case is reported in which zonular dialysis occurred in both eyes during extracapsular cataract extraction. In particular surgery was complicated by difficulty in performing anterior capsulotomy. Careful preoperative assessment and peroperative technique may help to reduce the risk of surgical complication in PES.

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

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    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.

  12. Sutureless Cataract Surgery: Principles and Steps

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    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.

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

    Scientific Electronic Library Online (English)

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

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Reddy RK

    2011-06-01

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

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

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    Albrecht Hennig

    2003-01-01

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

  16. Nuclear management in manual small incision cataract surgery by snare technique

    OpenAIRE

    Bhattacharya Debasish

    2009-01-01

    Manual small incision cataract surgery has evolved into a popular method of cataract surgery in India. However, in supra hard cataract, bringing out the whole nucleus through the sclerocorneal flap valve incision becomes difficult. A bigger incision required in such cataracts loses its value action, as the internal incision and corneal valve slips beyond the limbus into sclera. Struggling with the supra hard cataracts through a regular small incision. Phacofracture in the anterior chamber bec...

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

    OpenAIRE

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

    2012-01-01

    Abstract Background To evaluate results after seven years using prophylactic intracameral cefazolin for the prevention of endophthalmitis in cataract surgery. Methods A prospective, observational study of all patients submitted to cataract surgery over the period January 1996 to December 2009. All cases of postoperative endophthalmitis over that period were reviewed. The patients were classified in two groups: Group 1 (11,696 patients) operated on between January 1996 and December 2002, Group...

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

    OpenAIRE

    Marseille, E.

    1996-01-01

    Presented is an assessment of the cost-effectiveness of cataract surgery using cost and services data from the Lumbini Zonal Eye Care Programme in Nepal. The analysis suggests that cataract surgery may be even more cost-effective than previously reported. Under a "best estimate" scenario, cataract surgery had a cost of US$5.06 per disability-adjusted life year (DALY). This places it among the most cost-effective of public health interventions. Sensitivity analysis indicates that cataract surg...

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

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    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.

  20. Conjunctival inclusion cysts following small incision cataract surgery

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    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.

  1. Focussing both eyes on health outcomes: revisiting cataract surgery

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    Davis Jennifer C

    2012-09-01

    Full Text Available Abstract Background The appropriateness of cataract surgery procedures has been questioned, the suggestion being that the surgery is sometimes undertaken too early in the disease progression. Our three study questions were: What is the level of visual impairment in patients scheduled for cataract surgery? What is the improvement following surgery? Given the thresholds for a minimal detectable change (MDC and a minimal clinically important difference (MCID, do gains in visual function reach the MDC and MCID thresholds? Methods The sample included a prospective cohort of cataract surgery patients from four Fraser Health Authority ophthalmologists. Visual function (VF-14 was assessed pre-operatively and at seven weeks post-operatively. Two groups from this cohort were included in this analysis: ‘all first eyes’ (cataract extraction on first eye and ‘both eyes’ (cataract removed from both eyes. Descriptive statistics, change scores for VF-14 for each eye group and proportion of patients who reach the MDC and MCID are reported. Results One hundred and forty-two patients are included in the ‘all first eyes’ analyses and 55 in the ‘both eyes’ analyses. The mean pre-operative VF-14 score for the ‘all first eyes’ group was 86.7 (on a 0–100 scale where 100 is full visual function. The mean change in VF-14 for the 'both eyes' group was 7.5. Twenty-three percent of patients achieved improvements in visual function beyond the MCID threshold and 35% saw improvement beyond the MDC. Conclusions Neither threshold level for MDC or MCID for the VF-14 scale was achieved for a majority of patients. A plausible explanation for this is the very high levels of pre-operative visual functioning.

  2. DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Cillino Giovanni; Pillitteri Francesco; Di Pace Francesco; Casuccio Alessandra; Cillino Salvatore; Lodato Gaetano

    2007-01-01

    Abstract Background Cataract day surgery has rapidly gained worldwide acceptance, because the new surgical techniques and costs are generally lower than those involved in ordinary hospitalization. Cataract surgery serves as a proxy indicator of the trend towards day surgery hospitalization in Italy and, therefore, of regional variability in health-care delivery and cost. The aim of this study was to update the diffusion of cataract day surgery through various surgical ophthalmological centers...

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

    OpenAIRE

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

    2012-01-01

    Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL...

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

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    Yu-Sen Huang

    2013-04-01

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

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

    Scientific Electronic Library Online (English)

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

    2013-12-01

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

  7. Accuracy of intraocular lens power calculation in paediatric cataract surgery

    OpenAIRE

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

    2001-01-01

    AIMS—To determine the accuracy of intraocular lens (IOL) power calculation in a group of pseudophakic children.?METHODS—A retrospective analysis of biometric and refractive data was performed on 52 eyes of 40 infants and children, who successfully underwent cataract extraction and IOL implantation. The following parameters were included: age at the time of surgery, keratometry, axial length, estimated refraction, and the power of IOL implanted. The postoperative refractive outcome was...

  8. Argon laser photocoagulation of cyclodialysis clefts after cataract surgery

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    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(? 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.

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

    OpenAIRE

    Al-Shaer Mutahar; Bamashmus Mahfouth; Al-Barrag Abdulmoghni

    2010-01-01

    Purpose: To study the point prevalence of pseudoexfoliation syndrome (PXS) among Yemeni patients in different governorates with age-related cataract scheduled for surgery. Settings: Eye camps organized by the Nibras Health Society to perform cataract surgeries during the years 2002-2006. All patients aged 40 years and above were included in the study. Materials and Methods: A total of 2535 eyes of 2535 patients from 13 governorates, scheduled for cataract surgery in eye camps, were included. ...

  11. Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery

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    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.

  12. Cirurgia da catarata infantil unilateral / Unilateral pediatric cataract surgery

    Scientific Electronic Library Online (English)

    Adriana Maria Drummond, Brandão; Márcia Beatriz, Tartarella.

    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. Abstract in english PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, [...] the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow), and the best corrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.

  13. Are routine preoperative medical tests needed with cataract surgery?

    Directory of Open Access Journals (Sweden)

    Lira Rodrigo P. C.

    2001-01-01

    Full Text Available Objective. The objective of this study was to investigate whether routine medical testing before cataract surgery reduces the rate of complications during the perioperative period in adults. Methods. The study was carried out in an academic medical center in Brazil, between 10 February 2000 and 10 January 2001. The scheduled cataract operations were randomly assigned to one of two groups: 1 to be preceded by routine testing (the "routine-testing group" or 2 not to be preceded by routine medical testing (the "selective-testing group". If the patient was assigned to the selective-testing group, it was requested that no preoperative testing be performed unless the patient presented with a new or worsening medical problem that would warrant medical evaluation with testing. In the case of patients assigned to the routine-testing group, three tests were requested: a 12-lead electrocardiogram, a complete blood count, and measurements of serum glucose. Results. The sample of 1 025 patients scheduled to undergo cataract surgery was comprised of 512 assigned to the routine-testing group and of 513 assigned to the selective-testing group. The two groups had similar proportions of operations canceled and not subsequently rescheduled, 2% in each group. The cumulative rate of medical events was similar in the two groups, 9.6% in the routine-testing group and 9.7% in the selective-testing group (P = 0.923. The types of medical events were also similar in both groups. Discussion. The results of this study suggest that routine medical testing before cataract surgery does not reduce the rate of complications during the perioperative period. The results also suggest it would be more efficient not to request routine preoperative tests unless indicated by patient history or physical examination.

  14. Selective suture cutting for control of astigmatism following cataract surgery

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    Bansal R

    1992-01-01

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

  15. Management of intraoperative miosis during pediatric cataract surgery using healon 5

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    Jhanji Vishal

    2011-01-01

    Full Text Available 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 including anterior and posterior capsulorrhexis and aspiration were performed successfully. Conclusions : Viscomydriasis is a simple and effective technique for the management of intraoperative pupillary miosis during cataract surgery in pediatric eyes.

  16. Cost of cataract surgery after implantation of three intraocular lenses

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    Catherine Boureau

    2009-03-01

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

  17. Dixyrazine premedication for cataract surgery. A comparison with diazepam.

    Science.gov (United States)

    Oikkonen, M; Heine, H; Salminen, U; Romppanen, O; Inberg, P

    1994-04-01

    Peroral dixyrazine (15-30 mg, n = 50) and diazepam (4-10 mg, n = 50) were used as premedicants for geriatric patients having cataract surgery under regional block. Compared to the diazepam patients, a larger number of the dixyrazine medicated patients appeared anxious, and there was a statistically significant difference between the groups, when summing up changes in anxiety throughout the study period. The dixyrazine patients needed more frequent supplementation with intravenous sedative drugs, compared with their diazepam counterparts. Peroral dixyrazine is an applicable choice for calm patients, when only slight sedation, or avoidance of somnolence are required. PMID:7912876

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Cataracts in Diabetic Patients: A Review Article

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

    International Nuclear Information System (INIS)

    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)

  2. Using corneal topography design personalized cataract surgery programs

    Directory of Open Access Journals (Sweden)

    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.

  3. Recognising ‘high-risk’ eyes before cataract surgery

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    Parikshit Gogate

    2008-03-01

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

  4. Conjunctival sac bacterial flora isolated prior to cataract surgery

    Directory of Open Access Journals (Sweden)

    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

  5. Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy : a 10-year follow-up study

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lux, Anja

    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 were 3 months and 1, 3, 5 and 10 years after surgery. RESULTS: In total, 167 patients had diabetic vitrectomy indicated for non-clearing vitreous haemorrhage (47%) and tractional retinal detachment (53%). The proportion of patients with visual acuity ?0.3 increased from 29% before surgery to 60% after 3 months (p 4 and p-values ? 0.03, logistic regression). Of the 134 patients who were phakic after surgery, 43% and 29% were phakic 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.

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

    OpenAIRE

    Arantes Tiago Eugênio Faria e; Cavalcanti Ronald Fonseca; Diniz Maria de Fátima Alves; Severo Maiara Santos; Lins Neto João; Castro Célia Maria Machado Barbosa de

    2006-01-01

    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 anal...

  7. Impact of cataract surgery on car driving: a population based study in Sweden

    OpenAIRE

    Monestam, E.; Wachtmeister, L.

    1997-01-01

    AIMS—To investigate the outcome of cataract surgery on the patients' self estimation of visual function while driving. Furthermore, the benefit of surgery to the car driving population was determined.?METHODS—A total of 208 consecutive patients (211 cases) with driving licences, who underwent cataract surgery with intraocular lenses, were studied prospectively using self administered questionnaires. Their self estimated degree of visual functional problems while driving were analysed ...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Orbital cellulits following cataract surgery under peribulbar anaesthesia

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Cillino Giovanni

    2007-02-01

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

  11. Nucleus management in manual small incision cataract surgery by phacosection

    Directory of Open Access Journals (Sweden)

    Ravindra M

    2009-01-01

    Full Text Available Nucleus management is critical in manual small incision cataract surgery (MSICS, as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in toto or bisected or trisected into smaller segments. The pressure in the eye can be maintained at the desired level with the use of an anterior chamber maintainer or kept at atmospheric levels. In MSICS, unlike phacoemulsification, there is no need to limit the size of the tunnel or restrain the size of capsulorrhexis. Large well-structured tunnels and larger capsulorrhexis provide better control on the surgical maneuvers. Safety and simplicity of MSICS has made it extremely popular. The purpose of this article is to describe nucleus management by phacosection in MSICS.

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

    Science.gov (United States)

    Marseille, E

    1996-01-01

    Presented is an assessment of the cost-effectiveness of cataract surgery using cost and services data from the Lumbini Zonal Eye Care Programme in Nepal. The analysis suggests that cataract surgery may be even more cost-effective than previously reported. Under a "best estimate" scenario, cataract surgery had a cost of US$5.06 per disability-adjusted life year (DALY). This places it among the most cost-effective of public health interventions. Sensitivity analysis indicates that cataract surgery remains highly cost-effective even under a very pessimistic set of assumptions. The estimated mortality rates of those who receive surgery and of those who do not are among the variables that most influence the cost per DALY. PMID:8789930

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

    Directory of Open Access Journals (Sweden)

    V. H. Karambelkar

    2014-07-01

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

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

    LENUS (Irish Health Repository)

    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.

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

    Scientific Electronic Library Online (English)

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

    2010-10-01

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

  16. Cirugía de catarata en el paciente diabético / Cataract surgery in the diabetic patient

    Scientific Electronic Library Online (English)

    Iraisi F, Hormigó Puertas; Kenia, Galindo Reymond; Taimí, Cárdenas Díaz; Pablo, León Cabrera; Katia M, Trujillo Fonseca; Eric, Montero Díaz.

    2015-03-01

    Full Text Available La diabetes mellitus es una de las principales causas de ceguera en el mundo. La retinopatía diabética sola representa al menos el 12 % de los nuevos casos cada año. Los diabéticos tienen un riesgo 25 veces más de volverse ciegos y desarrollar catarata de forma precoz que la población en general. La [...] calidad de la atención en estos pacientes define el resultado visual. Profundizar en los elementos de la cirugía de catarata en el paciente diabético es esencial. Se realizó una búsqueda bibliográfica de las publicaciones y guías de prácticas clínicas sobre la cirugía de catarata en el paciente diabético publicadas durante los años 2009-2014. La información obtenida fue revisada y procesada por el equipo de investigadores. Se definieron los elementos de importancia en el paciente diabético en las etapas del proceso de atención para la cirugía de catarata pre, trans y posoperatorio. La evaluación integral en los pacientes diabéticos para la cirugía de catarata tiene particularidades que definen la ganancia visual. Las técnicas de facoemulsificación y la implantación de lentes hidrofílicos en el saco capsular han representado un avance en el tratamiento de los pacientes diabéticos, con menor incidencia de cuadros inflamatorios en el posoperatorio, lo que se atribuye al escaso traumatismo quirúrgico que conlleva la técnica. El tratamiento farmacológico o con láser (fotocoagulación) y la cirugía precoz mejoran el pronóstico visual. Abstract in english Diabetes mellitus is one of the main causes of blindness worldwide. Diabetic retinopathy represents 12 % of the new cases every year. The risk of becoming blind is twenty five times higher in diabetics and they may develop cataract earlier than the general population. The quality of care in these pa [...] tients defines the visual result. Delving into the cataract surgery elements in the case of a diabetic patient is fundamental. A literature review of publications and clinical practice guidelines on cataract surgery in the diabetic patient published from 2009 to 2014. The gathered information was reviewed and processed by the team of researchers. Important elements were defined in the diabetic patient in the different stages of care during the preoperative, perioperative and postoperative periods. The comprehensive assessment of diabetic patients to be performed cataract surgery has particularities defining the visual gain. The phacoemulsification techniques and the implantation of hydrophilic lenses in the capsular sack represent an advance in treating diabetic patients, with lower incidence of inflammatory conditions postoperatively due to the little surgical traumatism involved in this technique. The drug or the laser-assisted (photocoagulation) treatment and the early surgery improve the visual prognosis.

  17. 60 FR 52396 - Medicare Program; Limitations on Medicare Coverage of Cataract Surgery

    Science.gov (United States)

    1995-10-06

    ...cataract surgery, and Nd:YAG capsulotomy. DATES: Comments will be considered...opacification (PCO) is Nd:YAG capsulotomy, also referred to as YAG or...Panel lists indications for Nd:YAG capsulotomy in its Clinical Practice...

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

    OpenAIRE

    V. H. Karambelkar; Ankit Sharma; Viraj Pradhan

    2014-01-01

    Background: With accurate estimation of power of intraocular lens (IOL), uncomplicated cataract surgery and uneventful post operative period, the implant is capable of providing a visual acuity of 6/6 and a normal field of vision. However, post operative results are not always according to the expectations. This study is an attempt to find out causes of subnormal vision post uneventful cataract surgery with posterior chamber intraocular lens by various surgical techniq...

  19. Biometry and formula accuracy with intraocular lenses used for cataract surgery in extreme hyperopia.

    OpenAIRE

    Maclaren, Re; Natkunarajah, M.; Riaz, Y.; Bourne, Rr; Restori, M.; Allan, Bd

    2007-01-01

    PURPOSE: To audit intraocular lens (IOL) power predictions for cataract surgery in extreme hyperopia and to compare the accuracy across different biometry formulae and IOL types. DESIGN: A retrospective analysis of 76 eyes from 56 patients undergoing cataract surgery with IOLs ranging in power from 30 to 35 diopters (D). METHODS: Axial lengths, corneal powers and anterior chamber depths were measured with ultrasound or optical methods, and the IOLMaster (Carl Zeiss Meditech, Inc, Dublin, Cali...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Lira Rodrigo Pessoa; Ed Cio, Nascimento Maur X.; Arieta Carlos Eduardo; Duarte Luis Eduardo; Hirata Fabio; Nadruz Wilson

    2010-01-01

    Incidence of preoperative rise in blood pressure (BP) in cataract surgery among hypertensive and normotensive patients. Objective: To study the incidence of preoperative rise in BP in cataract surgery among normotensive individuals and hypertensive patients with historic good BP control in a population without other major chronic diseases. Settings: Ophthalmology Service of a University Hospital. Materials and Methods: A prospective study with 822 patients older than 40 years of age, with cat...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

    Krarup, Therese; Holm, Lars Morten

    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 contralateral eye operated by CPS (stop and chop technique). Both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality with a non-contact specular microscope were assessed 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 ± 0.42) by CPS (p = 0.56). Mean CDVA was 0.89 (0.3; 1.25) by FLACS and 0.93 (0.4; 1.25) by CPS at 3 months postoperatively (p = 0.36). Within both groups, 70% gained a CDVA of 6/6. Mean surgery time was 9.3 min (SD ± 1.9) by FLACS and 8.0 min (SD ± 1.9) by CPS, (p = 0.0018). Mean phaco energy was 3.78 U/S (SD ± 5.1) and 5.45 U/S (SD ± 4.6) (p < 0.0001) by FLACS and CPS, respectively. CONCLUSION: We found no significant difference in ECL and refractive predictability between FLACS and CPS 3 months postoperatively.

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

    Scientific Electronic Library Online (English)

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

    2012-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Henry Pérez González

    2012-12-01

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

  6. Endophthalmitis: controlling infection before and after cataract surgery

    Directory of Open Access Journals (Sweden)

    Nuwan Niyadurupola

    2008-03-01

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

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

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Aj, Kanellopoulos

    2013-01-01

    Anastasios John KanellopoulosLaserVision gr Institute, Athens, Greece; New York University Medical School, New York, NY, USAPurpose: To report the safety and efficacy of a novel surgical technique using two lasers in cataract surgery.Methods: In this contralateral eye report, a 57-year-old female underwent cataract extraction. Two laser devices and a standard phacoemulsification, platform were used to conduct the procedures. First, a femtosecond laser was used to perform the corneal incision,...

  12. Sustained release of antibiotic from poly(2-hydroxyethyl methacrylate) to prevent blinding infections after cataract surgery

    OpenAIRE

    Anderson, Erin M.; Noble, Misty L.; Garty, Shai; Ma, Hongyan; Bryers, James D.; Shen, Tueng T.; Ratner, Buddy D.

    2009-01-01

    Intraocular lens implantation after opacified natural lens removal is the primary treatment for cataracts in developed countries. Cataract surgery is generally considered safe, but entails significant risks in countries where sophisticated sterile operating theaters are not widely available. Post-operative infection (endophthalmitis) is a potential blinding complication. Infection often results from bacterial colonization of the new lens implant and subsequent antibiotic-tolerant biofilm form...

  13. Optical quality of toric intraocular lens implantation in cataract surgery

    Directory of Open Access Journals (Sweden)

    Xian-Wen Xiao

    2015-02-01

    Full Text Available AIM: To analyze the optical quality after implantation of toric intraocular lens with optical quality analysis system. METHODS: Fifty-two eyes of forty-four patients with regular corneal astigmatism of at least 1.00 D underwent implantation of AcrySof toric intraocular lens, including T3 group 19 eyes, T4 group 18 eyes, T5 group 10 eyes, T6 group 5 eyes. Main outcomes evaluated at 3mo of follow-up, included uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, residual refractive cylinder and intraocular lens (IOL axis rotation. Objective optical quality were measured using optical quality analysis system (OQAS ?®, Visiometrics, Spain, included the cutoff frequency of modulation transfer function (MTFcutoff, objective scattering index (OSI, Strehl ratio, optical quality analysis system value (OV 100%, OV 20% and OV 9% [the optical quality analysis system (OQAS values at contrasts of 100%, 20%, and 9%]. RESULTS: At 3mo postoperative, the mean UDVA and CDVA was 0.18±0.11 and 0.07±0.08 logMAR; the mean residual refractive cylinder was 0.50±0.29 D; the mean toric IOL axis rotation was 3.62±1.76 degrees, the mean MTFcutoff, OSI, Strehl ratio, OV 100%, OV 20% and OV 9% were 22.862±5.584, 1.80±0.84, 0.155±0.038, 0.76±0.18, 0.77±0.19 and 0.78±0.21. The values of UDVA, CDVA, IOL axis rotation, MTFcutoff, OSI, Strehl ratio, OV100%, OV20% and OV9% depending on the power of the cylinder of the implantation were not significantly different (P>0.05, except the residual refractive cylinder (PCONCLUSION: The optical quality analysis system was useful for characterizing the optical quality of AcrySof toric IOL implantation. Implantation of an AcrySof toric IOL is an effective and safe method to correct corneal astigmatism during cataract surgery.

  14. Factors associated with strabismus after cataract extraction and primary intraocular lens implantation in congenital cataracts

    Directory of Open Access Journals (Sweden)

    Soo Jung Lee

    2014-06-01

    Full Text Available AIM: To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation.METHODS: The medical records of 122 patients, aged 1.5mo to 9y, who had undergone cataract extraction with primary intraocular lens implantation between January 1993 and August 2011 were reviewed. Fourteen patients (17 eyes with strabismus before cataract surgery were excluded. Patients were divided into those with congenital bilateral cataracts (64 patients, 128 eyes and those with unilateral cataracts (44 patients, 44 eyes. The associations between the development of strabismus and age at cataract surgery, pre- and post-cataract extraction corrected distance visual acuity (CDVA, interocular CDVA difference, nystagmus, surgical method, and secondary cataract were evaluated.RESULTS: Factors significantly associated with the development of strabismus included age at cataract surgery (?1y, preoperative mean CDVA ?20/100, presence of nystagmus in the bilateral cataract group and postoperative interocular CDVA difference ?20/70 in the unilateral group. Postoperative CDVA ?20/100 and preservation of posterior capsule, and presence of secondary cataract were significant factors in both groups.CONCLUSION: Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus, especially when they underwent surgery at age ?1y, and they have nystagmus, large postoperative interocular CDVA difference, poor preoperative and postoperative CDVA, preservation of the posterior capsule, or secondary cataract.

  15. Improvement of circular capsulorhexis technique during huge hardcore small incision cataract surgery

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    Xin He

    2014-11-01

    Full Text Available AIM: To analyze huge hardcore cataract surgery with the diameter of the circular capsulorhexis size, discuss circular capsulorhexis technique improvement and evaluate the application advantages of anterior capsule continuous curvilinear capsulorrhexis combined with anterior capsule opening radial multi-point cutting surgery in huge hardcore cataract surgery. METHODS: Sixty-nine cases(80 eyeswith huge hardcore cataract, successfully underwent anterior capsule continuous curvilinear capsulorrhexis combined with anterior capsule opening radial multi-point cutting surgery, and delivered nuclear smoothly. RESULTS: Seventy-eight eyes(98%successfully completed surgery. Two eyes occurred capsular rupture or part of the suspensory ligament rupture caused by squeezing huge hardcore. Intraoperative, nuclear was spun into the anterior chamber by hands, or dragged into the anterior chamber using circle key and delivered. Pupil vitreous was cleaned up, then suspensory intraocular lens was implanted at second stage.CONCLUSION: As the improvement surgery of anterior capsule continuous curvilinear capsulorrhexis combined with anterior capsule opening radial multi-point cutting method is safe and effective in huge hardcore cataract surgery.

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

    Directory of Open Access Journals (Sweden)

    Wan-Soo Kim

    2013-06-01

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

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

    Scientific Electronic Library Online (English)

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

    2012-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Idalia Triana

    2012-07-01

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

  19. Role of interleukin 6 in the inflammatory response after cataract surgery. An experimental and clinical study.

    Science.gov (United States)

    Malecaze, F; Chollet, P; Cavrois, E; Vita, N; Arné, J L; Ferrara, P

    1991-12-01

    The mechanism of uveitis following cataract surgery, which is mediated in part by the cyclooxygenase pathway, is complex, the complexity of which is likely to be due to several factors. We investigated the possible local involvement of interleukin 6 (IL-6) in this response. Using a specific bioassay, we showed a dramatic increase of IL-6 levels (> 4 x 10(3) times) in all of the aqueous humors of 12 patients following cataract surgery. The IL-6 levels in serum samples were below detection limits, indicating a local production of this cytokine. In addition, the injection of highly purified recombinant interleukin 6 in the anterior chamber of the eye in rabbits resulted in an inflammatory response. These observations suggest that IL-6 may play a crucial role in the occurrence of inflammation after cataract surgery, and it may lead to new therapeutic approaches to this problem. PMID:1841575

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

    Directory of Open Access Journals (Sweden)

    Romero-Aroca Pedro

    2012-01-01

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

  1. Use of Cataract Surgery in Urban Beijing: a Post Screening Follow-up of the Elderly with Visual Impairment due to Age-related Cataract.

    Science.gov (United States)

    Ren, Xue-Tao; Snellingen, Torkel; Gu, Hong; Assanangkornchai, Sawitri; Zou, Yan-Hong; Chongsuvivatwong, Virasakdi; Lim, Apiradee; Jia, Wei; Liu, Xi-Pu; Liu, Ning-Pu

    2015-03-01

    Objective To understand the perception for the use of cataract surgical services in a population of acceptors and non-acceptors of cataract surgery in urban Beijing.Methods From a community-based screening program a total of 158 patients with presenting visual acuity of less than 6/18 on either eye due to age-related cataract were informed about the possibility of surgical treatment. These patients were interviewed and re-examined 36 to 46 months after initial screening. The main reasons for not accepting surgery were obtained using a questionnaire. Vision function and vision-related quality of life scores were assessed in those who received and did not receive surgery. Results At the follow-up examination 116 of the 158 patients were available and 36 (31.0%) had undergone cataract surgery. Cases who chose surgery had higher education level than those who did not seek surgery (OR=2.64, 95% CI: 1.08-6.63, P=0.02). There were no significant differences in vision function (P=0.11) or quality of life scores (P=0.16) between the surgery group and the non-surgery group. Main reasons for not having surgery included no perceived need (50.0%), feeling of being "too old" (19.2%), and worry about the quality of surgery (9.6%). Cost was cited by 1 (1.9%) subject as the main reason for not seeking surgery. Conclusions The data suggest that in China's capital urban center for patients with moderate visual impairment there is a relative low acceptance rate of cataract surgery, mainly due to people's perception of marginal benefits of surgery. Cost is not a determining factor as barrier to undergo surgery and patients with poorer education are less likely to undertake surgery. PMID:25837353

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Eperon, Simone; Rodriguez-Aller, Marta; Balaskas, Konstantinos; Gurny, Robert; Guex-Crosier, Yan

    2013-02-25

    Cataract surgery is a common ocular surgical procedure consisting in the implantation of an artificial intraocular lens (IOL) to replace the ageing, dystrophic or damaged natural one. The management of postoperative ocular inflammation is a major challenge especially in the context of pre-existing uveitis. The association of the implanted IOL with a drug delivery system (DDS) allows the prolonged intraocular release of anti-inflammatory agents after surgery. Thus IOL-DDS represents an "all in one" strategy that simultaneously addresses both cataract and inflammation issues. Polymeric DDS loaded with two model anti-inflammatory drugs (triamcinolone acetonide (TA) and cyclosporine A (CsA)) were manufactured in a novel way and tested regarding their efficiency for the management of intraocular inflammation during the 3 months following surgery. The study involved an experimentally induced uveitis in rabbits. Experimental results showed that medicated DDS efficiently reduced ocular inflammation (decrease of protein concentration in aqueous humour, inflammatory cells in aqueous humour and clinical score). Additionally, more than 60% of the loading dose remained in the DDS at the end of the experiment, suggesting that the system could potentially cover longer inflammatory episodes. Thus, IOL-DDS were demonstrated to inhibit intraocular inflammation for at least 3 months after cataract surgery, representing a potential novel approach to cataract surgery in eyes with pre-existing uveitis. PMID:23291445

  5. Anesthetic management of cardiac patient for cataract surgery

    International Nuclear Information System (INIS)

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

  6. Study: Cataract Surgery Can Reduce Hip Fracture Risk

    Science.gov (United States)

    ... Medical Assisting: An Independent Study Course, Fifth Edition eBook Focal Points 2015 Module: Choroidal Nevus ProVision Series ... Ophthalmic Multiple-Choice Questions With Discussions, Series 5 eBook Focal Points 2014 Module: Meibomian Gland Dysfunction Cataract ...

  7. Cataract surgery in Knobloch syndrome: a case report

    OpenAIRE

    Cs, Bongiovanni; Ccs, Ferreira; Aps, Rodrigues; Jb, Fortes Filho; Mb, Tartarella

    2011-01-01

    Carmen Sílvia Bongiovanni1, Carla Cristina Serra Ferreira1, Ana Paula Silvério Rodrigues1, João Borges Fortes Filho2, Márcia Beatriz Tartarella11Department of Ophthalmology, Congenital Cataract Section, Medical School, Federal University of São Paulo, São Paulo; 2Department of Ophthalmology, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, BrazilAbstract: Knobloch syndrome is an autosomal recessive disorde...

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

    DEFF Research Database (Denmark)

    Lou, Astrid R; Madsen, Kristoffer H

    2013-01-01

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

  9. Spectrum and clinical profile of post cataract surgery endophthalmitis in North India

    OpenAIRE

    Gupta Amit; Gupta Vishali; Gupta Amod; Dogra Mangat; Pandav Surinder; Ray Pallab; Chakraborty Arunaloke

    2003-01-01

    Purpose: To determine the spectrum, clinical profile and risk factors for poor visual outcome in patients of post cataract surgery endophthalmitis. Methods: Data from 124 eyes were analysed. Various clinical and microbiological parameters were evaluated and risk factors for unfavourable outcome identified. Results: The mean age of the patients was 59.50±13.75 years; 60.5% were males. The median surgery-symptom interval was 7 days (mean 15.81±24.01) and the medium sy...

  10. Is cataract surgery justified in patients with age related macular degeneration? A visual function and quality of life assessment

    OpenAIRE

    Armbrecht, A; Findlay, C; Kaushal, S; Aspinall, P; A Hill; Dhillon, B

    2000-01-01

    AIMS—To determine whether patients with age related macular degeneration (ARMD) benefit from cataract surgery in terms of visual function and quality of life measures, and to assess the impact of surgery on the progression of ARMD.?METHODS—A prospective study was carried out of patients with and without ARMD undergoing cataract surgery. Data were collected from 187 patients at the Princess Alexandra Eye Pavilion, Edinburgh and the Oxford Eye Hospital, Oxford. The patients were divided into th...

  11. Nuclear management in manual small incision cataract surgery by snare technique

    Directory of Open Access Journals (Sweden)

    Bhattacharya Debasish

    2009-01-01

    Full Text Available Manual small incision cataract surgery has evolved into a popular method of cataract surgery in India. However, in supra hard cataract, bringing out the whole nucleus through the sclerocorneal flap valve incision becomes difficult. A bigger incision required in such cataracts loses its value action, as the internal incision and corneal valve slips beyond the limbus into sclera. Struggling with the supra hard cataracts through a regular small incision. Phacofracture in the anterior chamber becomes a useful option in these cases. In the snare technique, a stainless steel wire loop when lassoed around the nucleus in the anterior chamber constricts from the equator, easily dividing the hardest of the nuclei into two halves. The wire loop constricts in a controlled way when the second cannula of snare is pulled. The divided halves can easily be brought out by serrated crocodile forceps. This nuclear management can be safely performed through a smaller sclerocorneal flap valve incision where the corneal valve action is retained within the limbus without sutures, and the endothelium or the incision is not disturbed. However, the technique requires space in the anterior chamber to maneuver the wire loop and anterior chamber depth more than 2.5 mm is recommended. Much evidence to this wonderful technique is not available in literature, as its popularity grew through live surgical workshops and small interactive conferences.

  12. Relation between postoperative blood-aqueous barrier damage and LOCS III cataract gradings following routine phacoemulsification surgery

    OpenAIRE

    Ursell, P; Spalton, D; Tilling, K.

    1997-01-01

    AIM—To examine the relation between cataract density, the phacoemulsification energy required for its removal, and blood-aqueous barrier (BAB) damage on the first day after surgery.?METHODS—A prospective study recruiting patients with normal eyes apart from senile cataract. Preoperatively, visual acuity, anterior chamber laser flare, and cell values were measured using the Kowa laser flare meter, and the LOCS III grading of the cataract defined. The patients all underwent standardised phacoem...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Cost of cataract surgery after implantation of three intraocular lenses

    OpenAIRE

    Catherine Boureau; Antoine Lafuma; Viviane Jeanbat; Smith, Andrew F.; Gilles Berdeaux

    2009-01-01

    Catherine Boureau1, Antoine Lafuma2, Viviane Jeanbat2, Andrew F Smith3, Gilles Berdeaux41Clinique Geoffroy St Hilaire, Paris, France; 2Cemka-Eval, Bourg la Reine, France; 3Alcon Laboratories Ltd, Hemel Hempstead, UK and Nuffield Laboratory of Ophthalmology, University of Oxford, UK; 4Alcon France, Rueil Malmaison, France; Conservatoire National des Arts et Métiers, Paris, FranceBackground: Posterior capsule opacification is one of the most frequent adverse events following cataract...

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

    OpenAIRE

    Js, Chang; Hw, Flynn Jr; Miller D.; We, Smiddy

    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...

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

    Directory of Open Access Journals (Sweden)

    Abdulmoghni Al-Barrag

    2009-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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 ? 1 eye, nuclear hardness ? 4 eyes, nuclear hardness ? 5 eyes. One case with ? 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.

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

    DEFF Research Database (Denmark)

    Munk, Sofie J; Heegaard, Steffen

    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 for a detached retina avoiding HPMC. This case stresses the importance of considering all medication given to patients as possible causes of an anaphylactic reaction. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

  19. Phacoemulsification Surgery in Patients with Cataract Formation After Intravitreal Injection of Triamcinolone Acetonide

    Directory of Open Access Journals (Sweden)

    Esra Ayhan Tuzcu

    2008-03-01

    Full Text Available AbstractPurpose: To evaluate the results and complications of phacoemulsification surgery due to various factors in patients with cataract formation after intravitreal injection of triamcinolone acetonide (IVTA. Materials and Methods: Forty-five eyes of 32 patients with cataract formation that had developed after one or multiple IVTA injections were included in the study. Among these patients, 28 eyes had diabetic macular edema, 7 eyes had branch retinal vein occlusion, 2 eyes had central retinal vein occlusion, 4 eyes had choroidal neovascular membrane due to age-related macular degeneration, 2 eyes had uveitic cystoid macular edema and 2 eyes had posterior uveitis. The mean age of the patients was 52.4±11.0 years, and all patients underwent standard phacoemulsification surgery with foldable intraocular lens implantation. Results: Minimal hemorrhage developed during surgery in 2 patients with diabetic retinopathy. After anterior chamber lavage, there was no hemorrhage after surgery and during the following days. Postoperatively, transient intraocular pressure elevation treated with topical antiglaucomatous medication was observed in 5 eyes. Seven eyes required Nd:YAG laser therapy due to posterior capsule opasification after a mean follow-up time of 8.5 months.Conclusion: There were no additional complications secondary to IVTA injection during or after phacoemulsification surgery in patients with cataract formation following IVTA injection.

  20. Combined cataract-glaucoma surgery using the THC:YAG (holmium) laser ab interno without gonioscopy.

    Science.gov (United States)

    Kendrick, R M; Kollarits, C R

    1992-10-01

    We describe a simple method of combined cataract-glaucoma surgery, involving use of the THC:YAG (holmium) laser ab interno, without gonioscopy, in which the initial cataract incision remains small and the glaucoma filtering procedure can be completed relatively quickly, with minimal surgical manipulation of the conjunctiva. In a series of 15 eyes (13 patients) with visually significant cataracts and medically uncontrolled glaucoma, followed for an average of 14 weeks (range, 1 to 26 weeks), 13 of the 15 eyes had decreased IOP. Visual acuity was improved in 9 eyes, remained the same in 4 eyes (with age-related macular degeneration), and was worse in 2 eyes (with opacification of the posterior capsule sufficient to account for the decrease in acuity). PMID:1436972

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

    Science.gov (United States)

    Marseille, E; Brand, R

    1997-11-01

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

  2. The role of environmental light in sleep and health: effects of ocular aging and cataract surgery.

    Science.gov (United States)

    Turner, Patricia L; Van Someren, Eus J W; Mainster, Martin A

    2010-08-01

    Environmental illumination profoundly influences human health and well-being. Recently discovered photoreceptive retinal ganglion cells (pRGCs) are primary mediators of numerous circadian, neuroendocrine and neurobehavioral responses. pRGCs provide lighting information to diverse nonvisual (non-image-forming) brain centers including the suprachiasmatic nuclei (SCN) which serve as the body's master biological clock. The SCN exert functional control over circadian aspects of physiology. The timing and strength (amplitude) of SCN rhythmic signals are affected by light exposure. Light deficiency may attenuate SCN function and its control of physiological and hormonal rhythms which in turn can result in a cascade of adverse events. Inadequate pRGC photoreception cannot be perceived consciously, but may aggravate many common age-associated problems including insomnia, depression and impaired cognition. In this review we (1) summarize circadian physiology, emphasizing light's critical role as the most important geophysical timing cue in humans; (2) analyze evidence that typical residential lighting is insufficient for optimal pRGC requirements in youth and even more so with advancing age; (3) show how ocular aging and cataract surgery impact circadian photoreception; and (4) review some of the diverse morbidities associated with chronodisruption in general and those which may be caused by light deficiency in particular. PMID:20056462

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

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    Al-Shaer Mutahar

    2010-01-01

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

  4. Case Control Analyses of Acute Endophthalmitis after Cataract Surgery in South India Associated with Technique, Patient Care, and Socioeconomic Status

    OpenAIRE

    Taraprasad Das; Anjli Hussain; Thomas Naduvilath; Savitri Sharma; Subhadra Jalali.; Ajit B. Majji

    2012-01-01

    Purpose. We investigated acute endophthalmitis incidence following cataract surgery vis-a-vis the current technological and postoperative care changes in higher and lower socioeconomic categories of patients in South India. Methods. In a retrospective case control study, we analyzed 62 cases of acute endophthalmitis and 5 controls for each endophthalmitis case from 46,095 cataract surgeries done between years 1993 and 1998. The time period covered the transition of surgical technique and afte...

  5. Suture-related keratitis following cataract surgery caused by methicillin-resistant Staphylococcus aureus

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    Ahmad B Tarabishy

    2010-03-01

    Full Text Available Ahmad B Tarabishy1, Thomas L Steinemann21Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; 2Cornea and External Eye Disease, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USAAbstract: A 54-year old-man presented with a two-day history of severe pain and decreased vision. Examination revealed a corneal ulcer associated with a loose suture from cataract surgery done approximately two years ago. The suture was removed and the patient was started on topic antibiotic treatment with cefazolin and gentamycin. Cultures revealed methicillin-resistant Staphylococcus aureus (MRSA. The antibiotic regimen was changed to include vancomycin but the ulcer continued to progress. Three days later, the ulcer had perforated and an emergent corneal patch graft was performed. To our knowledge, this is the first reported case of suture-related MRSA keratitis after uncomplicated clear corneal cataract surgery.Keywords: keratitis, MRSA, suture, staphylococcus aureus

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

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    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.

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

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    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.

  8. A real-time automatic instrument tracking system on cataract surgery videos for dexterity assessment

    OpenAIRE

    Baldas, V.; Tang, L.; Bountris, P.; Saleh, G.; Koutsouris, D.

    2011-01-01

    In this paper we describe the SUITS (Surrey University Instrument Tracking System), an automated video processing system that analyzes videos of cataract surgeries to extract parameters for surgical skill assessment. Through image processing and object tracking techniques the eye is identified, and its movement and direction changes throughout the operation are monitored. Any instrument that moves into or out of the eye is located with its path measured. So far we have developed a prototype r...

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

    OpenAIRE

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

    2011-01-01

    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 ba...

  10. Adjunctive intravitreal dexamethasone in the treatment of acute endophthalmitis following cataract surgery

    OpenAIRE

    Hall, Edward F.; Scott, Garrett R.; Musch, David C.; Zacks, David N.

    2008-01-01

    Edward F Hall1, Garrett R Scott1, David C Musch1,2, David N Zacks11Department of Ophthalmology and Visual Sciences, Medical School; 2Department of Epidemiology, School of Public Health; University of Michigan, Ann Arbor, MI, USAPurpose: Controversy exists regarding the use of intravitreal dexamethasone (IVD) as an anti-inflammatory adjunct to intravitreal antibiotics in patients with acute endophthalmitis following cataract surgery. The purpose of this project was to evaluate our experience r...

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

    OpenAIRE

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

    2014-01-01

    Objectives. The aim of this study was to assess the effects of clonidine on intraoperative analgesia, sedation, intraocular and blood pressure, arrhythmia, and ischemia. Methods. Forty patients undergoing cataract surgery were allocated into two groups. They were monitored with Holter machine, the pupil was dilated, and 30 minutes later, 20 patients received clonidine (4?µg/kg), while the other 20 patients were given a 0.9% saline intravenously. Twenty minutes later, 2% lidocaine gel w...

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

    Science.gov (United States)

    ... see both near and distant objects clearly. The design of the accommodative lens allows certain eye muscles ... surgery to exchange an IOL for another type, implant an additional IOL, or make limbal relaxing incisions ...

  13. Complications of cataract and refractive surgery: a clinicopathological documentation.

    OpenAIRE

    Apple, D J; Werner, L

    2001-01-01

    PURPOSE: To present selected complications of keratorefractive and phakic intraocular lens (IOL) surgery and a series of IOLs that required explantation because of various postimplantation opacification of the IOL optic. METHODS: Two specimens obtained after keratorefractive surgery, 2 phakic IOLs, and a total of 23 explanted IOLs from cases in which postimplantation opacification of the IOL optic had occurred were studied. These included 6 Bausch and Lomb (B&L) Hydroview H60 M designs, 9 Med...

  14. Influence of IOL refractive index on straylight level following cataract surgery

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    Yu-Wei Zheng

    2015-01-01

    Full Text Available AIM:To investigate the influence of IOL refractive index(RIon measurement of straylight following cataract surgery. METHODS:In this case-control study, 77 eyes of 77 age-related cataract patients who underwent cataract phacoemulsification with posterior chamber aspherical arylic IOL implantation surgery in the Eye Hospital of China Medical University from Aug 2013 to Mar 2014, with a best corrected visual acuity(BCVAof 0.5 or better, were classified into 3 groups randomly using 3 types of IOL: Tecnis ZCB00 Group(RI=1.47, 22 eyes of 22 subjects; Hoya PY60AD Group(RI=1.52, 24 eyes of 24 subjects; Alcon SN60WF or IQ Group(RI=1.55, 31 eyes of 31 subjects. BCVA, pupil size, astigmatism, axial length, intraocular straylight were measured respectively.RESULTS:Age, axial length, BCVA, pupil size, astigmatism of the three groups were not significant difference(P>0.05. The straylight of Tecnis, Hoya, IQ group were 1.04±0.15, 1.19±0.14, 1.14±0.18. Straylight levels had significant differences among three groups(F=5.352, P=0.007r=-0.133, P=0.124>0.05.CONCLUSION:Patients chosen the higher RI IOL may have a higher straylight level after the surgery.

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

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    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.

  16. Comparison of the prediction error in cataract surgery with Lenstar and conventional ultrasound

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    Hou-Cheng Liang

    2013-12-01

    Full Text Available AIM: To compare the prediction errors(PEin cataract surgery with Lenstar and conventional ultrasound. METHODS: The data of age-related cataract patients were retrospectively analyzed from March, 2013 to June, 2013 in our hospital. Preoperative measurements of ocular biological parameters and calculation of intraocular lens(IOLdegree using SRK/T's formula with ultrasound, keratometry and Lenstar were performed. Cataract extraction combined with IOL implantation in capsule was taken in every patient. Retinoscopy was taken postoperatively after 3 months. Comparison of the two inspection methods for measuring axial length, mean corneal curvature and postoperative refractive PE and absolute value of PE(APE. RESULTS: Preoperative axial length was 24.68±1.70mm and 24.42±1.65mm with Lenstar and ultrasound, respectively, and there was significant difference(t=-12.688, Pr=0.992, Pt=-1.241, P=0.217, but was the significant correlation(r=0.963, Pt=-5.494, Pt=6.379, PCONCLUSION: Accurate ocular biological parameters can be achieved with Lenstar, and postoperative PE is more precise with Lenstar compared with conventional ultrasound. Lenstar can be used for precise calculation of IOL degree in cataract operation.

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

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    Kanellopoulos AJ

    2013-09-01

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

  18. Visual acuity assessment after cataract surgery by pattern reversal visual evoked potential

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    Yi-Chen Zheng

    2013-12-01

    Full Text Available AIM: To discuss visual acuity assessment after cataract surgery by pattern reversal visual evoked potential. METHODS:Data of 72 adult cataract patients received PRVEP before and after phaco and IOL in Department of Ophthalmology, Tongji Hospital from October 2012 to May 2013 was analyzed retrospectively. A total of 114 eyes were studied, including 76 eyes with senile cataract and 38 eyes with complicated cataract. According to the degree of lens opacity and the hardness of lens nucleus, these data were divided into two groups: Group 1(grade?, ?, ? and Group 2(grade ?, ? and was statistically studied with correlation analysis. RESULTS: Group 1:(1Preoperative: the average of visual acuity was 0.344, the incubation time of P100 wave was 107ms and the amplitude of N75- P100 wave was 4.633?V; postoperative: the average of visual acuity was 0.672, the incubation time of P100 wave was 104.37ms and the amplitude of N75- P100 wave was 4.400?V.(2The visual acuity before and after operation were both significantly negatively correlated with the incubation time of P100 wave(P75- P100 wave(preoperative: PP100 wave. Group 2:(1Preoperative: the average of visual acuity was 0.116,the incubation time of P100 wave was 118.905ms and the amplitude of N75-P100 wave was 1.650?V; postoperative: the average of visual acuity was 0.576, the incubation time of P100 wave was 108.429ms and the amplitude of N75- P100 wave was 5.132?V.(2The visual acuity before operation was significantly negatively correlated with the incubation time of P100 wave(P100 wave; the visual acuity before and after operation showed no relationship with the amplitude of N75- P100 wave.(3The improved rows of the visual acuity before and after operation showed no relationship with the change of the incubation time of P100 wave. CONCLUSION:According to the correlation among the visual acuity, the incubation time of P100 wave and the amplitude of N75- P100 wave, PRVEP is significantly affected by preoperative visual acuity(the degree of opacity in refractive media. PRVEP is not helpful as an indicator of visual prognosis after cataract surgery, and PRVEP before cataract surgery has no clinical significance.

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

    Scientific Electronic Library Online (English)

    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.

  20. 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

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    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.

  1. Effectiveness of relevant examination on visual function assessment and retinal disease detection before cataract surgery

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    Wei Chen

    2015-02-01

    Full Text Available AIM: To evaluate the effectiveness of applying visual electrophysiological examination, including flash visual evoked potentials(FVEP, flash electroretinogram(FERG, pattrn electroretinogram(PERG, fundus photography, eye B-type ultrasound, optical coherence tomography(OCT, on visual function assessment and retinal disease detection before cataract surgery.METHODS: Visual elctrophysiological examination,fundus photography, eye B-type ultrasound and OCT were applied in 148 cases(196 eyes. The positive rate was analyzed according to the results of FVEP, FERG(or PERG, fundus photography, eye B-type ultrasound and OCT.RESULTS: In 148 cases(196 eyes, vitreous opacities was showed in 165 eyes(84.2%by eye B-type ultrasound examination, 31 eyes(15.8%without access to B-type ultrasound image; success for fundus camera images in 161 eyes(80.6%, and unable to get image in 35 eyes(19.4%; the VEP and ERG in 58 eyes(29.6%were get valuable, and the VEP and ERG were saw no obvious abnormal in 138 eyes(70.4%; success for OCT image in 167 eyes(85.2%, without access to OCT image in 29 eyes(14.8%. CONCLUSION: Visual elctrophysiological detection,fundus photography, eye B-type ultrasound and OCT can predict the preoperative visual acuity of cataractous patients. A variety of inspection methods complement each other, can further improve detection rate of retinal diseases and other eye disease before cataract surgery.

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

    Science.gov (United States)

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

    2006-01-01

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

  3. Spectrum and clinical profile of post cataract surgery endophthalmitis in North India

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    Gupta Amit

    2003-01-01

    Full Text Available Purpose: To determine the spectrum, clinical profile and risk factors for poor visual outcome in patients of post cataract surgery endophthalmitis. Methods: Data from 124 eyes were analysed. Various clinical and microbiological parameters were evaluated and risk factors for unfavourable outcome identified. Results: The mean age of the patients was 59.50±13.75 years; 60.5% were males. The median surgery-symptom interval was 7 days (mean 15.81±24.01 and the medium symptom-presentation interval 7.5 days (mean 14.19±19.13. Corneal infiltrates were seen in 29%, hypopyon in 62 (50%. Smear positivity was 52.5% and culture positivity 38%. Equivocal microbiological positivity was seen in 22 (18%, bacterial 12 (10%, fungal 27 (21.5%, polymicrobial 8 (6.5% and negative 55 (44%. 20% eyes had total loss of vision at last follow-up. Poor visual acuity at presentation, presence of intraocular lens, shorter surgery-symptom interval, corneal and surgical wound infiltrates, loss of red reflex, microbiological positivity of the vitreous tap and systemic diabetes mellitus were significant risk factors for unfavourable outcome. Conclusion: Our data highlights a low culture positivity and a predominance of fungal pathogens as a cause of post cataract surgery endophthalmitis. The visual outcome in these patients is still dismal and better treatment strategies should be evolved keeping in mind the microbiological spectrum. The risk factors identified may be helpful in prognosticating the outcome in such patients.

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

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    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

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

    Science.gov (United States)

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

    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) and 100 individuals received standard care (control group). Patients stress coping skills were measured by the Sense of Coherence Scale (SOC Scale). Systolic and diastolic blood pressure and heart rate were defined as outcome measures. RESULTS According to the SOC Scale, both groups had similar stress coping skills (mean score: 127.6 for the intervention group and 127.3 for the control group). Before entering the operating room (OR) as well as during surgery the rise in systolic and diastolic pressures was significantly lower in the intervention group (P < 0.001). Among patients receiving antihypertensive therapy, those in the intervention group presented a lower increase only in systolic pressure (P < 0.001) at both time recordings. For those patients in the intervention group who did not receive antihypertensive treatment, lower systolic blood pressure at both time recordings was recorded (P < 0.001) while lower diastolic pressure was observed only during entry to the OR (P = 0.021). Heart rate was not altered between the two groups in any of the recordings. CONCLUSIONS Meditation music influenced patients’ preoperative stress with regard to systolic blood pressure. This kind of music can be used as an alternative or complementary method for blood pressure stabilizing in patients undergoing cataract surgery.

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

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    Alexandru Cosmin TUTUNARU

    2012-01-01

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

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

    Scientific Electronic Library Online (English)

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

    2004-05-01

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

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

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    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

  9. Chopper de irrigación oblicua en MICS / Oblique irrigation chopper in microincision cataract surgery

    Scientific Electronic Library Online (English)

    Juan Raúl, Hernández Silva; Meisy, Ramos López; Marcelino, RíoTorres; Luis, Curbelo Cunill; Gilberto, Fernández Vásquez; Francisco, Núñez Ordóñez; Carmen Ma., Padilla González.

    2008-12-01

    Full Text Available El propósito de este estudio fue determinar los resultados obtenidos con la técnica de prechop (PCh) y su combinación con la microincision cataract surgery MICS (por sus siglas en inglés) (PChMICS) en la cirugía de catarata por facoemulsificación con el uso de el chopper de irrigación oblicua en el [...] Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología «Ramón Pando Ferrer» desde septiembre de 2006 hasta enero de 2007. El universo de trabajo estuvo constituido por 120 pacientes (ojos) con diagnóstico de catarata presenil y senil, que recibieron tratamiento quirúrgico. Se analizaron como variables: edad, sexo, agudeza visual con corrección, microscopia endotelial y cilindro refractivo, todos en el preoperatorio y posoperatorio, así como el tiempo de ultrasonido y complicaciones más frecuentes. Estos datos se analizaron a través de tablas de contingencia con frecuencias absolutas y relativas, medias y se utilizó la prueba t de Student para su comparación. Se encontró que la catarata predominó en pacientes menores de 60 años; la agudeza visual con corrección mejoró 5 líneas en la cartilla de Sellen, el cilindro refractivo apenas se modificó; el tiempo de ultrasonido aplicado estuvo dentro de valores normales; la pérdida de células endoteliales no fue importante, y la complicación transoperatoria más frecuente fue rotura de cápsula posterior con salida de vítreo. Abstract in english The objective of this study was to present the results of the prechop technique (PCh) combined with microincision cataract surgery (MICS) that was used in cataract surgery by phacoemulsification with the oblique irrigation chopper in the Center of Eye Microsurgery of "Ramón Pando Ferrer" Cuban Insti [...] tute of Ophthalmology from September, 2006 to January, 2007. The universe of study was made up of 120 patients (eyes) diagnosed with pre-senile and senile cataract and surgically treated. The analyzed variables were age, sex, visual acuity with correction, endothelial microscopy and refractive cylinder during the preoperative and postoperative periods, as well as ultrasound time and most common complications. For this analysis, contingency tables with absolute and relative frequencies and medians, and also Student´s t test for comparing data were used. It was found that cataract prevailed in patients under 60 years; visual acuity with correction improved 5 lines in Sellen chart, the refractive cylinder slightly changed, the time of ultrasound application was within the normal values; loss of endothelial cells was not significant and the most frequent transoperative complication was rupture of posterior capsule with vitreous detachment.

  10. Chopper de irrigación oblicua en MICS Oblique irrigation chopper in microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Juan Raúl Hernández Silva

    2008-12-01

    Full Text Available El propósito de este estudio fue determinar los resultados obtenidos con la técnica de prechop (PCh y su combinación con la microincision cataract surgery MICS (por sus siglas en inglés (PChMICS en la cirugía de catarata por facoemulsificación con el uso de el chopper de irrigación oblicua en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología «Ramón Pando Ferrer» desde septiembre de 2006 hasta enero de 2007. El universo de trabajo estuvo constituido por 120 pacientes (ojos con diagnóstico de catarata presenil y senil, que recibieron tratamiento quirúrgico. Se analizaron como variables: edad, sexo, agudeza visual con corrección, microscopia endotelial y cilindro refractivo, todos en el preoperatorio y posoperatorio, así como el tiempo de ultrasonido y complicaciones más frecuentes. Estos datos se analizaron a través de tablas de contingencia con frecuencias absolutas y relativas, medias y se utilizó la prueba t de Student para su comparación. Se encontró que la catarata predominó en pacientes menores de 60 años; la agudeza visual con corrección mejoró 5 líneas en la cartilla de Sellen, el cilindro refractivo apenas se modificó; el tiempo de ultrasonido aplicado estuvo dentro de valores normales; la pérdida de células endoteliales no fue importante, y la complicación transoperatoria más frecuente fue rotura de cápsula posterior con salida de vítreo.The objective of this study was to present the results of the prechop technique (PCh combined with microincision cataract surgery (MICS that was used in cataract surgery by phacoemulsification with the oblique irrigation chopper in the Center of Eye Microsurgery of "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from September, 2006 to January, 2007. The universe of study was made up of 120 patients (eyes diagnosed with pre-senile and senile cataract and surgically treated. The analyzed variables were age, sex, visual acuity with correction, endothelial microscopy and refractive cylinder during the preoperative and postoperative periods, as well as ultrasound time and most common complications. For this analysis, contingency tables with absolute and relative frequencies and medians, and also Student´s t test for comparing data were used. It was found that cataract prevailed in patients under 60 years; visual acuity with correction improved 5 lines in Sellen chart, the refractive cylinder slightly changed, the time of ultrasound application was within the normal values; loss of endothelial cells was not significant and the most frequent transoperative complication was rupture of posterior capsule with vitreous detachment.

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

    Scientific Electronic Library Online (English)

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

    2012-03-01

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

  12. Comparison of subtenon anaesthesia with peribulbar anaesthesia for manual small incision cataract surgery

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    Parkar Tasneem

    2005-01-01

    Full Text Available Purpose: To compare the safety and efficacy of subtenon anaesthesia with peribulbar anaesthesia in manual small incision cataract surgery using a randomised control clinical trial. Method: One hundred and sixty-eight patients were randomised to subtenon and peribulbar groups with preset criteria after informed consent. All surgeries were performed by four surgeons. Pain during administration of anaesthesia, during surgery and 4 h after surgery was graded on a visual analogue pain scale and compared for both the techniques. Sub-conjuntival haemorrhage, chemosis, akinesia after administration of anaesthesia and positive pressure during surgery were also compared. Patients were followed up for 6 weeks postoperatively. Results: About 146/168 (86.9% patients completed the six-week follow-up. Thirty-one out of 88 (35.2% patients of peribulbar group and 62/80(77.5% of subtenon group experienced no pain during administration of anaesthesia. There was no significant difference in pain during and 4 h after surgery. Subtenon group had slightly more sub-conjunctival haemorrhage. About 57 (64.8% patients of the peribulbar group had absolute akinesia during surgery as compared to none (0% in sub-tenon group. There was no difference in intraoperative and postoperative complications and final visual acuity. Conclusion: Sub-tenon anaesthesia is safe and as effective as peribulbar anaesthesia and is more comfortable to the patient at the time of administration.

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

    International Nuclear Information System (INIS)

    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)

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

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    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.

  15. Impact of incisions of cataract surgery on patients with corneal astigmatism

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    Jing Li

    2013-05-01

    Full Text Available AIM: To research the impact of different 3.2mm incisions of cataract surgery on patients whose corneal astigmatism was within 25 degrees by Orbscan. METHODS: We collected 40 cases of cataract patients whose corneal astigmatism was within 25 degrees detected by Orbscan and randomly divided them into groups A, B. Detected by Orbscan, 20 patients(20 eyesin group A was conducted with 3.2mm corneal astigmatism axial incision and 20 patients(20 eyesin group B was conducted with 3.2mm corneal incision on 90 degrees of the axis. All cataract operations were implemented by the same physician. We observed the postoperative changes of corneal astigmatism between two groups. RESULTS: The comparisons of Polar K on each time preoperative and postoperative point were significant differences within each group. But the comparisons of Polar K on each time preoperative and postoperative point were not statistically significant between two groups. After 3 months, two kinds of incisions would both increase about 0.3D Polar K in the cornea. CONCLUSION: 3.2mm corneal incision may cause Polar K 0.3D in corneal astigmatism.

  16. Cataract surgery with a mid-infrared endo-laser system

    Science.gov (United States)

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

    1992-08-01

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

  17. [Opacification of a hydrophilic intraocular lens 4 years after cataract surgery. A biomaterial analysis].

    Science.gov (United States)

    Khoramnia, R; Salgado, J P; Auffarth, G U; Schmidt, S; Wegner, A; Kobuch, K A; Winkler von Mohrenfels, C

    2012-05-01

    Calcification of hydrophilic intraocular lenses (IOL) is a rare complication. We report about the uneventful replacement of an opacified hydrophilic IOL. The patient presented 4 years after uneventful cataract surgery with a reduction of visual acuity due to calcification of the IOL. Macroscopically, the optic and the haptics were opacified. Light and scanning electron microscopy revealed granular deposits on the external surface of the IOL and numerous fine granular deposits within the optic of the IOL which were distributed in a line parallel to the surface of the IOL. PMID:22415452

  18. Angle-closure glaucoma secondary to inflammatory capsular block syndrome following routine cataract surgery.

    Science.gov (United States)

    Srinivasan, Sathish; Hanumanthu, Saileela; Varikkara, Mohan

    2013-03-01

    A 78-year-old man had uneventful cataract surgery with implantation of a 1-piece plate-haptic intraocular lens in the capsular bag. Seven weeks later, he presented as an emergency with intense fibrinous uveitis and increased intraocular pressure (IOP). Examination revealed an inflammatory capsular block syndrome (CBS) causing fibrinous anterior uveitis and secondary angle-closure glaucoma. The glaucoma resolved and the patient's vision improved following neodymium:YAG laser posterior capsulotomy. Inflammatory CBS should be considered in pseudophakic patients presenting with fibrinous anterior uveitis, increased IOP, and secondary angle closure. PMID:23506925

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

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    Gupta Sanjiv

    2010-01-01

    Full Text Available A prospective comparative study was undertaken to compare the patients? pain experience, surgical outcome and surgeon?s experience in phacoemulsification and manual small incision cataract surgery (MSICS under topical anesthesia supplemented with intracameral lignocaine (TASIL. In Group 1 (n=88 phacoemulsification was done and in Group 2 (n=92 MSICS was done. Pain scores were marked by the patients on a Visual analog scale (VAS after the surgery. The surgical experience was noted on a questionnaire by the operating surgeon. Descriptive analysis and one-tailed Mann-Whitney test were used to draw results. The average VAS score in Group 1 was 0.65 (SD 1.31 and in Group 2 it was 0.90 (SD 1.22. This difference in the average was not statistically significant with P=0.09. The study demonstrates that MSICS and phacoemulsification both can be done safely under TASIL with acceptable patient comfort, and the pain experienced by the patients during the procedures is comparable.

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

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    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(?2=1.344, P?2=0.146, P?2=0.236, P?2=0.846, PCONCLUSION: “The prevention of blindness project for millions of poor cataract patients” has been carried out smoothly in our hospital which proves that we do have the ability to undertake the prevention of blindness in our city, but there is still some deficiency to be improved.

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

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    Westborg I

    2013-10-01

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

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

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    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.

  3. Intraocular Lens Opacification following Intracameral Injection of Recombinant Tissue Plasminogen Activator to Treat Inflammatory Membranes after Cataract Surgery.

    Science.gov (United States)

    Fung, Simon S M; Sykakis, Evripidis; Islam, Niaz M; Zambarakji, Hadi J; Khoramnia, Ramin; Auffarth, Gerd U; Parmar, Dipak N

    2015-01-01

    Purpose. To report 7 cases of intraocular lens (IOL) opacification following treatment of postoperative anterior chamber fibrin with recombinant tissue plasminogen activator (rtPA) after cataract surgery. Methods. Retrospective case series of 7 eyes in 7 patients who developed IOL opacification after receiving rtPA for anterior chamber inflammatory membrane formation resulting from phacoemulsification cataract surgery. Three explanted IOLs were investigated with light microscopy, histochemical analysis, scanning electron microscopy, and X-ray spectrometry. Results. All patients underwent uncomplicated cataract surgery and posterior chamber hydrophilic IOL implantation. Anterior chamber inflammatory membranes developed between 1 and 4 weeks of surgery and were treated with intracameral rtPA. IOL opacification was noted between 4 weeks and 6 years after rtPA treatment with reduced visual acuity, and IOL exchange was carried out in 3 patients. Light microscopy evaluation revealed diffuse fine granular deposits on the anterior surface/subsurface of IOL optic that stained positive for calcium salts. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS) confirmed the presence of calcium and phosphate on the IOL. Conclusions. Intracameral rtPA, though rapidly effective in the treatment of anterior chamber inflammatory membranes following cataract surgery, may be associated with IOL opacification. PMID:25861464

  4. Evaluation of response variables in computer-simulated virtual cataract surgery

    Science.gov (United States)

    Söderberg, Per G.; Laurell, Carl-Gustaf; Simawi, Wamidh; Nordqvist, Per; Skarman, Eva; Nordh, Leif

    2006-02-01

    We have developed a virtual reality (VR) simulator for phacoemulsification (phaco) surgery. The current work aimed at evaluating the precision in the estimation of response variables identified for measurement of the performance of VR phaco surgery. We identified 31 response variables measuring; the overall procedure, the foot pedal technique, the phacoemulsification technique, erroneous manipulation, and damage to ocular structures. Totally, 8 medical or optometry students with a good knowledge of ocular anatomy and physiology but naive to cataract surgery performed three sessions each of VR Phaco surgery. For measurement, the surgical procedure was divided into a sculpting phase and an evacuation phase. The 31 response variables were measured for each phase in all three sessions. The variance components for individuals and iterations of sessions within individuals were estimated with an analysis of variance assuming a hierarchal model. The consequences of estimated variabilities for sample size requirements were determined. It was found that generally there was more variability for iterated sessions within individuals for measurements of the sculpting phase than for measurements of the evacuation phase. This resulted in larger required sample sizes for detection of difference between independent groups or change within group, for the sculpting phase as compared to for the evacuation phase. It is concluded that several of the identified response variables can be measured with sufficient precision for evaluation of VR phaco surgery.

  5. Cataract Surgery

    Medline Plus

    Full Text Available ... or cover the lens completely. Surgeon: The lens implant is contained within the tip of this insertion device. And this lets us put the implant in through a small incision. Announcer: So it's ...

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

    Directory of Open Access Journals (Sweden)

    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..

  7. Assessment of visual outcomes of cataract surgery in Tujia nationality in Xianfeng County, China

    Science.gov (United States)

    Yuan, Jing; Wang, Xia; Yang, Li-Qin; Xing, Yi-Qiao; Yang, Yan-Ning

    2015-01-01

    AIM To evaluate the visual outcome and factors influencing visual outcome of manual small incision cataract surgery (MSICS) in the rural area in the Xianfeng County. METHODS Eighty-two eyes of 82 patients who underwent cataract surgery performed by using MSICS technique were identified. Data collected included each patient's age, gender, the level of education. Uncorrected and corrected distance visual acuity (UDVA and CDVA) at presentation and at 1, 6, 8wk postoperatively, pre-existing eye disease, operative findings and complications, the risk factors were evaluated. RESULTS In 82 patients, the average age was 69.6±0.6y, illiterate were 52 (63.4%). Of 82 eyes, pseudophakia was present in 77 eyes (93.9%). At 1wk postoperatively, 47 eyes (57.3%) had the UDVA of ?6/18, and 52 eyes (63.4%) had the CDVA of ?6/18. At 6 to 8wk postoperatively, 50 eyes (61.0%) had UDVA of ?6/18, and 57 eyes (69.5%) had the CDVA of ?6/18. Postoperative visual status was significantly related to the co-morbidities, such as corneal pathology, glaucoma (P<0.001). Operative complications, such as posterior capsule opacity and cystoid macular edema were main operative cause for the poor visual outcome. CONCLUSION MSICS provides a good visual recovery in our study but the vision outcome did not fulfill the standards proposed by WHO, which highlights the need for an improvement in local socioeconomic understanding, population education and surgery quality. PMID:25938043

  8. Conjunctival bacterial flora and antibiotic resistance pattern in patients undergoing cataract surgery Flora bacteriana conjuntival e padrão de resistência a antibióticos em pacientes submetidos à cirurgia de catarata

    OpenAIRE

    Tiago Eugênio Faria e Arantes; Ronald Fonseca Cavalcanti; Maria de Fátima Alves Diniz; Maiara Santos Severo; João Lins Neto; Célia Maria Machado Barbosa de Castro

    2006-01-01

    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 anal...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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 (-0.88±0.61D×90 degrees with Inverted V incision which was statistically significant.CONCLUSION:Inverted V (Chevron incision gives minimal SIA.

  11. Schlieren visualization of fluid dynamics phenomena during phacosonication in cataract surgery

    Science.gov (United States)

    Serafino, Gabriella; Piuzzi, Barbara; Sanguinetti, G.; Sirotti, C.; Sirotti, Paolo; Tognetto, D.

    2005-03-01

    In ultrasonic phacoemulsification during cataract surgery the lens material fragmentation has been described as being caused by a combination of several mechanisms. The different theories involve tip vibration, acoustic waves produced by the tip, particles and liquids impact on the surface of the lens and cavitation. However the mechanisms are still not clear. To better understand phaco-related phenomena we have tried to produce a description in term of images of the cataract phacoemulsification procedure. An expanded and collimated laser diode beam transilluminates a transparent tube containing a liquid medium. The machine is activated separating the different phases of irrigation, aspiration and phacosonication. Fluid turbulences and phenomena related to the tip vibration constitute the phase images, visualized using Schlieren or similar techniques. The optical Fourier transform is filtered by a blade or by a black dot. The filtered transform is reconstructed into the visualized phase image and this is acquired by a digital image processing system. The presence of acoustic cavitation and possibly of ultrasonic radiation has been revealed. The technique promises to be a possible means for evaluation of single phaco apparatus power setting and comparison between different machines in terms of power modulation and cavitation production.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Aspergillus terreus infection in a sutureless self-sealing incision made during cataract surgery.

    Science.gov (United States)

    Erdem, Elif; Kandemir, Hazal; Ar?kan-Akda?l?, Sevtap; Esen, Ebru; Aç?kal?n, Arbil; Ya?mur, Meltem; ?lkit, Macit

    2015-02-01

    Here, we describe a case of keratitis caused by Aspergillus terreus in an 80-year-old immunocompetent woman 1 month after uneventful cataract surgery. The patient presented with decreased visual acuity (20/50) and severe pain in her right eye. Examination revealed a 3.5 × 4.5 mm white-colored deep stromal infiltration located on the temporal corneal tunnel incision. Corneal scraping samples were obtained for cytological and culture examinations. The cinnamon-brown colonies consisting of a dense felt of conidiophores were identified as A. terreus using molecular data. Using CLSI M38-A2 microdilution method, minimum inhibitory concentration values of amphotericin B, itraconazole, voriconazole, and posaconazole were determined to be 2, 1, 0.25, and 1 ?g/ml, respectively, and minimum effective concentration values of caspofungin and anidulafungin were ?0.03 and ?0.03, respectively, at 48 h for the A. terreus strain. Antifungal therapy was started as topical 1 % voriconazole drops hourly and 5 % natamycin ointment five times a day; however, corneal infection and melting progressed despite the ongoing intensive treatment and visual acuity dropped to the 20/200 level at the end of the first week. Amniotic membrane transplantation was performed to promote corneal healing. Topical medication was tapered and discontinued within 2 months based on the clinical features. The ulcer healed with scarring and vascularization, and visual acuity improved to 20/50. In conclusion, A. terreus is a very uncommon cause of mycotic keratitis and is especially rare after cataract surgery. We suggest that early and accurate diagnosis and appropriate treatment of A. terreus keratitis may have a major impact on preventing severe disease complications. PMID:25362536

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

    Directory of Open Access Journals (Sweden)

    Ciftci S

    2012-11-01

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

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

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Kessel, Line

    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 analogue reverse-transcriptase inhibitors (NNRTIs) were estimated by Poisson regression analyses and adjusted for age, sex, and calendar year. Results. HIV-infected individuals had a higher risk of cataract surgery than the comparison cohort (adjusted IRR, 1.87; 95% confidence interval (CI): 1.50-2.33). The highest risk was found in patients with a CD4 cell count =200 cells/µL (adjusted IRR before HAART initiation, 3.11 [95% CI, 1.26-7.63]; adjusted IRR after HAART initiation, 4.74 [95% CI, 2.60-8.62]). In patients not receiving HAART and those receiving HAART with a CD4 cell count >200 cells/mL the adjusted IRRs were 0.60 (95% CI: 0.22-1.61) and 1.87 (95% CI: 1.46-2.39). Treatment with abacavir, tenofovir, protease inhibitors, or NNRTIs did not increase the risk substantially. Conclusions. HIV-infected individuals have an increased risk of cataract surgery. The risk is mainly associated with immunodeficiency and HAART, but accelerated aging cannot be excluded as part of the possible explanation.

  16. Cataract surgery in a population-based cohort of patients with type 1 diabetes : long-term incidence and risk factors

    DEFF Research Database (Denmark)

    Grauslund, Jakob; Green, Anders

    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 surgery were 59.3 and 42 years, respectively. Cataract surgery in the cohort took place approximately 20 years earlier compared to non-diabetic persons. In a multivariate regression analysis, baseline age [hazard ratio (HR) 1.89 per 10 years, 95% CI 1.46-2.27] and maculopathy (HR 1.89, 95% CI 1.05-3.40) were the only statistically significant predictors of cataract surgery. Duration of diabetes, gender, glycaemic regulation, proteinuria, smoking, blood pressure and level of retinopathy were not associated with cataract surgery. Conclusion: Type 1 diabetes is associated with a high long-term incidence of cataract surgery. The association between maculopathy and subsequent cataract surgery is a novel finding and should be addressed in future studies.

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

    Scientific Electronic Library Online (English)

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

    2005-05-01

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

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

    Science.gov (United States)

    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-?m 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.

  19. Ultrasound Biomicroscopy and Scheimpflug Imaging in Anterior Megalophthalmos: Changes Seen after Cataract Surgery

    Science.gov (United States)

    Nawani, Nishant; Jain, Arun K.; Singh, Ramandeep

    2015-01-01

    Purpose. With this report we describe ultrasound biomicroscopic (UBM) findings in a patient with anterior megalophthalmos before and after undergoing phacoemulsification with posterior chamber intraocular lens implantation. Methods. Phacoemulsification was carried out for nuclear sclerosis in both eyes of a patient diagnosed with anterior megalophthalmos. The patient was subjected to detailed ophthalmic examination including ultrasound biomicroscopy and Scheimpflug imaging prior to and after surgery. Preoperative ultrasound biomicroscopy revealed a deep anterior chamber with posterior bowing of the midperipheral iris in both eyes. The ciliary processes were inserted on the posterior surface of the iris. UBM was repeated postoperatively as well. Results. Phacoemulsification and posterior chamber intraocular lens implantation (IOL) were carried out successfully in both eyes. The IOLs were well centered and captured within the anterior capsulorhexis. The anterior chambers were hyperdeep, 6.24?mm (OD) and 6.08?mm (OS), respectively. The posterior bowing of the midperipheral iris was absent, with the iris having a more flat profile. Conclusion. UBM findings in anterior megalophthalmos seemed to partially resolve after cataract surgery. The anterior chamber deepens appreciably as well.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Lee Teak Tan; Huw Jenkins; John Roberts-Harry; Michael Austin

    2008-01-01

    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 disorientati...

  2. Washout of pseudoexfoliation material combined with cataract surgery: a new surgical approach to lower intraocular pressure in pseudoexfoliation syndrome.

    Science.gov (United States)

    Tran, V Tao

    2015-04-01

    Glaucoma or ocular hypertension can be caused by the presence of pseudoexfoliation (PEX) material and/or pigmented cells in the trabecular meshwork (TM) and/or in the irido-corneal angle (ICA). Accumulation of this material can be highlighted by slit-lamp (SL), gonioscopy, and ultrasound biomicroscopy (UBM). Such material prevents aqueous humor from flowing out and thus induces intraocular pressure (IOP) elevation. A new technique using a special cannula for washing the TM and ICA, combined with cataract surgery, can lower IOP and reduce the number of hypotensive drugs needed. This study analyzed 11 patients (13 eyes) presenting a pseudoexfoliation glaucoma with cataract. They all had cataract surgery combined with the special washing technique. Visual acuity and IOP were noted before surgery, just after surgery and during follow-up. The number of hypotensive drugs needed was also recorded. Mean follow-up time was 34.4 months (range 21.8-59.2). The first case underwent surgery in 2007 and has a 5-year follow-up time. Local status was controlled by SL, gonioscopy, and UBM. Mean age was 79 years (range 71.6-86.0). Mean visual acuity was 0.37 pre-op (range 0.05-0.6) and 0.89 post-op (range 0.05-1.0). Mean IOP before and after surgery was 32.8 ± 8.7 mmHg (range 20-53) and 15.1 ± 3.5 mmHg (range 10-20), respectively. The amount of hypotensive drugs needed was 87 % lower after surgery. No PEX material recurrence was seen with SL, gonioscopy, and UBM during the mean follow-up of 3 years. No complication was recorded in this study. Cataract surgery combined with the new washout technique of the TM and ICA to remove PEX material or pigmented cells significantly lowers IOP and the amount of drugs needed. Long-term follow-up gives good results with no complication or recurrence. Eye status after surgery remains physiological and further glaucoma surgery can be performed if necessary. More research with a higher number of patients should be initiated to confirm this technique. PMID:24706084

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

    LENUS (Irish Health Repository)

    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. Central Corneal Thickness, Corneal Endothelial Characteristics and Intraocular Pressure after Pediatric Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Naveed Nilforushan

    2008-11-01

    Full Text Available

    PURPOSE: To investigate central corneal thickness (CCT, endothelial cell characteristics and intraocular pressure (IOP in eyes with prior pediatric cataract surgery and to compare them with eyes of normal age and sex matched controls. METHODS: Specular microscopy CCT and IOP measurements were performed in 31 eyes of 17 patients with prior congenital cataract extraction and 40 eyes of 20 age and sex matched subjects. The mean of three pachymetric and specular microscopic measurements were recorded. IOP was measured using Goldmann applanation tonometry. RESULTS: Mean CCT was 632±45 µm in eyes with prior pediatric cataract surgery vs 546±33 µm in control eyes (P < 0.001, independent t test and Mann Whitney U-test. Mean IOP was 22.1±3.9 mmHg in eyes with prior pediatric cataract surgery and 14.0±1.6 mmHg in the control group (P < 0.001, independent t-test. There was no significant difference between the two groups in cell count, polymegethism and mean cell area of corneal endothelial cells. CONCLUSIONS: Although the corneas were clinically clear and there was no significant difference in endothelial characteristics in eyes with prior pediatric cataract surgery as compared to normal controls, central corneal thickness in the operated eyes was significantly greater. To differentiate actual glaucoma from artifactual IOP increase, CCT measurement should be performed in these patients.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Endoftalmitis poscirugía de catarata por Sphingomonas paucimobilis / Sphingomonas paucimobilis-induced endophthalmitis after cataract surgery

    Scientific Electronic Library Online (English)

    Omar, Mauri Garrido; Elida Beatriz, Borges Mendoza; Meisy, Ramos López; Lissette, Valle Rodríguez; Raylen, Escobar Román.

    2014-06-01

    Full Text Available Se presenta la caracterización y manejo terapéutico de un caso de endoftalmitis bacteriana posoperatoria causada por el germen Sphingomonas paucimobilis. La endoftalmitis es la inflamación de los tejidos intraoculares, considerada como la más devastadora de las complicaciones posoperatorias; posee p [...] ronóstico visual muy reservado y un elevado riesgo de secuela. Las Sphingomonas paucimobilis son bacterias gramnegativas con forma de bacilo, quimioheterótrofa y estrictamente aerobias que causan enfermedades en los seres humanos, principalmente infecciones hospitalarias que típicamente son tratadas fácilmente con antibióticos. Por sus capacidades biodegradantes y biosintéticas, son pocos los reportes hallados de infección intraocular por este germen. El pronóstico visual es favorable con un diagnóstico precoz y la aplicación del tratamiento adecuado. En este artículo se presentan un caso de endoftalmitis poscirugía de catarata por Sphingomonas paucimobilis reportado en Cuba en el mes de septiembre de 2009. Abstract in english The characterization and therapeutic management of a case of postsurgery bacterial endophthalmitis caused by Shingomonas paucimobilis was presented. Endophthalmitis is the inflammation of the intraocular tissues and considered as the most devastating postoperative complication. The visual prognosis [...] of this disease is very reserved judgement and high risk of sequelae. Sphingomonas paucimobilis are bacillus-shaped, chemoheterotrophic and strictly aerobic Gramnegative bacteria that cause diseases in the human being, mainly nosocomial infections that are typically treated with antibiotics. Based on its biodegrading and biosynthetic capacities, there are few reports on intraocular infections caused by this germ. The visual prognosis is favourable when the disease is early diagnosed and adequately managed. A case of endophthalmitis following a cataract surgery and caused by Shingomonas paucimobilis in Cuba in September 2009 was presented in this article.

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

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    Alireza Ghaffariyeh

    2008-05-01

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

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

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    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.

  5. Pediatric cataract: challenges and future directions

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    Medsinge A

    2015-01-01

    Full Text Available Anagha Medsinge,1,2 Ken K Nischal1,2 1Pediatric Ophthalmology, Strabismus, and Adult Motility, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, (UPMC 2University of 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

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

    OpenAIRE

    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.

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

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

    2012-06-01

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

  8. Use of intraocular lenses in cataract surgery in developing countries: memorandum from a WHO meeting.

    OpenAIRE

    1991-01-01

    Visual loss or disability from cataract represents a massive public health and socioeconomic problem in most developing countries. At present, some 13.5 million cases require treatment and this number will increase, as most countries in the Third World are unable to cope with both the backlog and new cases. Cataract extraction with intraocular lens (IOL) implantation is now the established and preferred method in industrialized countries. The introduction of IOLs in developing countries, howe...

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

    International Nuclear Information System (INIS)

    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)

  10. COMPARISON OF RESULTS OF SURGICALLY INDUCED ASTIGMATISM AND VISUAL ACUITY FOLLOWING TEMPORAL VERSUS SUPERIOR SCLEROCORNEAL INCISIONS IN MANUAL SMALL INCISION SUTURE LESS CATARACT SURGERY

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    Sowbhagya

    2013-06-01

    Full Text Available ABSTRACT : OBJECTIVE: To evaluate the effect of superior and temporal sclerocorneal incisions on astigmatism in small incision cataract surgery. To evaluate the success of different meridional approaches in cataract surgery by changing the sites of incision. To evaluate visual acuity outcomes on temporal versus superior sclerocorneal incisions. DESIGN: Prospective, non - randomized, comparative cli nical study. PARTICIPANTS: One hundred and twenty eyes of 120 patients with cataracts scheduled to undergo routine cataract surgery. METHODS: 120eyes of 120 patients were allocated to two groups of 60 each, Group TI (Temporal incision and Group SI (Superi or incision. Manual Small Incision sutureless Cataract Surgery was (MSICS done. Post operative follow - up was done on day 1, 2 nd , 4 th and 6 th weeks for post - operative clinical findings, visual acuity and keratometry. Data was analyzed by1] Descriptive and in ferential statistical analysis.2] Mean SD (Min - Max. 3] Student T test (Two tailed, independent.4] Chi - Square/Fisher Exact Test

  11. Clear-cornea cataract surgery: pupil size and shape changes, along with anterior chamber volume and depth changes. A Scheimpflug imaging study

    OpenAIRE

    Kanellopoulos AJ; Asimellis G

    2014-01-01

    Anastasios John Kanellopoulos,1,2 George Asimellis11Laservision.gr Eye Institute, Athens, Greece; 2New York University School of Medicine, New York, NY, USA Purpose: To investigate, by high-precision digital analysis of data provided by Scheimpflug imaging, changes in pupil size and shape and anterior chamber (AC) parameters following cataract surgery.Patients and methods: The study group (86 eyes, patient age 70.58±10.33 years) was subjected to cataract removal surgery with in-the-bag...

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

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    DeMill DL

    2011-08-01

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

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

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    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.

  14. Safety, efficacy, and intraoperative characteristics of DisCoVisc and Healon ophthalmic viscosurgical devices for cataract surgery

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    Modi SS

    2011-09-01

    Full Text Available Satish S Modi1, James A Davison2, Tom Walters3 1Seeta Eye Centers, Poughkeepsie, NY, USA; 2Wolfe Clinic, Marshalltown, IA, USA; 3Texas Eye Care, Austin, TX, USA Purpose: To evaluate the safety and efficacy of DisCoVisc ophthalmic viscosurgical device (OVD, Alcon Laboratories, Inc with respect to a comparator, Healon OVD (Advanced Medical Optics, Inc. Patients and methods: In this prospective study, patients with cataracts were randomized to an OVD, and then received phacoemulsification and injection of an intraocular lens. After each surgery, unmasked investigators completed subjective questionnaires about OVD characteristics during each stage of the procedure. Masked technicians evaluated objective safety parameters of intraocular pressure (IOP and endothelial cell density, with 90 days of follow-up. Results: The DisCoVisc OVD group (128 eyes and the Healon OVD group (121 eyes had statistically similar outcomes for IOP and for endothelial cell loss. Subjectively assessed viscosity was statistically different (P < 0.0001, with Healon OVD most often rated “cohesive” and DisCoVisc OVD most often rated “both dispersive and cohesive”. Workspace maintenance differed between groups (P < 0.0001, with workspace most frequently rated “full chamber maintained” when using DisCoVisc OVD and most frequently rated “workspace maintained” when using Healon OVD. “Flat” or “shallow” workspace ratings occurred only in the Healon OVD group. Conclusion: DisCoVisc OVD had both cohesive and dispersive properties, and was safe and effective for every stage of cataract surgery. Keywords: cataract, endothelial cell density, viscoelastic, phacoemulsification

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

    Scientific Electronic Library Online (English)

    Rafael, Iribarren; Guillermo, Iribarren.

    2013-06-01

    Full Text Available La cirugía moderna de facoemulsificación del cristalino tiene una recuperación muy rápida. La elección correcta del lente intraocular que se coloca en la cirugía permite, muchas veces, anticipar si el paciente va a precisar anteojos luego de la cirugía. Este estudio analiza una muestra de pacientes [...] con catarata, mostrando la frecuencia relativa de cambios miópicos que permiten a los pacientes ver de cerca sin lentes antes de la cirugía. Se estudiaron retrospectivamente una serie de pacientes consecutivos que realizaron cirugía electiva de catarata. El cambio refractivo miópico fue documentado comparando las prescripciones antiguas con la medición subjetiva al momento del estudio. Los sujetos fueron agrupados de acuerdo a la presencia o ausencia de cambios miópicos, y se estudiaron las proporciones con respecto a su grado de opacidad nuclear. La edad promedio de los 229 sujetos estudiados fue de 71.5 ± 10.4 años, 109 (47.6%) varones. Se halló un cambio miópico, definido como un cambio mayor de - 0.5 dioptrías, en 85 (37.1%, IC95%: 30.8-43.4%). El porcentaje de sujetos con cambio miópico fue significativamente mayor en aquellos que tenían mayor opacidad nuclear al tiempo del examen. En este estudio de pacientes no seleccionados que buscaban realizar cirugía de catarata, más de un tercio tuvo cambios miópicos en la refracción. Si el paciente lograba ver bien de cerca antes de la cirugía, esto debería ser tenido en cuenta a la hora de elegir un correcto lente intraocular para que el sujeto no pierda este beneficio de la catarata. Abstract in english Modern cataract surgery by phacoemulsification is a widely accepted procedure with a rapid recovery time. The prescription of specific intraocular lens, implanted during surgery, makes it possible to anticipate whether the patient will need reading glasses after the procedure. The present study anal [...] yses a sample of cataract surgery patients to show the frequency of myopic shifts related to nuclear opacity, which can result in clear near vision before surgery. A non-selected sample of consecutive patients who underwent elective cataract surgery in a private clinic was studied retrospectively. The myopic shift in refraction was assessed by comparing the old prescription with the spectacle correction at the time of interviewing.The mean age of the 229 subjects studied was 71.5 ± 10.4 years (109, 47.6%, males). A myopic shift in refraction, defined as at least - 0.5 diopters, was present in 37.1% of subjects (95% CI: 30.8%-43.4%). The mean change in refraction in these subjects was -2.52 ± 1.52 diopters. The percentage of subjects who had developed a myopic shift was significantly greater in those who presented greater nuclear opalescence. There were also differences in the mean myopic shift by refractive group, with the emmetropes having the greatest myopic shift. In this study of patients seeking cataract surgery in a clinical setting, more than one third had myopic shifts in refraction. This must be taken into account in order that patients maintain the benefit of clear near vision after surgery.

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

    Scientific Electronic Library Online (English)

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

    2008-12-01

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

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

    Directory of Open Access Journals (Sweden)

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

    2012-12-01

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

  18. Incisiones limbares relajantes y cirugía de la catarata: nuestra experiencia Limbal relaxing incisions and cataract surgery: our experience

    Directory of Open Access Journals (Sweden)

    I. Coloma-González

    2007-09-01

    Full Text Available Objetivo: Evaluar la reducción del astigmatismo corneal preexistente en la cirugía de catarata mediante incisiones limbares relajantes (ILRs. Método: Estudio prospectivo de dos grupos de pacientes (tratamiento y control con astigmatismo prequirúrgico ?1D. Los 30 pacientes del grupo control fueron sometidos a facoemulsificación por incisión temporal en córnea clara y los 32 pacientes del grupo tratamiento a ILRs junto a facoemulsificación por incisión temporal en córnea clara. Se usó el test de Holladay para valorar la eficacia del tratamiento. Asimismo, presentamos un pequeño estudio de la prevalencia y distribución del astigmatismo en nuestra población de trabajo. Resultados: El seguimiento promedio de los 62 pacientes fue de 3 meses, con un cambio astigmático medio a los 3 meses de -0.55D (-0,75 a -0,35 en el grupo tratamiento y de 0.04D (-0,3 a 0,3 en el grupo control (pPurpose: To evaluate the reduction of pre-existing corneal astigmatism at the time of cataract surgery with limbal relaxing incisions (LRIs. Methods: A prospective study of two groups of patients (treatment and control with pre-existing astigmatism ?1D was performed. The 30 patients in the control group had a temporal clear corneal phacoemulsification and the 32 patients of treatment group had combined temporal clear corneal phacoemulsification and LRIs. Holladay analysis was used to assess the efficacy of treatment. An astigmatism distribution and prevalence study in our population is also presented. Results: Three months after surgery, the mean astigmatism change was -0.55D (-0.75 to -0.35 in the treatment group and 0.04D (-0.3 to 0.3 in the control group (p<.0001. Conclusions: LRI is a simple, safe and effective method not only for reducing pre-existing astigmatism during cataract surgery but in providing good unaided visual acuity.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Difluprednate ophthalmic emulsion 0.05% (Durezol®) administered two times daily for managing ocular inflammation and pain following cataract surgery

    Science.gov (United States)

    Smith, Stephen; Lorenz, Douglas; Peace, James; McLeod, Kimberly; Crockett, RS; Vogel, Roger

    2010-01-01

    Objective: To evaluate the efficacy and safety of twice-daily difluprednate ophthalmic emulsion 0.05% (Durezol®) versus placebo administered before surgery for managing inflammation and pain following cataract extraction. Methods: Eligible subjects (N = 121) were randomized 2:1 to topical treatment with 1 drop difluprednate or placebo administered twice daily for 16 days, followed by a 14-day tapering period. Dosing was initiated 24 hours before unilateral ocular surgery. Clinical signs of inflammation (anterior chamber [AC] cell and flare grade, bulbar conjunctival injection, ciliary injection, corneal edema, and chemosis), ocular pain/discomfort, intraocular pressure (IOP), and adverse events were assessed. Results: Clearing of inflammation on day 14 (primary endpoint), defined as an AC cell grade of 0 (?5 cells) and a flare grade of 0 (complete absence), was achieved in a significantly greater percentage of subjects treated with difluprednate, compared with placebo (74.7% vs 42.5%; P = 0.0006). A significantly greater percentage of difluprednate-treated subjects were free of ocular pain/discomfort on day 14 than placebo-treated subjects (64.6% vs 30.0%; P = 0.0004). Three subjects (3.7%) in the difluprednate group had a clinically significant IOP rise (defined as ?21 mmHg and a change from baseline ?10 mmHg at same visit). Conclusions: Difluprednate, administered 2 times daily starting 24 hours before cataract surgery, was highly effective for managing ocular inflammation and relieving pain and discomfort postoperatively. Difluprednate was well tolerated and provides a convenient twice-daily option for managing postoperative ocular inflammation. PMID:20856594

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

    Scientific Electronic Library Online (English)

    Juan Raúl, Hernández Silva; Alejandro, Campero Crispin; Meisy, Ramos López; Iramis, Miranda Hernández; Yanele, Ruiz Rodríguez; Marcelino, Rio Torres.

    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 cir [...] ugía 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. Abstract in english 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 catara [...] ct 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.

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

    Scientific Electronic Library Online (English)

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

    2013-04-01

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

  3. The cost of cataract surgery in a public health eye care program in Nepal.

    Science.gov (United States)

    Marseille, E; Gilbert, S

    1996-02-01

    Using data from the Lumbini Zonal Eye Care Program in Nepal, the authors estimated marginal costs, capital costs, and average recurring costs for a public health cataract program with and without donor agency overhead expenditures. Each estimate is useful for guiding decisions under certain conditions. Marginal costs are appropriate for short-term planning. Average in-country recurring cost figures are needed to project budgets for longer term program costs or major program expansion. A portion of donor agency overhead costs should be included if expansion requires more donor agency contributions. Marginal costs are estimated at US$3.01 per case. In country recurring costs are about $13.91. Capital costs excluding hospital construction are an additional $2.42. Seva's USA administrative expenditures in support of the cataract component of the program add about another $5.38. Total costs were about $21.71 per case. PMID:10156651

  4. Astigmatism and visual recovery after 'large incision' extracapsular cataract surgery and 'small' incisions for phakoemulsification.

    OpenAIRE

    Zheng, L.; Merriam, J. C.; Zaider, M.

    1997-01-01

    PURPOSE: This study compares the change over time of the astigmatism caused by "large" incision extracapsular cataract extraction (ECCE) and three smaller incisions for phakoemulsification. Based on this data, a mathematical model that predicts the course of astigmatism after a superior incision of length 3 to 12 mm has been developed. The relationship of axial length and preoperative astigmatism to induced post-operative astigmatism, the recovery of visual acuity, and the rate of YAG laser c...

  5. Influence of the prediction error of the first eye undergoing cataract surgery on the refractive outcome of the fellow eye

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    Gorodezky L

    2014-10-01

    Full Text Available Ludmilla Gorodezky,1,2 Babac AE Mazinani,2 Niklas Plange,2 Peter Walter,2 Martin Wenzel,1 Gernot Roessler2 1Petrisberg Eye Clinic, Trier, Germany; 2Department of Ophthalmology, RWTH Technical University of Aachen, Aachen, Germany Introduction: In addition to measurement errors, individual anatomical conditions could be made responsible for unexpected prediction errors in the determination of the correct intraocular lens power for cataract surgery. Obviously, such anatomical conditions might be relevant for both eyes. The purpose of this study was to evaluate whether the postoperative refractive error of the first eye has to be taken in account for the biometry of the second. Methods: In this retrospective study, we included 670 eyes of 335 patients who underwent phacoemulsification and implantation of a foldable intraocular lens in both eyes. According to the SRK/T formula, the postoperative refractive error of each eye was determined and compared with its fellow eye. Results: Of 670 eyes, 622 showed a postoperative refractive error within ±1.0 D (93%, whereas the prediction error was 0.5 D or less in 491 eyes (73%. The postoperative difference between both eyes was within 0.5 D in 71% and within 1.0 D in 93% of the eyes. Comparing the prediction error of an eye and its fellow eye, the error of the fellow eye was about half the value of the other. Conclusion: Our results imply that substitution of half of the prediction error of the first eye into the calculation of the second eye may be useful to reduce the prediction error in the second eye. However, prospective studies should be initiated to demonstrate an improved accuracy for the second eye’s intraocular lens power calculation by partial adjustment. Keywords: cataract surgery, biometry, IOL power calculation, refractive error, fellow eye

  6. Contraindicaciones de la cirugía de catarata en pacientes del municipio Maracaibo / Cataract surgery contraindications for patients from Maracaibo municipality

    Scientific Electronic Library Online (English)

    Ernesto, Marrero Rodríguez; Osmar, Sánchez Vega; Blanca Rosa, Barrera Garcés; Dania, Valdés Boza.

    2011-02-01

    Full Text Available Se hizo un estudio descriptivo y transversal de 76 pacientes con catarata, que no pudieron ser intervenidos quirúrgicamente en el Centro Oftalmológico del municipio de Maracaibo, perteneciente al estado de Zulia (Venezuela), desde junio hasta julio del 2009, a fin de identificar las principales caus [...] as que estaban contraindicando la operación de esa oftalmopatía, para lo cual se examinó un ojo de cada integrante de la serie. En la casuística predominaron el grupo etario de 60-69 años y el sexo masculino, así como la agudeza visual por debajo de 0,3 y el diagnóstico prequirúrgico de catarata senil. La degeneración macular asociada a la edad prevaleció como la enfermedad más frecuente que invalidara la cirugía, con primacía de la opacidad lenticular nuclear en cuanto a la clasificación morfológica. Se concluyó que no siempre la opacidad del cristalino causa la mala visión, por lo que es necesario realizar un detallado examen oftalmológico. Abstract in english A descriptive and cross-sectional study of 76 patients with cataract, who could not be surgically treated at the Ophthalmological Center from Maracaibo municipality, belonging to Zulia State (Venezuela), was carried out from June to July, 2009 in order to identify the main causes that were contraind [...] icating the ophthalmopathy surgery, for which each participant's eye was examined. The 60-69-year-old age group and male sex, as well as the visual sharpness under 0,3 and pre-surgical diagnosis of senile cataract, were predominant in the case material. Macular degeneration associated with age prevailed as the most frequent disease invalidating the surgery, giving some priority to nuclear lenticular opacity according to morphological classification. It was concluded that opacity of crystalline lens does not always cause bad vision, thus it is necessary to carry out a detailed ophthalmological test.

  7. Randomised controlled single-blind study of conventional versus depot mydriatic drug delivery prior to cataract surgery

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    Madge Simon

    2006-11-01

    Full Text Available Abstract Background A prerequisite for safe cataract surgery is an adequately dilated pupil. The authors conducted a trial to assess the efficacy (in terms of pupil diameter of a depot method of pre-operative pupil dilatation, as compared with repeated instillations of drops (which is time-consuming for the nursing staff and uncomfortable for the patient. Methods A prospective randomised masked trial was conducted comprising 130 patients with no significant ocular history undergoing elective clear corneal phacoemulsification. 65 patients had mydriatic drops (Tropicamide 1%, Phenylephrine 2.5%, Diclofenac sodium 0.1% instilled prior to surgery, 65 had a wick soaked in the same drop mixture placed in the inferior fornix. Horizontal pupil diameters were recorded on a millimetre scale immediately prior to surgery. Results There was no significant difference in pupil size between the two groups (p = 0.255, Student's t-test. Conclusion There was no significant difference between the mydriasis obtained with the depot system compared with conventional drop application. Use of a depot mydriatic delivery system appears to be a safe and efficient method of drug delivery. Trial Registration International Standard Randomised Controlled Trial Number Register ISRCTN78047760

  8. Cystoid macular edema after cataract surgery in a patient with previous severe iritis following argon laser peripheral iridoplasty

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    Bagnis A

    2011-04-01

    Full Text Available Alessandro Bagnis1, Sergio Claudio Saccà2, Michele Iester1, Carlo Enrico Traverso11Centro di Ricerca Clinica e Laboratorio per il Glaucoma e la Cornea, Clinica Oculistica Di NOG, University of Genova, 2Division of Ophthalmology, St. Martino Hospital, Genova, ItalyAbstract: This report describes a patient who had exaggerated responses to different inflammatory stimuli represented by laser and incisional surgery, respectively. These separate episodes should have a common link represented by a genetic predisposition to abnormal release of proinflammatory mediators within the eye. This 51-year old Hispanic woman showed a narrow iridocorneal angle with plateau iris configuration. Nd-YAG laser peripheral iridotomy was successfully performed to both eyes. No substantial changes in the iridotrabecular angle occurred despite patent iridotomies, thus confirming the diagnosis of plateau iris configuration. Argon laser iridoplasty was then performed to the right eye, while the left eye was scheduled for a later session. A severe inflammatory reaction within the anterior chamber developed after tapering of a one-week course of steroid therapy. Phacoemulsification of the lens was performed some months later when no signs of inflammation were detectable; no intraoperative complications occurred during surgery and an intraocular lens was placed. Cystoid macular edema developed four weeks after surgery despite no apparent risk factors, and resolved completely after anti-inflammatory medical therapy. Based on this case report, the unusual occurrence of severe iritis after laser treatment should be regarded as a risk factor for any other incisional or nonincisional procedures because it might indicate that the patient's ocular tissues are prone to release of abnormally elevated proinflammatory mediators. Although further studies are needed to confirm this predisposition, prophylactic adjunctive topical nonsteroidal anti-inflammatory drug administration after cataract surgery should be considered in such cases in order to prevent potentially sight-threatening conditions.Keywords: cystoid macular edema, inflammation, laser surgery, plateau iris configuration

  9. Prospective evaluation of visual outcomes with three presbyopia-correcting intraocular lenses following cataract surgery

    OpenAIRE

    Re, Ang; Ga, Martinez; Em, Cruz; Aa, Tiongson; Ag, Dela Cruz

    2013-01-01

    RE Ang,1,2 GA Martinez,2,3 EM Cruz,1 AA Tiongson,1 AG Dela Cruz1 1Asian Eye Institute, Makati City, Philippines; 2Cardinal Santos Medical Center, San Juan City, Philippines; 3Pasig City General Hospital, Pasig City, Philippines Purpose: To compare the visual acuity and quality of vision achieved with three widely-used intraocular lenses (IOLs) in subjects with bilateral cataracts. Patients and methods: This three-arm, parallel, prospective, partially masked, single-surgeon study randomized 78...

  10. Extremely small incisions 25G in surgery of congenital cataracts complicated with microphthalmia in children of the first year of life

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    M.M. Bikbov

    2013-03-01

    Full Text Available ABSTRACT Purpose. Aim of the work was a comparative study of the results of cataract surgery with IOL implantation in children with congenital cataracts, complicated with microphthalmia operated on in the age from 1 to 12 months using the 20G and 25G technology. Materials and methods. A comparative study of cataract extraction with IOL implantation and pars plana removal of posterior capsule with a limited anterior vitrectomy were performed in 54 children with congenital cataracts, complicated with microphthalmia operated on in the age from 1 to 12 months (79 eyes. The children were divided into two subgroups: in the first group after the IOL implantation the pars plana removal of posterior capsule with a limited anterior vitrectomy 20G was carried in 26 children (41 eyes, and in the second group - with an access through pars plana using extremely small incisions 25G (28 patients, 38 eyes. Results. In the first subgroup in the early postoperative follow-up the complication rate was higher due to a more frequent occurrence of hyphema and a development of inflammatory reaction, the difference is statistically significant (34.1 and 10.5% respectively, p<0.01. Conclusions. The use of ultra-small accesses 25G, for the posterior casulectomy with the anterior vitrectomy after IOL implantation allows to reduce the quantity of early postoperative complications after removal of congenital cataracts, complicated with microphthalmia.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Difluprednate ophthalmic emulsion 0.05% (Durezol® administered two times daily for managing ocular inflammation and pain following cataract surgery

    Directory of Open Access Journals (Sweden)

    Stephen Smith

    2010-08-01

    Full Text Available Stephen Smith1, Douglas Lorenz2, James Peace3, Kimberly McLeod4, RS Crockett5, Roger Vogel4, and the Difluprednate ST601-004 Study Group1Eye Associates of Fort Myers, Fort Myers, Florida, USA; 2Nevada Eye and Ear, Henderson, Nevada, USA; 3United Medical Research, Inglewood, California, USA; 4Sirion Therapeutics, Inc., Tampa, Florida, USA; 5DATA, Inc., Bayou La Batre, Alabama, USA. Clinical trial registration number: NCT00616993Objective: To evaluate the efficacy and safety of twice-daily difluprednate ophthalmic ­emulsion 0.05% (Durezol® versus placebo administered before surgery for managing inflammation and pain following cataract extraction.Methods: Eligible subjects (N = 121 were randomized 2:1 to topical treatment with 1 drop difluprednate or placebo administered twice daily for 16 days, followed by a 14-day ­tapering period. Dosing was initiated 24 hours before unilateral ocular surgery. Clinical signs of ­inflammation (anterior chamber [AC] cell and flare grade, bulbar conjunctival injection, ciliary injection, corneal edema, and chemosis, ocular pain/discomfort, intraocular pressure (IOP, and adverse events were assessed.Results: Clearing of inflammation on day 14 (primary endpoint, defined as an AC cell grade of 0 (?5 cells and a flare grade of 0 (complete absence, was achieved in a significantly greater percentage of subjects treated with difluprednate, compared with placebo (74.7% ­vs 42.5%; P = 0.0006. A significantly greater percentage of difluprednate-treated subjects were free of ocular pain/discomfort on day 14 than placebo-treated subjects (64.6% vs 30.0%; P = 0.0004. Three subjects (3.7% in the difluprednate group had a clinically significant IOP rise (defined as ?21 mmHg and a change from baseline ?10 mmHg at same visit.Conclusions: Difluprednate, administered 2 times daily starting 24 hours before cataract ­surgery, was highly effective for managing ocular inflammation and relieving pain and discomfort postoperatively. Difluprednate was well tolerated and provides a convenient twice-daily option for managing postoperative ocular inflammation.Keywords: difluprednate, safety, efficacy, twice daily, postoperative ocular inflammation, corticosteroids

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

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    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

  14. Resultados de la cirugía de cataratas por la técnica de facoemulsificación Results of cataract surgery using quick chop phacoemulsification

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    Luis Curbelo Cunill

    2007-12-01

    Full Text Available La catarata, en la mayoría de los casos, se considera una causa remediable de disminución de agudeza visual. A través del tiempo se han conseguido mejoras tecnológicas que hacen que la cirugía de catarata sea relativamente fácil, segura y la rehabilitación visual usualmente exitosa sobre todo cuando esta se acompaña de implante de lente intraocular. Varias alternativas para dividir el núcleo del cristalino surgieron desde entonces, pero pocas son realmente necesarias. Este trabajo tiene como objetivo describir los resultados funcionales y anatómicos alcanzados con la técnica de facoemulsificación con quick chop, las edades de los pacientes, la agudeza visual corregida preoperatoria y posoperatoria, el astigmatismo preoperatorio y posoperatorio, la microscopia endotelial preoperatorio y posoperatoria, el tiempo de ultrasonido aplicado y las complicaciones presentadas. Realizamos un estudio descriptivo, prospectivo, de corte transversal, en 146 pacientes (ojos operados entre enero de 2004 y enero de 2006 en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología “Ramón Pando Ferrer” El universo de trabajo lo constituyeron todos los pacientes con diagnóstico de catarata presenil y senil que cumplían con los criterios de selección y que aceptaron someterse a la técnica quirúrgica señalada. Con el fin de evaluar la eficacia de la técnica, se analizaron como variables: edad, sexo, agudeza visual con corrección (AVCC, y cilindro refractivo, así como microscopia endotelial, tiempo de ultrasonido, y complicaciones más frecuentes. Estos datos se analizaron a través de tablas de contingencia con frecuencias absolutas y relativas además con medias; se utilizó la prueba t de Student para compararlos. Se encontró que la catarata predominó en el sexo masculino en mayores de 60 años, la agudeza visual con corrección obtenida como promedio fue mejor que en el preoperatorio, el cilindro refractivo apenas se modificó, el tiempo de ultrasonido aplicado estuvo dentro de valores normales, y se correlacionó con la dureza del núcleo, la pérdida de células endoteliales no fue importante, y la complicación operatoria más frecuente fue la ruptura capsular.Cataract is mostly considered a remediable cause of visual acuity reduction. In the course of time, technical improvements have been implemented to make cataract surgery relatively easy and safe, and to support successful visual rehabilitation mainly when intraocular lens implant is added. Since then, a number of alternatives for dividing the crystalline nucleus emerged, but few are really necessary. This paper was aimed at describing the functional and anatomic results of quick chop phacoemulsification, the age of patients, preoperative and postoperative corrected visual acuity, preoperative and postoperative astigmatism, preoperative and postoperative microscopy, ultrasound time and complications. A prospective, descriptive and cross-sectional study was conducted in 146 patients (eyes operated on from January 2004 to January 2006 at the Center of Eye Microsurgery of “Ramon Pando Ferrer” Cuban Ophthalmologic Institute. The universe of study was all the patients diagnosed with pre-senile and senile cataract, who also met the selection criteria and accepted to be operated on by this technique. With the objective of evaluating the technique effectiveness, the following variables were analyzed: age, sex, corrected visual acuity and refractive cylinder, endothelial microscopy, ultrasound time and most frequent complications. These data were studied through contingency tables using absolute and relative frequencies and medians. Student’s t test served to compare them. It was found that cataract predominated in males over 60 years of age; average corrected visual acuity was better after surgery, the refractive cylinder barely changed, the ultrasound time of application was within the normal range and depending on the core hardness, the loss of endothelial cells was neglectable and the most frequent su

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

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    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.

  16. Principle and advantages of using viscoelastic agent undergo goniosynechialysis during glaucoma and cataract combined surgery

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    Jun-Xia Zhang

    2014-09-01

    Full Text Available AIM: To investigate the advantage of using the medical sodium hyaluronate gel undergo goniosynechialysis, and to compare the difference of the viscoelastic agent and perfusion fluid by clinical control study. METHODS:Totally 103 cases(103 eyespatients who had angle-closure glaucoma(ACGwith cataract all in Beijing Tongren Hospital affiliated to Capital Medical University, from September 2012 to February 2013. All the patients had primary glaucoma or recurrence ACG with cataract. Their intraocular pressure(IOPcould be controlled in normal value using one or two anti-glaucoma medications. We divided all the patients into two groups by chance. Experimental group had 53 cases(50 eyes, and control group had 50 cases(53 eyes. Two groups all had been performed phacoemulsification combined with goniosynechialysis by the same experiential operator. But experimental group did goniosynechialysis using the medical sodium hyaluronate gel, control group did goniosynechialysis using perfusion fluid. We observed the change of IOP, central anterior chamber depth and anterior chamber structure of two groups in postoperative 1mo. RESULTS: SPSS19.0 statistics software was utilized to analyze the data, This study selected one-side test ?=0.05, adopted paired t-test or two-sample t-test. We obtained that experimental group IOP decreased 12.42±0.04mmHg, anterior chamber depth increased 1.276±0.201mm; that control group IOP decreased 6.56±0.08mmHg, anterior chamber depth increased 0.852±0.132mm. And experimental group anterior chamber angle opened more widely than the other group, the comparison had statistical significance(PCONCLUSION:In phacoemulsification combine with goniosynechialysis,use medical sodium hyaluronate gel do goniosynechialysis can more effectively decrease IOP. This because the medical sodium hyaluronate gel has high glutinousness, it can separate angle of anterior chamber and controlling IOP effectively.

  17. Study of Steroid Induced Rise in Intraocular Pressure Using Non-contact Tonometer After Cataract Surgery in Camp Patients at P.D.U. Medical College Rajkot, Gujarat

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    Dodiya Kamal S

    2012-04-01

    Full Text Available Objectives: To study the incidence of steroid induced rise in intraocular pressure following cataract surgery using non contact tonometer. Materials and Methods: The study was undertaken in a tertiary care centre. 500 eyes which underwent uncomplicated cataract surgery were studied for IOP changes for up to six weeks following omission of steroid eye drops using non contact tonometer. Results: At the end of six weeks of steroid therapy, 21% patients had persistently raised IOP of which 2% had raised IOP at the end of six weeks following omission of steroid therapy. Conclusion: Non contact tonometry is equally effective for diagnosis and following up patients of drug (steroid induced glaucoma. [National J of Med Res 2012; 2(2.000: 169-172

  18. Neodymium:yttrium-aluminum garnet capsulotomy rates after combined cataract surgery with implantation of a 4% water content hydrophobic acrylic intraocular lens and vitrectomy

    OpenAIRE

    Kabata Y; Takahashi G; Tsuneoka H

    2013-01-01

    Yoshiaki Kabata,1 Genichiro Takahashi,1 Hiroshi Tsuneoka21Department of Ophthalmology, Jikei University School of Medicine, Katsushika Medical Center, 2Department of Ophthalmology, Jikei University School of Medicine, Tokyo, JapanBackground: The purpose of this study was to examine neodymium:yttrium-aluminum garnet (Nd:YAG) capsulotomy rates after combined cataract surgery with implantation of a three-piece 4% water content hydrophobic acrylic intraocular lens (X-70, Eternity®) and vitrec...

  19. Colirio de diclofenaco sódico en cirugía de catarata por facoemulsificación / Diclofenac sodium eyedrops in cataract's surgery by phacoemulsification

    Scientific Electronic Library Online (English)

    Yanele, Ruiz Rodríguez; Yoanner, Martín Perera; Iramis, Miranda Hernández; Raydel, Ibarra Ávila; Juan Raúl, Hernández Silva; Madelyn, Jareño Ochoa.

    2011-06-01

    Full Text Available OBJETIVOS: Determinar la efectividad clínica del diclofenaco sódico en colirio para mantener la midriasis pupilar durante la cirugía de catarata por facoemusificación y disminuir la inflamación en el posoperatorio, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" durante el año 2010. MÉTO [...] DOS: Se estudiaron 40 ojos distribuidos al azar en dos grupos de 20 cada uno: a) se les aplicó en el preoperatorio y posoperatorio tratamiento tópico de rutina, y b) se les adicionó diclofenaco sódico en colirio durante el preoperatorio y la primera semana del posoperatorio. Se midieron los diámetros pupilares al inicio de la cirugía y al finalizar la aspiración de restos corticales. Se evaluaron los pacientes en el posoperatorio a las 24 horas, a los seis días y al mes de la intervención; se observó la presencia o no de hiperemia cilioconjuntival y celularidad en cámara anterior. RESULTADOS: Se observó que los pacientes en quienes se utilizó el diclofenaco sódico en colirio mantuvieron mayor grado de midriasis. A las 24 horas el número 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 días y al mes estas variables se comportaron de forma similar en ambos grupos de estudio. CONCLUSIONES: Se ha comprobado que el diclofenaco sódico en colirio es efectivo en el mantenimiento de la midriasis transoperatoria y ofrece ventajas al disminuir la inflamación en la cirugía de catarata. Abstract in english 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 "Ramón 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. Measuring benefits and patients' satisfaction when glasses are not needed after cataract and presbyopia surgery: scoring and psychometric validation of the Freedom from Glasses Value Scale (FGVS©

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    Arnould Benoit

    2010-05-01

    Full Text Available Abstract Background The purpose of this study was to reduce the number of items, create a scoring method and assess the psychometric properties of the Freedom from Glasses Value Scale (FGVS, which measures benefits of freedom from glasses perceived by cataract and presbyopic patients after multifocal intraocular lens (IOL surgery. Methods The 21-item FGVS, developed simultaneously in French and Spanish, was administered by phone during an observational study to 152 French and 152 Spanish patients who had undergone cataract or presbyopia surgery at least 1 year before the study. Reduction of items and creation of the scoring method employed statistical methods (principal component analysis, multitrait analysis and content analysis. Psychometric properties (validation of the structure, internal consistency reliability, and known-group validity of the resulting version were assessed in the pooled population and per country. Results One item was deleted and 3 were kept but not aggregated in a dimension. The other 17 items were grouped into 2 dimensions ('global evaluation', 9 items; 'advantages', 8 items and divided into 5 sub-dimensions, with higher scores indicating higher benefit of surgery. The structure was validated (good item convergent and discriminant validity. Internal consistency reliability was good for all dimensions and sub-dimensions (Cronbach's alphas above 0.70. The FGVS was able to discriminate between patients wearing glasses or not after surgery (higher scores for patients not wearing glasses. FGVS scores were significantly higher in Spain than France; however, the measure had similar psychometric performances in both countries. Conclusions The FGVS is a valid and reliable instrument measuring benefits of freedom from glasses perceived by cataract and presbyopic patients after multifocal IOL surgery.

  1. Investigation on the changes of corneal curvature after non-phacoemulsification in small-incision cataract surgery with intraocular lens implantation

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    Hai-Jiang Qiu

    2014-05-01

    Full Text Available AIM: To investigate the changes of corneal curvature after non-phacoemulsification in small-incision cataract surgery with intraocular lens implantation and discuss the essence of iatrogenic astigmatism. METHODS: In this study, the horizontal corneal curvature(HCCand vertical corneal curvature(VCCof 99 patients(116 eyeswere documented before and after cataract surgery,with the postoperative follow-up of 3d; 1, 2wk; 1, 3, 6mo; 1, 2, 3a. The difference value of the HCC and the VCC between preoperation and postoperation were calculated and statistically analyzed. RESULTS: The VCC was deceased by 2.01D, while the HCC was increased by 1.62D on the 3d after surgery; the difference value of the HCC and VCC were both decreased acutely in the 3mo postoperationly(the difference value of the VCC was -0.52D and HCC was 0.46D; the difference value of the HCC and VCC both were decreased mildly after 3mo of postoperation, There was no significant difference between the difference value of HCC(0.29Dand VCC(-0.29Dat 6mo(P=0.801; VCC was still smaller than that of preoperation(-0.26D, and HCC was larger than that of preoperation(0.25Dat the 3a. Paired t test was performed in these curvature differences, which both decreased apparently from 3d to 6mo after surgery(PP=0.284; HCC:P=1.000. CONCLUSION: It remains astigmatism for a short time after small-incision cataract surgery and the treatment requires improvement so as to minimize the astigmatism as much as possible.

  2. Prospective evaluation of visual outcomes with three presbyopia-correcting intraocular lenses following cataract surgery

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    Ang RE

    2013-09-01

    Full Text Available RE Ang,1,2 GA Martinez,2,3 EM Cruz,1 AA Tiongson,1 AG Dela Cruz1 1Asian Eye Institute, Makati City, Philippines; 2Cardinal Santos Medical Center, San Juan City, Philippines; 3Pasig City General Hospital, Pasig City, Philippines Purpose: To compare the visual acuity and quality of vision achieved with three widely-used intraocular lenses (IOLs in subjects with bilateral cataracts. Patients and methods: This three-arm, parallel, prospective, partially masked, single-surgeon study randomized 78 subjects to receive bilateral Crystalens® Advanced Optics (AO accommodating IOLs, AcrySof® IQ ReSTOR® +3.0 multifocal IOLs, or TECNIS® Multifocal IOLs. Examinations were assessed through days 120 to 180. Results: The Crystalens AO group had statistically significantly better monocular and binocular, high-contrast (HC and low-contrast (LC uncorrected intermediate visual acuity, HC and LC distance-corrected intermediate visual acuity, and significantly fewer monocular and binocular halos and starbursts than did the ReSTOR and TECNIS groups. Monocular and binocular, HC and LC uncorrected near visual acuity exhibited no significant differences among the three lenses. For monocular and binocular HC distance-corrected near visual acuity, the Crystalens AO performed significantly better than the TECNIS and was not significantly different from the ReSTOR. For monocular and binocular LC distance-corrected near visual acuity, the Crystalens AO performed significantly better than both the ReSTOR and the TECNIS. Contrast sensitivity was clinically similar between groups. The Crystalens AO produced statistically fewer halos and starbursts. Conclusion: All three IOLs had excellent uncorrected acuity results at all distances and had good safety, confirming the established safety and effectiveness of these IOLs. Distance and near vision were similar between all three IOLs, and the Crystalens AO provided statistically significantly better intermediate vision. Keywords: Crystalens, accommodating, AcrySof, TECNIS, multifocal

  3. CIRUGÍA EXTRACAPSULAR DE CATARATAS CON LENTE INTRAOCULAR EN UN CANINO: REPORTE DE CASO / EXTRACAPSULAR CATARACT SURGERY WITH INTRAOCULAR LENS IN A DOG: A CASE REPORT

    Scientific Electronic Library Online (English)

    S. P, Acevedo; S. C, Ramírez; M, Restrepo.

    2011-12-01

    Full Text Available El presente artículo expone el caso de Muñeco, un perro macho de 12 años de edad de raza poodle que presenta cataratas bilaterales desde hace cinco meses, perdiendo de manera progresiva su visión, hasta el punto que presentó ceguera total. Durante el examen clínico se encontró un paciente con soplo [...] 3/6 de la válvula mitral, al que se le diagnosticó insuficiencia valvular mitral por endocardiosis valvular. En el examen oftalmológico se encontraron ambos ojos con epífora leve y cataratas seniles hipermaduras. Por tanto, el paciente fue intervenido quirúrgicamente para extraer la catarata y colocar en su lugar un lente intraocular, utilizando la técnica conocida como cirugía extracapsular de cataratas. Luego de esto, el paciente recuperó su capacidad visual después de llevar varios años con ceguera bilateral. Abstract in english This article presents the case of Muñeco, a poodle, male; 12 years of age, which presents opaqueness in both eyes for five months, losing his vision progressively until reaching total blindness. During the clinical examination we found a patient with heart murmur 3/6 in mitral valve, diagnosed with [...] mild mitral regurgitation secondary to valvular endocardiosis. In the ophthalmological examination we found mild bilateral epiphora, opacity of the crystalline lens and hyper mature senile Cataracts. The patient underwent surgery to remove the cataract and an intraocular lens was placed using a technique known as extracapsular cataract surgery. The patient recovered visual capacity after several years of being blind in both eyes.

  4. Three cases of extracapsular cataract extraction for radiation cataract

    International Nuclear Information System (INIS)

    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)

  5. Three cases of extracapsular cataract extraction for radiation cataract

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    Hirokane, Kenji; Kosaka, Toshiya; Nii, Hiroki; Kiuchi, Yoshiaki; Nakano, Kensuke; Choshi, Kanji [Hiroshima Univ. (Japan). School of Medicine

    1996-02-01

    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).

  6. Presence of free radicals in intracameral agents commonly used during cataract surgery

    OpenAIRE

    Lockington, David; Macdonald, Elisabeth Ca; Young, David; Stewart, Philip; Caslake, Muriel; Ramaesh, Kanna

    2010-01-01

    Abstract Background: Free radicals are known to cause cellular damage and are present in ophthalmic preparations. Corneal defence mechanisms are bypassed in intra-ocular surgery. We evaluated commonly used intracameral agents to ascertain the presence of free radicals and investigate the possibility of anterior segment and endothelial toxicity. Methods: Samples of 19 commonly used intracameral preparations were analysed for total free radical presence on an Instrument Lab...

  7. The prevalence of pseudoexfoliation syndrome and possible systemic associations in patients scheduled for cataract surgery at the Military Medical Academy in Belgrade

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    Kova? Bojan

    2014-01-01

    Full Text Available Background/Aim. Pseudoexfoliation syndrome (PEX is an age-related systemic degenerative disorder characterized by the production and progressive accumulation of extracellular fibrillar eosinophilic material in the anterior segment of the eye. The aim of the study was to evaluate several clinical aspects of PEX, such as frequency of PEX and pseudoexfoliation glaucoma (PEXG, intraocular pressure (IOP, the type of lens opacity, and the possible relationship of PEX and systemic diseases. Methods. All 674 cataract patients had a comprehensive eye examination, including slitlamp biomicroscopy before and after mydriasis, IOP measurement, and fundus examination. The patients were classified into two groups: the PEX and the non-PEX group. Results. The overall prevalence of PEX syndrome was found to be 17.5% (118 patients. The mean age of PEX patients (79.7 ± 6.1 years was significantly higher when compared with those without PEX (73.5 ± 9.1 years (p = 0.000. The prevalence of PEX syndrome was found to increase with age, from 7.3% in the 7th decade of life to 27% in patients older than 80 years (p < 0.001. The most common cataract type in the PEX patients was mature cataract observed in 40.7% of patients. The rest of the patients had mixed (30.5%, nuclear (25.4%, cortical (1.7% and hypermature cataract (1.7%. Among the PEX patients 44 (37.2% had glaucoma. Intraocular pressure was significantly higher in eyes with pseudoexfoliations than in eyes without it (17.8 ± 3.2 mmHg and 15.8 ± 2.8 mmHg, respectively; p = 0.001. Moreover, the prevalence of coronary heart disease was found to be higher in PEX patients. Conclusion. PEX syndrome is a common problem among Serbian patients scheduled for cataract surgery. It represents one of the major glaucoma risk factors and probably associated with ischemic heart disease, intraoperative and postoperative problems in cataract surgery.

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

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    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.

  9. Clear-cornea cataract surgery: pupil size and shape changes, along with anterior chamber volume and depth changes. A Scheimpflug imaging study

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    Kanellopoulos AJ

    2014-10-01

    Full Text Available Anastasios John Kanellopoulos,1,2 George Asimellis11Laservision.gr Eye Institute, Athens, Greece; 2New York University School of Medicine, New York, NY, USA Purpose: To investigate, by high-precision digital analysis of data provided by Scheimpflug imaging, changes in pupil size and shape and anterior chamber (AC parameters following cataract surgery.Patients and methods: The study group (86 eyes, patient age 70.58±10.33 years was subjected to cataract removal surgery with in-the-bag intraocular lens implantation (pseudophakic. A control group of 75 healthy eyes (patient age 51.14±16.27 years was employed for comparison. Scheimpflug imaging (preoperatively and 3 months postoperatively was employed to investigate central corneal thickness, AC depth, and AC volume. In addition, by digitally analyzing the black-and-white dotted line pupil edge marking in the Scheimpflug “large maps,” the horizontal and vertical pupil diameters were individually measured and the pupil eccentricity was calculated. The correlations between AC depth and pupil shape parameters versus patient age, as well as the postoperative AC and pupil size and shape changes, were investigated.Results: Compared to preoperative measurements, AC depth and AC volume of the pseudophakic eyes increased by 0.99±0.46 mm (39%; P<0.001 and 43.57±24.59 mm3 (36%; P<0.001, respectively. Pupil size analysis showed that the horizontal pupil diameter was reduced by -0.27±0.22 mm (-9.7%; P=0.001 and the vertical pupil diameter was reduced by -0.32±0.24 mm (-11%; P<0.001. Pupil eccentricity was reduced by -39.56%; P<0.001.Conclusion: Cataract extraction surgery appears to affect pupil size and shape, possibly in correlation to AC depth increase. This novel investigation based on digital analysis of Scheimpflug imaging data suggests that the cataract postoperative photopic pupil is reduced and more circular. These changes appear to be more significant with increasing patient age. Keywords: cataract removal, anterior chamber, pupil size, pupil eccentricity, Scheimpflug imaging, pupil changes, pseudophakic eyes, postoperative myosis

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

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    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.

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

    Scientific Electronic Library Online (English)

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

    2003-07-01

    Full Text Available 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 tip [...] os 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. Abstract in english 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 mi [...] croorganisms 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.

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

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    Jaichandran Venkatakrishnan

    2010-01-01

    Full Text Available Aim: To compare self-reported pain and efficacy of warmed, alkalinized, and warmed alkalinized lidocaine with plain 2% lidocaine at room temperature for peribulbar anesthesia in cataract surgery. Materials and Methods: Through a prospective, single-blinded, randomized, controlled clinical trial 200 patients were divided into four groups. They received either lidocaine at operating room temperature 18°C, control group (Group C, lidocaine warmed to 37°C (Group W, lidocaine alkalinized to a pH of 7.09 ± 0.10 (Group B or lidocaine at 37°C alkalinized to a pH of 6.94 ± 0.05 (Group WB. All solutions contained Inj. Hyaluronidase 50 IU/ml. Pain was assessed using a 10-cm visual analog score scale. Time of onset of sensory and motor blockade and time to onset of postoperative pain were recorded by a blinded observer. Results: Mean pain score was significantly lower in Group B and WB compared with Group C ( P < 0.001. Onset of analgesia was delayed in Group C compared with Group B ( P = 0.021 and WB ( P < 0.001. Mean time taken for the onset of complete akinesia and supplementation required for the block was significantly lower in Group B. Time of onset of pain after operation was significantly earlier in Group W compared with Group C ( P = 0.036. Conclusion: Alkalinized lidocaine with or without warming produced less pain than lidocaine injected at room temperature. Alkalinization enhances the effect of warming for sensory nerve blockade, but warming does not enhance alkalinization, in fact it reduces the efficacy of alkalinized solution for blocking the motor nerves in the eye.

  13. Analysis of protein composition of rabbit aqueous humor following two different cataract surgery incision procedures using 2-DE and LC-MS/MS

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    McDonnell Peter J

    2011-02-01

    Full Text Available Abstract Background The aqueous humor (AH, a liquid of the anterior and posterior chamber of the eye, comprises many proteins with various roles and important biological functions. Many of these proteins have not been identified yet and their functions in AH are still unknown. Recently, our laboratory published the protein database of AH obtained from healthy rabbits which expanded known protein identifications by 65%. Our present study extends our previous work and analyses AH following two types of cataract surgery incision procedures (clear corneal and limbal incisions by using two dimensional gel electrophoresis (2-DE and liquid chromatography tandem mass spectrometry (LC-MS/MS. Although both incision protocols are commonly used during cataract surgeries, the difference in protein composition and their release into AH following each surgery has never been systematically compared and remains unclear. The first step, which is the focus of this work, is to assess the scale of the protein change, at which time does maximum release occurs and when possible, to identify protein changes. Results Samples of AH obtained prior to surgery and at different time points (0.5, 2, 12, 24 and 48 hours following surgery (n = 3/protocol underwent protein concentration determination, 2-DE and LC-MS/MS. There was a large (9.7 to 31.2 mg/mL and rapid (~0.5 hour influx of proteins into AH following either incision with a return to baseline quantities after 12 hours and 24 hours for clear corneal and limbal incision, respectively. We identified 80 non-redundant proteins, and compared to our previous study on healthy AH, 67.5% of proteins were found to be surgery-specific. In addition, 51% of those proteins have been found either in clear corneal (20% or limbal incision (31% samples. Conclusions Our results imply that a mechanism of protein release into AH after surgery is a global response to the surgery rather than increase in amount of protective proteins found in healthy AH and a mechanism of protein release for each type of incision procedure could be different. Although the total protein concentration was increased (at 0.5 and 2 hour time points and between types of surgery many of 2-DE protein spots were similar based on 2-DE and MS analyses, and only a small number of protein spots changed with either the time points or surgical conditions (0.4 -1.9%. This suggests that the high protein content is due to an increase in the concentration of the same proteins with only a few unique proteins being altered per time point and with the different surgery type. This is the first report on the comparison of AH protein composition following two different cataract surgery procedures and it establishes the basis for better understanding of protein release into AH during events such as cataract surgery or other possible intervention to the eyes.

  14. Country-Wide Monitoring of Cataract Surgical Outcomes

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    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.

  15. Astigmatismo inducido en la cirugía de catarata por técnica de facoemulsificación / Induced astigmatism in cataract's surgery by phacoemulsification technique

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    Anabel, González Peña; Lorelei, Ortega Díaz; Eneida, Pérez Candelaria.

    2011-06-01

    Full Text Available OBJETIVO: Determinar el astigmatismo inducido en la cirugía de catarata por la técnica de facoemulsificación, en los pacientes operados en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el período de enero a diciembre de 2007. MÉTODOS: Se realizó un estudio descriptivo, longitudinal y [...] retrospectivo para evaluar el comportamiento del astigmatismo posquirúrgico en 178 pacientes operados de catarata mediante la técnica de facoemulsificación (facochop) e implante de lente intraocular de polymethilmethacrylato o Acrílico por un mismo cirujano. Se analizaron variables como: agudeza visual sin cristales y mejor agudeza visual corregida, queratometría, tamaño y lugar de la incisión, así como el astigmatismo inducido. RESULTADOS: La media del astigmatismo queratométrico inducido fue de 0,61 dioptrías al mes de la cirugía, y fue menos de 1,00 dioptría queratométrica con tendencia a disminuir en el tiempo. El astigmatismo queratométrico inducido relacionado con el tamaño de la incisión fue directamente proporcional. Al relacionarlo con el lugar de la incisión no se encontraron diferencias significativas. La mejoría de agudeza visual sin cristales y la mejor agudeza visual corregida fue notable a medida que el astigmatismo queratométrico inducido fue menor. CONCLUSIONES: La facoemulsificación (facochop) ofrece al cirujano una incisión estable que induce un bajo astigmatismo posoperatorio y un resultado visual satisfactorio para el paciente. Abstract in english OBJECTIVE: To determine the induced astigmatism in cataract's surgery by phacoemulsification technique in patients operated on the "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from January to December, 2007. METHODS: A retrospective, longitudinal and descriptive study was conducted to asses [...] s the behavior of postsurgical astigmatism in 178 patients operated by phacoemulsification technique (phacochop) and implant of polymethilmethacrylate or acrylic intraocular lens carried out by the same surgeon. Variables analyzed were: visual acuity without glasses and a better corrected visual acuity, keratometry, incision's size and place, as well as the induced astigmatism. RESULTS: The mean of the induced keratometry astigmatism was of 0,61 dioptres at month of surgery and it was less than 1,00 keratometry dioptres with a trend to decrease in time. The induced keratometry astigmatism related to incision's size was directly proportional and its relation to the place of incision there were not significant differences. The improvement in visual acuity without glasses and the better corrected visual acuity was remarkable insofar as the induced keratometry astigmatism was less. CONCLUSIONS:The phacoemulsification (phacochop) offer to surgeon an stable incision inducing a low postoperative astigmatism and a satisfactory visual results for patient.

  16. Astigmatismo inducido en la cirugía de catarata por técnica de facoemulsificación Induced astigmatism in cataract's surgery by phacoemulsification technique

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    Anabel González Peña

    2011-06-01

    Full Text Available OBJETIVO: Determinar el astigmatismo inducido en la cirugía de catarata por la técnica de facoemulsificación, en los pacientes operados en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el período de enero a diciembre de 2007. MÉTODOS: Se realizó un estudio descriptivo, longitudinal y retrospectivo para evaluar el comportamiento del astigmatismo posquirúrgico en 178 pacientes operados de catarata mediante la técnica de facoemulsificación (facochop e implante de lente intraocular de polymethilmethacrylato o Acrílico por un mismo cirujano. Se analizaron variables como: agudeza visual sin cristales y mejor agudeza visual corregida, queratometría, tamaño y lugar de la incisión, así como el astigmatismo inducido. RESULTADOS: La media del astigmatismo queratométrico inducido fue de 0,61 dioptrías al mes de la cirugía, y fue menos de 1,00 dioptría queratométrica con tendencia a disminuir en el tiempo. El astigmatismo queratométrico inducido relacionado con el tamaño de la incisión fue directamente proporcional. Al relacionarlo con el lugar de la incisión no se encontraron diferencias significativas. La mejoría de agudeza visual sin cristales y la mejor agudeza visual corregida fue notable a medida que el astigmatismo queratométrico inducido fue menor. CONCLUSIONES: La facoemulsificación (facochop ofrece al cirujano una incisión estable que induce un bajo astigmatismo posoperatorio y un resultado visual satisfactorio para el paciente.OBJECTIVE: To determine the induced astigmatism in cataract's surgery by phacoemulsification technique in patients operated on the "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from January to December, 2007. METHODS: A retrospective, longitudinal and descriptive study was conducted to assess the behavior of postsurgical astigmatism in 178 patients operated by phacoemulsification technique (phacochop and implant of polymethilmethacrylate or acrylic intraocular lens carried out by the same surgeon. Variables analyzed were: visual acuity without glasses and a better corrected visual acuity, keratometry, incision's size and place, as well as the induced astigmatism. RESULTS: The mean of the induced keratometry astigmatism was of 0,61 dioptres at month of surgery and it was less than 1,00 keratometry dioptres with a trend to decrease in time. The induced keratometry astigmatism related to incision's size was directly proportional and its relation to the place of incision there were not significant differences. The improvement in visual acuity without glasses and the better corrected visual acuity was remarkable insofar as the induced keratometry astigmatism was less. CONCLUSIONS:The phacoemulsification (phacochop offer to surgeon an stable incision inducing a low postoperative astigmatism and a satisfactory visual results for patient.

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

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    Dada Tanuj; Behera Geeta; Agarwal Anand; Kumar Sanjeev; Sihota Ramanjit; Panda Anita

    2010-01-01

    Purpose: To study the effect of cataract extraction on the retinal nerve fiber layer (RNFL) thickness, and assessment by scanning laser polarimetry (SLP), with variable corneal compensation (GDx VCC), at the glaucoma service of a tertiary care center in North India. Materials and Methods: Thirty-two eyes of 32 subjects were enrolled in the study. The subjects underwent RNFL analysis by SLP (GDx VCC) before undergoing phacoemulsification cataract extraction with intraocular lens (IOL) implanta...

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

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    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.

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

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    Roberta Ferrari, Marback; Rodrigo França de, Espíndola; Marcony Rodrigues de, Santhiago; Edméa Rita, Temporini; Newton, Kara-Junior.

    2012-12-01

    Full Text Available OBJETIVO: 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. RES [...] ULTADOS: 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 Abstract in english 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. R [...] ESULTS: 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

  20. Congenital cataract surgery with intraocular lens implantation in microphthalmic eyes: visual outcomes and complications / Cirurgia de catarata congênita com implante de lente intraocular em olhos microftálmicos: resultados visuais e complicações

    Scientific Electronic Library Online (English)

    Marcelo Carvalho, Ventura; Virgínia Vilar, Sampaio; Bruna Vieira, Ventura; Liana Oliveira, Ventura; Walton, Nosé.

    2013-08-01

    Full Text Available OBJETIVOS: Relatar os resultados visuais e as complicações da cirurgia de catarata congênita com implante primário de lente intraocular em olhos microftálmicos de crianças menores de 4 anos. MÉTODOS: Esta série de casos retrospectiva incluiu 14 olhos microftálmicos de 10 crianças menores de 4 anos q [...] ue foram submetidas à cirurgia de catarata congênita com implante primário de lente intraocular. Sete pacientes tinham catarata bilateral (11 foram incluídos no estudo) e 3 tinham catarata unilateral. Os prontuários dos pacientes foram revisados para se obter informação sobre o exame oftalmológico pré- e pós-operatório. As principais variáveis analisadas foram pressão intraocular, acuidade visual com melhor correção e complicações intra- e pós-operatórias. RESULTADOS: A média da idade dos pacientes na época da cirurgia foi de 21,7 ± 2,9 meses. O diâmetro antero-posterior médio foi de 19,2 ± 0,9 mm. A pressão intraocular média pré-operatória foi 9,7 ± 1,7 mmHg e 10,3 ± 3,1 mmHg no último exame de acompanhamento pós-operatório (P=0,18). Não houve complicações intraoperatórias. Dois (15,4%) olhos desenvolveram opacificação secundária do eixo visual, dos quais um foi reoperado devido à baixa visual significativa (0,5 logMAR). AV pré- e pós-operatórias foram 2,09 ± 0,97 logMAR e 0,38 ± 0,08 logMAR em casos de catarata congênita bilateral e 1,83 ± 1,04 logMAR e 0,42 ± 0,13 logMAR em casos unilaterais, respectivamente. CONCLUSÃO: O implante primário de lente intraocular em cirurgia de catarata congênita em olhos microftálmicos resultou em uma melhora significativa da acuidade visual com nenhuma complicação intraoperatória e com pouca complicação no pós-operatório. Abstract in english PURPOSE: To report the visual outcomes and complications of congenital cataract surgery with primary intraocular lens implantation in microphthalmic eyes of children younger than 4 years of age. METHODS:This retrospective interventional case series included 14 microphthalmic eyes from 10 children wh [...] o underwent congenital cataract surgery with primary intraocular lens implantation younger than 4 years of age. Seven patients had bilateral cataracts (11 eyes met the study's inclusion criteria) and 3 patients had unilateral cataract. Patients' medical charts were reviewed to obtain information regarding the preoperative and postoperative ophthalmological examination. Main outcome measures were intraocular pressure (IOP), best-corrected visual acuity, and intraoperative and postoperative complications. RESULTS: Mean age at the time of surgery was 21.7 ± 2.9 months. Mean ocular axial length was 19.2 ± 0.9 mm. Mean preoperative IOP was 9.7 ± 1.7 mmHg and 10.3 ± 3.1 mmHg on final follow-up (P=0.18). There were no intraoperative complications. Two (15.4%) eyes developed secondary visual axis opacification, of which only one needed to be reoperated due to significantly decreased vision (0.5 logMAR). Preoperative and postoperative best-corrected visual acuity was 2.09 ± 0.97 logMAR and 0.38 ± 0.08 logMAR in bilateral cases and 1.83 ± 1.04 logMAR and 0.42 ± 0.13 logMAR in unilateral cases, respectively. CONCLUSION: Primary intraocular lens implantation in congenital cataract surgery in microphthalmic eyes resulted in a significant best-corrected visual acuity improvement with no intraoperative complications and minimal postoperative complications.

  1. A Comparison of the American Society of Cataract and Refractive Surgery post-myopic LASI K/PRK Intraocular Lens (IOL) calculator and the Ocular MD IOL calculator

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    Hsu M; Neuffer MC; Moshirfar M; DeMill DL; Sikder S

    2011-01-01

    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 photor...

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

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    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.

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

    Scientific Electronic Library Online (English)

    Janet, González Sotero; Eduardo, Rojas Álvarez; Alexei, Díaz Pérez; Ariadna, Pérez Ruíz; Liliana, Taño Lazo.

    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. Abstract in english 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.

  4. Clinical effective observation on monocular serious cataract with exotropia

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    Qiong Lei

    2014-05-01

    Full Text Available AIM: To evaluate the clinical effect of surgical treatment on monocular serious cataract with exotropia.METHODS: Reviewed 45 patients diagnosed as cataract with exotropia who accepted cataract surgery and intraocular lens implantation from Mar. 2010 to Dec. 2012 in our hospital. Preoperatively the visual acuity of 44 patients wasRESULTS: One 2-year old child couldn't cooperate with the examination. The other congenital cataract patient didn't acquire BSV and diplopia. Among 5 middle-aged patients, the BCVA of 3 cases were above 0.6 with normal fundus and BSV, 2 cases were finger count with abnormal fundus and without BSV. Among 38 senile cataract cases, 31 cases acquired BSV, 3 cases without BSV and diplopia, 3 cases appeared diplopia postoperatively and recovered in 6 months, 1 case with exotropia and diplopia accepted triple prism treatment.CONCLUSION: Most of adult patients with monocular serious cataract andexotropia can acquire normal eye position and BSV.

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

    Scientific Electronic Library Online (English)

    Zucell Ana, Veitía Rovirosa; Malvys, Vidal Castillo; Juan Raúl, Hernández Silva; Eneida de la Caridad, Pérez Candelaria; Ileana, Vila Dopico; Francisco, Fumero González.

    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 form [...] a 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. Abstract in english 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.

  6. Cirurgia combinada de catarata e glaucoma com ponto escleral perilímbico: técnica cirúrgica e resultados a longo prazo / Combined cataract and glaucoma surgery with scleral peri-limbic suture: surgical technique and long-term results

    Scientific Electronic Library Online (English)

    Luciano Sólia, Násser; Pedro Eleutério dos, Santos Neto; Lívia Máris Ribeiro, Paranaíba; Luciana dos Mares Guia, Ribeiro; Luciano Pimenta de, Figueiredo; Hercílio, Martelli Júnior.

    2012-08-01

    Full Text Available OBJETIVO: Analisar os resultados da cirurgia combinada de catarata e glaucoma (FACO-TREC) e apresentar a técnica com o ponto escleral perilímbico. MÉTODOS: Estudo retrospectivo por levantamento de prontuários com informações sobre a pressão intraocular, acuidade visual, medicação hipotensora antes e [...] depois da cirurgia e descrição do ato cirúrgico combinado (FACO-TREC), com acompanhamento mínimo de seis meses. Foram selecionados 10 pacientes com glaucoma e catarata (15 olhos), acompanhados de janeiro de 2005 a junho de 2007, no Departamento de Glaucoma da Santa Casa Olhos de Montes Claros (MG). A cirurgia de TREC utilizada foi a de base fórnix, sem uso de Mitomicina C, com a incisão principal da cirurgia de catarata realizada no mesmo sítio da TREC. A confecção do ponto escleral perilímbico se dá como uma sutura que se inicia na esclera nua, passa por cima do retalho escleral e é ancorada na esclera do outro lado do retalho. A conjuntiva é suturada com pontos simples por sobre o ponto. RESULTADOS: A acuidade visual, após seis meses da cirurgia mostrou-se melhor em 86,6% (13) dos olhos, inalterada em 6,66% (1 olho) e pior em 6,66%. A pressão intraocular média pré-operatória foi de 18,02 mmHg, a pós-operatória após 6 meses foi de 15,06 mmHg. Cinquenta por cento dos olhos operados ficaram livres dos colírios. CONCLUSÃO: Conclui-se que o ponto escleral perilímbico apresentou resultados favoráveis na obtenção de uma melhora na acuidade visual, redução da pressão intraocular e uma diminuição significativa no uso de drogas hipotensoras à custa de um número muito pequeno de complicações. Abstract in english PURPOSE: To analyze the results of combined cataract and glaucoma surgery and to present the technique with scleral peri-limbic suture. METHODS: Retrospective study with review of the data about intraocular pressure, visual acuity, antihypertensive medication before and after surgery and description [...] of the combined surgery technique, with follow up of six months. We selected 10 patients with glaucoma and cataract (15 eyes) followed up from January 2005 to June 2007 from Santa Casa Olhos de Montes Claros (MG). The glaucoma surgery was fornix-based, without use of mitomycin C, with the main cataract surgery incision performed on the same site The preparation of the scleral peri-limbic suture is given as a suture that begins on bare sclera, passes over the scleral flap and is anchored in the sclera on the other side of flap. The conjunctiva is sutured over the peri-limbic point. RESULTS: The visual acuity after six months of surgery was better in 86.6% of eyes, unchanged in 6.66% (one eye) and worse in 6.66. The mean preoperative IOP was 18.02 mmHg, after six postoperative months was 15.06 mmHg. Fifty percente of the eyes were free of eye drops. CONCLUSION: We conclude that scleral limbic suture showed favorable results in obtaining an improvement in visual acuity, reduction of intraocular pressure and a significant decrease in the use of hypotensive drugs at the expense of a very small number of complications.

  7. Cirurgia combinada de catarata e glaucoma com ponto escleral perilímbico: técnica cirúrgica e resultados a longo prazo Combined cataract and glaucoma surgery with scleral peri-limbic suture: surgical technique and long-term results

    Directory of Open Access Journals (Sweden)

    Luciano Sólia Násser

    2012-08-01

    Full Text Available OBJETIVO: Analisar os resultados da cirurgia combinada de catarata e glaucoma (FACO-TREC e apresentar a técnica com o ponto escleral perilímbico. MÉTODOS: Estudo retrospectivo por levantamento de prontuários com informações sobre a pressão intraocular, acuidade visual, medicação hipotensora antes e depois da cirurgia e descrição do ato cirúrgico combinado (FACO-TREC, com acompanhamento mínimo de seis meses. Foram selecionados 10 pacientes com glaucoma e catarata (15 olhos, acompanhados de janeiro de 2005 a junho de 2007, no Departamento de Glaucoma da Santa Casa Olhos de Montes Claros (MG. A cirurgia de TREC utilizada foi a de base fórnix, sem uso de Mitomicina C, com a incisão principal da cirurgia de catarata realizada no mesmo sítio da TREC. A confecção do ponto escleral perilímbico se dá como uma sutura que se inicia na esclera nua, passa por cima do retalho escleral e é ancorada na esclera do outro lado do retalho. A conjuntiva é suturada com pontos simples por sobre o ponto. RESULTADOS: A acuidade visual, após seis meses da cirurgia mostrou-se melhor em 86,6% (13 dos olhos, inalterada em 6,66% (1 olho e pior em 6,66%. A pressão intraocular média pré-operatória foi de 18,02 mmHg, a pós-operatória após 6 meses foi de 15,06 mmHg. Cinquenta por cento dos olhos operados ficaram livres dos colírios. CONCLUSÃO: Conclui-se que o ponto escleral perilímbico apresentou resultados favoráveis na obtenção de uma melhora na acuidade visual, redução da pressão intraocular e uma diminuição significativa no uso de drogas hipotensoras à custa de um número muito pequeno de complicações.PURPOSE: To analyze the results of combined cataract and glaucoma surgery and to present the technique with scleral peri-limbic suture. METHODS: Retrospective study with review of the data about intraocular pressure, visual acuity, antihypertensive medication before and after surgery and description of the combined surgery technique, with follow up of six months. We selected 10 patients with glaucoma and cataract (15 eyes followed up from January 2005 to June 2007 from Santa Casa Olhos de Montes Claros (MG. The glaucoma surgery was fornix-based, without use of mitomycin C, with the main cataract surgery incision performed on the same site The preparation of the scleral peri-limbic suture is given as a suture that begins on bare sclera, passes over the scleral flap and is anchored in the sclera on the other side of flap. The conjunctiva is sutured over the peri-limbic point. RESULTS: The visual acuity after six months of surgery was better in 86.6% of eyes, unchanged in 6.66% (one eye and worse in 6.66. The mean preoperative IOP was 18.02 mmHg, after six postoperative months was 15.06 mmHg. Fifty percente of the eyes were free of eye drops. CONCLUSION: We conclude that scleral limbic suture showed favorable results in obtaining an improvement in visual acuity, reduction of intraocular pressure and a significant decrease in the use of hypotensive drugs at the expense of a very small number of complications.

  8. 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

    Directory of Open Access Journals (Sweden)

    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

  9. Recognizing Cataracts

    Science.gov (United States)

    ... the risk of age-related cataract. They recommend eating plenty of green leafy vegetables, fruits, nuts and other healthy foods. Also, don’t smoke, because smoking may speed cataract development. To screen for early signs of eye disease, Bishop recommends that everyone have a dilated ...

  10. The use of vital dyes in ocular surgery.

    Science.gov (United States)

    Rodrigues, Eduardo B; Costa, Elaine F; Penha, Fernando M; Melo, Gustavo B; Bottós, Juliana; Dib, Eduardo; Furlani, Bruno; Lima, Veronica C; Maia, Maurício; Meyer, Carsten H; Höfling-Lima, Ana Luisa; Farah, Michel E

    2009-01-01

    Vital dyes have advanced diagnosis and surgical technique in various specialties, including oncology, gastroenterology, and ophthalmology. In ocular surgery vital dyes are widely used in cataract and vitreoretinal surgery. Worldwide, intra-operative use of trypan blue during cataract surgery has enhanced visualization of the anterior capsule during capsulorrhexis, and patent blue has been recently licensed in Europe for cataract surgery. For chromovitrectomy, the vital dyes indocyanine green, infracyanine green, and brilliant blue stain the internal limiting membrane, and trypan blue and triamcinolone acetonide help visualize epiretinal membranes and vitreous, respectively. Intra-operative vital dyes are finding uses in corneal, glaucoma, orbit, strabismus, and conjunctival surgery. We provide a summary of current knowledge of the use of vital dyes in ocular surgery. We review the properties of dyes, techniques of application, indications, and complications in ocular surgery. Vital dyes represent an expanding area of research, and novel dyes deserve further investigation. PMID:19682624

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

    Scientific Electronic Library Online (English)

    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 à facoemulsificação com implante de LIO AcrySof® tórica versus LIO AcrySof® IQ e avaliar a redução da dioptria cilíndrica (DC) pós-operatória. MÉTODOS: Estudo analítico retrospectivo de 149 olhos submetidos à cirurgia de catara [...] ta por facoemulsificação, com astigmatismo ceratométrico regular, simétrico, com 1 dioptria ou mais. Foram divididos em dois grupos. O grupo tórica com 85 olhos e o grupo não tórica com 64 olhos. No pré-operatório foram avaliados dados topográficos do olho a ser operado e refração. No período pós-operatório foram revisados dados da refração e acuidades visuais com e sem correção. RESULTADOS: O astigmatismo corneano pré-operatório variou de 1,00 a 5,6 DC em ambos os grupos, sendo que no grupo tórica houve redução média 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. Reversible Cataract as the Presenting Sign of Diabetes Mellitus: Report of Two Cases and Literature Review

    OpenAIRE

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

    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...

  13. Analyses of cataract surgery performed by the Unified Health System in Brazil, 2006-2007 Análisis de las intervenciones quirúrgicas de cataratas efectuadas en el Sistema Único de Salud del Brasil en el 2006 y el 2007

    Directory of Open Access Journals (Sweden)

    Ligia Santos Abreu Caligaris

    2011-06-01

    Full Text Available OBJECTIVE: Estimate cataract surgical rates (CSR for Brazil and each federal unit in 2006 and 2007 based on the number of surgeries performed by the Unified Health System to help plan a comprehensive ophthalmology network in order to eliminate cataract blindness in compliance with the target set by the World Health Organization (WHO of 3 000 cataract surgeries per million inhabitants per year. METHODS: This descriptive study calculates CSR by using the number of cataract surgeries carried out by the Brazilian Unified Health System for each federal unit and estimates the need for cataract surgery in Brazil for 2006-2007, with official population data provided by the Brazilian Institute of Geography and Statistics. The number of cataract surgeries was compared with the WHO target. RESULTS: To reach the WHO goal for eliminating age-related cataract blindness in Brazil, 560312 cataract surgeries in 2006 and 568 006 surgeries in 2007 needed to be done. In 2006, 179121 cataract surgeries were done by the Unified Health System, corresponding to a CSR of 959 per million population; in 2007, 223317 were performed, with a CSR of 1179. With the Brazilian Council of Ophthalmology estimation of 165 000 surgeries each year by the non-public services, the CSR for Brazil would be 1842 for 2006 and 2051 for 2007. The proportions needed to achieve the proposed target were 38.6% in 2006 and 31.6% in 2007. CONCLUSIONS: Human resources, technical expertise, and equipment are crucial to reach the WHO goal. Brazil has enough ophthalmologists but needs improved planning and infrastructure in order to eliminate the problem, aspects that require greater financial investment and stronger political commitment.OBJETIVO: Calcular las tasas de cirugía de cataratas (TCC correspondientes al 2006 y el 2007 en todo el Brasil y en cada estado según la cantidad de intervenciones efectuadas en el Sistema Único de Salud, con el objeto de planificar una red integral de atención oftalmológica tendiente a eliminar la ceguera por cataratas, en cumplimiento de la meta fijada por la Organización Mundial de la Salud (OMS, de 3 000 intervenciones quirúrgicas de cataratas por millón de habitantes por año. MÉTODOS: En este estudio descriptivo se calculó la TCC según la cantidad de intervenciones quirúrgicas de cataratas llevadas a cabo en el Sistema Único de Salud del Brasil en cada estado, y se calculó la necesidad de intervenciones quirúrgicas de cataratas en el Brasil en el 2006 y el 2007 según los datos oficiales de la población proporcionados por el Instituto Brasileño de Geografía y Estadística. Se comparó la cantidad de intervenciones quirúrgicas de cataratas con la meta de la OMS. RESULTADOS: Para alcanzar la meta de la OMS de eliminar la ceguera producida por cataratas seniles en el Brasil, deberían haberse efectuado 560 312 intervenciones quirúrgicas de cataratas en el 2006, y 568006 en el 2007. En el 2006, se efectuaron 179 121 intervenciones quirúrgicas de cataratas en el Sistema Único de Salud, lo que representa una TCC de 959 por millón de habitantes; en el 2007, se realizaron 223317, con una TCC de 1179. Si estos datos se consideran junto con la estimación del Consejo Brasileño de Oftalmología de 165000 intervenciones quirúrgicas efectuadas cada año en los servicios no públicos, la TCC correspondiente al Brasil sería de 1842 para el 2006 y de 2 051 para el 2007. Las proporciones faltantes para lograr la meta propuesta fueron de 38,6% en el 2006 y de 31,6% en el 2007. CONCLUSIONES: Los recursos humanos, los conocimientos técnicos especializados y el equipo son esenciales para alcanzar la meta de la OMS. Brasil tiene suficientes oftalmólogos pero, para eliminar el problema, necesita una mejor planificación y más infraestructura, aspectos que requieren una mayor inversión financiera y un compromiso político más firme.

  14. Analyses of cataract surgery performed by the Unified Health System in Brazil, 2006-2007 / Análisis de las intervenciones quirúrgicas de cataratas efectuadas en el Sistema Único de Salud del Brasil en el 2006 y el 2007

    Scientific Electronic Library Online (English)

    Ligia Santos Abreu, Caligaris; Norma Helen, Medina; Van C., Lansingh; Eliseu Alves, Waldman; Fernando, Yaacov-Peña.

    2011-06-01

    Full Text Available OBJETIVO: Calcular las tasas de cirugía de cataratas (TCC) correspondientes al 2006 y el 2007 en todo el Brasil y en cada estado según la cantidad de intervenciones efectuadas en el Sistema Único de Salud, con el objeto de planificar una red integral de atención oftalmológica tendiente a eliminar la [...] ceguera por cataratas, en cumplimiento de la meta fijada por la Organización Mundial de la Salud (OMS), de 3 000 intervenciones quirúrgicas de cataratas por millón de habitantes por año. MÉTODOS: En este estudio descriptivo se calculó la TCC según la cantidad de intervenciones quirúrgicas de cataratas llevadas a cabo en el Sistema Único de Salud del Brasil en cada estado, y se calculó la necesidad de intervenciones quirúrgicas de cataratas en el Brasil en el 2006 y el 2007 según los datos oficiales de la población proporcionados por el Instituto Brasileño de Geografía y Estadística. Se comparó la cantidad de intervenciones quirúrgicas de cataratas con la meta de la OMS. RESULTADOS: Para alcanzar la meta de la OMS de eliminar la ceguera producida por cataratas seniles en el Brasil, deberían haberse efectuado 560 312 intervenciones quirúrgicas de cataratas en el 2006, y 568006 en el 2007. En el 2006, se efectuaron 179 121 intervenciones quirúrgicas de cataratas en el Sistema Único de Salud, lo que representa una TCC de 959 por millón de habitantes; en el 2007, se realizaron 223317, con una TCC de 1179. Si estos datos se consideran junto con la estimación del Consejo Brasileño de Oftalmología de 165000 intervenciones quirúrgicas efectuadas cada año en los servicios no públicos, la TCC correspondiente al Brasil sería de 1842 para el 2006 y de 2 051 para el 2007. Las proporciones faltantes para lograr la meta propuesta fueron de 38,6% en el 2006 y de 31,6% en el 2007. CONCLUSIONES: Los recursos humanos, los conocimientos técnicos especializados y el equipo son esenciales para alcanzar la meta de la OMS. Brasil tiene suficientes oftalmólogos pero, para eliminar el problema, necesita una mejor planificación y más infraestructura, aspectos que requieren una mayor inversión financiera y un compromiso político más firme. Abstract in english OBJECTIVE: Estimate cataract surgical rates (CSR) for Brazil and each federal unit in 2006 and 2007 based on the number of surgeries performed by the Unified Health System to help plan a comprehensive ophthalmology network in order to eliminate cataract blindness in compliance with the target set by [...] the World Health Organization (WHO) of 3 000 cataract surgeries per million inhabitants per year. METHODS: This descriptive study calculates CSR by using the number of cataract surgeries carried out by the Brazilian Unified Health System for each federal unit and estimates the need for cataract surgery in Brazil for 2006-2007, with official population data provided by the Brazilian Institute of Geography and Statistics. The number of cataract surgeries was compared with the WHO target. RESULTS: To reach the WHO goal for eliminating age-related cataract blindness in Brazil, 560312 cataract surgeries in 2006 and 568 006 surgeries in 2007 needed to be done. In 2006, 179121 cataract surgeries were done by the Unified Health System, corresponding to a CSR of 959 per million population; in 2007, 223317 were performed, with a CSR of 1179. With the Brazilian Council of Ophthalmology estimation of 165 000 surgeries each year by the non-public services, the CSR for Brazil would be 1842 for 2006 and 2051 for 2007. The proportions needed to achieve the proposed target were 38.6% in 2006 and 31.6% in 2007. CONCLUSIONS: Human resources, technical expertise, and equipment are crucial to reach the WHO goal. Brazil has enough ophthalmologists but needs improved planning and infrastructure in order to eliminate the problem, aspects that require greater financial investment and stronger political commitment.

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. Adult amblyopia reversed by contralateral cataract formation.

    Science.gov (United States)

    Wilson, M E

    1992-01-01

    Two adult patients are presented whose childhood amblyopia improved markedly when the sound eye became cataractous. In each case, the amblyopic eye became the preferred eye for fixation, allowing each patient to temporarily delay cataract surgery. Most remarkably, the acuity improvement has been sustained for greater than 2 years in each patient after full visual rehabilitation of the sound eye by cataract extraction. PMID:1588469

  17. Repercusión de la intervención de cataratas en la capacidad funcional del anciano Impact of cataract surgery upon functional capacity of the elderly

    Directory of Open Access Journals (Sweden)

    J López-Torres Hidalgo

    2004-05-01

    Full Text Available Objetivo: Determinar la repercusión de la cirugía de cataratas en la función visual del anciano y en la autonomía para realizar actividades básicas, analizando la influencia de variables clínicas y sociodemográficas. Método: Estudio observacional longitudinal en el que 185 ancianos intervenidos de cataratas fueron comparados con 179 en lista de espera para cirugía. En todos se realizó una evaluación inicial y otra tras cuatro meses, determinándose la función visual mediante the Activities of Daily Vision Scale (ADVS, dependencia para la realización de actividades básicas (Índice de Katz, estado cognitivo y visión autopercibida. Otras variables fueron agudeza visual, existencia de otras enfermedades oculares y características sociodemográficas. Resultados: Entre los ancianos intervenidos la proporción de independientes para actividades básicas tras 4 meses de la intervención (60,7% fue muy similar a la inicial (62,2%, pero en el grupo control la proporción inicial (63,1% disminuyó significativamente a los 4 meses (48,8% (p=0,0001. Mejoraron su percepción de la visión tras cuatro meses el 75,7% de los intervenidos frente al 15,4% de los no intervenidos (p=0,00001. Tras la intervención, la puntuación media de la ADVS ascendió desde 51,0 D.E. 28,4 hasta 76,0 D.E. 25,4 (pPurpose: To determine the impact of cataract intervention on visual function of the elderly and on autonomy in daily activities, analyzing the influence of clinical and sociodemographic variables. Methods: Observational and longitudinal study. 185 elderly patients having undergone cataract surgery were compared with 179 elderly patients on a surgical waiting list. The first group was evaluated prior to surgery and at 4 months post-intervention. Control group patients were evaluated at the same times, without having received surgery. For all subjects, the state of visual function was determined by the Activities of Daily Vision Scale (ADVS. Degree of dependence in carrying out basic daily activities, cognitive state and self-perception of vision were also measured. Other variables were visual acuity, other ocular diseases and sociodemographic characteristics. Results: Amongst the elderly patients having undergone surgery, the proportion of subjects able to carry out basic activities 4 months post-intervention (60.7% was very similar to the initial pre-intervention figure (62.2%. However, in the control group, the proportion (63.1% diminished significantly at the 4-month mark (48.8% (p=0.0001. Of the intervened subjects, 75.7% demonstrated improved self-perception of vision after 4 months as opposed to 15.4% of the non-intervened patients (p=0.00001. Post-intervention, the mean score on the ADVS rose from 51.0 S.D. 28.4 to 76.0 S.D. 25.4 (p<0.001. In contrast, the control group´s mean score dropped from 54.8 S.D. 24.8 to 46.5 S.D. 27.1 (p<0.001. Conclusions: Cataract surgery in the elderly improves visual function and prevents loss of autonomy, delaying dependency in carrying out basic daily activities.

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

    International Nuclear Information System (INIS)

    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)

  19. Cataract formation following vitreoretinal procedures

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    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 6 months 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 1 month, 3 months, 6 months, 12 months, 24 months, and 36 months postoperatively.Results: A total of 193 eyes of 180 patients 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 24 months. 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

  20. Cataract surgery complications as a cause of visual impairment in a population aged 50 and over Complicações de facectomias como causa de baixa visual em uma população com 50 ou mais anos de idade

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    Denise Fornazari de Oliveira

    2008-10-01

    Full Text Available The purpose of this study was to measure the extent to which complications relating to cataract surgery are a cause of visual impairment in a population aged 50 and over from the city of Campinas, São Paulo State, Brazil. An assessment of cataract surgery services was conducted using random cluster sampling, with the sample composed of 60 clusters of 40 people aged 50 years or older. Of the selected sample of 2,400 subjects, 92.67% were examined. Of these 2,224 examined subjects, 75 (3.37% presented bilateral visual impairment and 164 unilateral, while a total of 314 (7.06% eyes presented visual impairment. 352 eyes had undergone cataract surgery. The causes of visual impairment after surgery were concurrent eye disease (56%, surgical complications (28.8% and refractive errors (15.2%. Cataract surgery complications represented the 5th most important cause of visual impairment. The other main causes were cataract, posterior segment disorders, diabetic retinopathy and glaucoma. These results suggest cataract surgery complications are a major cause of visual impairment in this population. Their prevention and treatment must be part of public health care policies.Objetivou-se avaliar a relevância das complicações de facectomias como causa de baixa acuidade visual na população > 50 anos em Campinas, São Paulo, Brasil. Uma avaliação dos serviços de cirurgia de catarata foi conduzida utilizando amostragem aleatória de agrupamentos populacionais, sendo composta por 60 agrupamentos de 40 pessoas > 50 anos. Na amostra de 2.400 indivíduos, 92,67% foram examinados. Dos 2.224 examinados, 75 (3,37% apresentaram baixa acuidade visual bilateral, 164, unilateral. e um total de 314 (7,06% olhos apresentou baixa acuidade visual. Trezentos e cinqüenta e dois olhos tinham sido submetidos a facectomias. As causas de baixa acuidade visual pós-cirurgia foram doenças oculares concomitantes (56%, complicações cirúrgicas (28,8% e erros refrativos (15,2%. Complicações de cirurgias de catarata foram a quinta causa mais importante de baixa acuidade visual. Outras causas principais foram catarata, doenças oculares do segmento posterior, retinopatia diabética e glaucoma. Estes resultados sugerem que complicações de cirurgias de catarata é uma importante causa de baixa acuidade visual na população em estudo. Sua prevenção e tratamento precisam fazer parte das políticas de saúde pública.

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

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    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

  2. Modificaciones del endotelio corneal en cirugía de catarata secuencial con vitrectomía / Changes of the corneal endothelium in sequential cataract surgery with vitrectomy

    Scientific Electronic Library Online (English)

    Malvys, Vidal Castillo; Zucell Ana, Veitía Rovirosa; Francisco Yunier, Fumero González; Ileana, Vila Dopico; Iván, López Hernández.

    2013-04-01

    Full Text Available Objetivo: determinar el comportamiento del endotelio corneal en pacientes sometidos a cirugías secuenciales de vítreo y catarata. Métodos: estudio observacional descriptivo, prospectivo en una muestra conformada por 15 ojos de 15 pacientes sometidos a cirugías múltiples del vítreo y del cristalino, [...] entre enero y noviembre de 2010. Resultados: la mayoría de los pacientes fueron hombres entre 53 y 67 años. Las causas de indicación quirúrgica de vitrectomía pars plana fueron desprendimiento de retina y hemorragia vítrea. La densidad celular promedio preoperatoria y posoperatoria descendió el 17,2 %. Predominó la ausencia de polimegatismo y sus formas leves en el preoperatorio, con un incremento de formas moderadas y severas en el posoperatorio. El pleomorfismo se comportó de una forma similar al polimegatismo. Las complicaciones posquirúrgicas fueron la hipertensión ocular, el síndrome tóxico de segmento anterior y la uveítis anterior, con 9 casos entre los dos momentos quirúrgicos. Conclusiones: el endotelio corneal sufre modificaciones, tanto anatómicas como funcionales luego de ser sometido a una vitrectomía pars plana, las que se acentúan luego de una segunda cirugía, más aún si esta es en el segmento anterior como la extracción de la catarata por facoemulsificación. Abstract in english Objective: to analyze the corneal endothelium behavior in patients undergoing sequential vitreous and cataract surgery. Methods: a prospective, descriptive and observational study of 15 patients (eyes) with several vitreous and lens surgeries at the "Ramón Pando Ferrer" Cuban Institute of Ophthalmol [...] ogy from January through November 2010. Results: most of the patients were males whose ages ranged 53 to 67 years. The main causes for indicating pars plana vitrectomy were retinal detachment and vitreous hemorrhage. Pre and postoperative cellular density averages in this group showed a cellular loss of 17.2 %. In the preoperative exam, lack of polymegatism in its mildest forms predominated, whereas moderate and severe forms increased in the postoperative phase. Pleomorfism behaved in a similar way. Postsurgical complications found were ocular hypertension,anterior segment toxic syndrome and anterior uveitis, with 9 cases at the two surgical periods. Conclusions: the corneal endothelium suffers both anatomical and functional changes after pars plana vitrectomy, which may be remarkable after a second surgery, even more if this occurs in the anterior segment such as the cataract extraction using phacoemulsification.

  3. Estudio comparativo entre cirugía de catarata por microincisión coaxial y facoemulsificación estándar Comparative study of coaxial microincision cataract surgery and standard phacoemulsification

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    M.J. Capella

    2010-08-01

    Full Text Available Objetivo: Analizar y comparar cuantitativamente los resultados obtenidos tras la cirugía de catarata por microincisión coaxial (CCMIC y la facoemulsificación convencional, valorando el astigmatismo inducido, la densidad de células endoteliales, el espesor corneal y el espesor foveal en el pre- y en el postoperatorio. Método: Estudio prospectivo y aleatorizado, incluyendo 74 ojos de 37 pacientes, con una edad media de 72,97±7,55 años. Todos ellos fueron intervenidos mediante facoemulsificación convencional en un ojo y CCMIC en el ojo contralateral. Las variables estudiadas fueron el astigmatismo refractivo y topográfico, la densidad de células endoteliales, el espesor corneal y el espesor foveal, estableciendo los controles al día siguiente, a la semana, al mes y a los 3 meses de la cirugía. Resultados: Las variaciones entre el pre- y el postoperatorio de las diferentes variables estudiadas no han mostrado diferencias estadísticamente significativas entre ambas modalidades quirúrgicas (p>0,05. Conclusiones: La CCMIC es una técnica efectiva y segura que ofrece una excelente alternativa para la extracción de la catarata, con una disminución en el tamaño de la incisión y resultados postoperatorios comparables con la técnica estándar. Se requieren estudios prospectivos con mayor número de pacientes y seguimiento más largo para establecer si realmente existen diferencias estadísticamente significativas y clínicamente relevantes entre ambas técnicas.Purpose: To analyse and quantitatively compare the outcomes of microincisional cataract surgery (CCMIC with those of conventional phacoemulsification, evaluating the induced astigmatism, endothelial cell count, corneal thickness and foveal thickness in the pre- and postoperative period. Methods: Prospective and randomised study, including 74 eyes of 37 patients with a mean age of 72.97±7.55 years. All of them underwent conventional phacoemulsification in one eye and CCMIC in the other eye. The evaluated parameters were refractive and topographic astigmatism, endothelial cell count, corneal thickness and foveal thickness, which were measured preoperatively and at 1 day, 1 week, 1 month and 3 months after surgery. Results: The variations between pre- and postoperative parameters showed no statistically significant differences between the two surgical procedures (p>0.05. Conclusions: CCMIC is an effective and safe technique that offers an excellent alternative for cataract surgery, with a smaller incision and postoperative outcomes comparable to the standard technique. Prospective studies with more patients and longer follow-ups are needed to establish if there really are statistically significant and clinically relevant differences between both techniques.

  4. Estudio comparativo entre cirugía de catarata por microincisión coaxial y facoemulsificación estándar / Comparative study of coaxial microincision cataract surgery and standard phacoemulsification

    Scientific Electronic Library Online (English)

    M.J., Capella; E., Barraquer.

    2010-08-01

    Full Text Available Objetivo: Analizar y comparar cuantitativamente los resultados obtenidos tras la cirugía de catarata por microincisión coaxial (CCMIC) y la facoemulsificación convencional, valorando el astigmatismo inducido, la densidad de células endoteliales, el espesor corneal y el espesor foveal en el pre- y en [...] el postoperatorio. Método: Estudio prospectivo y aleatorizado, incluyendo 74 ojos de 37 pacientes, con una edad media de 72,97±7,55 años. Todos ellos fueron intervenidos mediante facoemulsificación convencional en un ojo y CCMIC en el ojo contralateral. Las variables estudiadas fueron el astigmatismo refractivo y topográfico, la densidad de células endoteliales, el espesor corneal y el espesor foveal, estableciendo los controles al día siguiente, a la semana, al mes y a los 3 meses de la cirugía. Resultados: Las variaciones entre el pre- y el postoperatorio de las diferentes variables estudiadas no han mostrado diferencias estadísticamente significativas entre ambas modalidades quirúrgicas (p>0,05). Conclusiones: La CCMIC es una técnica efectiva y segura que ofrece una excelente alternativa para la extracción de la catarata, con una disminución en el tamaño de la incisión y resultados postoperatorios comparables con la técnica estándar. Se requieren estudios prospectivos con mayor número de pacientes y seguimiento más largo para establecer si realmente existen diferencias estadísticamente significativas y clínicamente relevantes entre ambas técnicas. Abstract in english Purpose: To analyse and quantitatively compare the outcomes of microincisional cataract surgery (CCMIC) with those of conventional phacoemulsification, evaluating the induced astigmatism, endothelial cell count, corneal thickness and foveal thickness in the pre- and postoperative period. Methods: Pr [...] ospective and randomised study, including 74 eyes of 37 patients with a mean age of 72.97±7.55 years. All of them underwent conventional phacoemulsification in one eye and CCMIC in the other eye. The evaluated parameters were refractive and topographic astigmatism, endothelial cell count, corneal thickness and foveal thickness, which were measured preoperatively and at 1 day, 1 week, 1 month and 3 months after surgery. Results: The variations between pre- and postoperative parameters showed no statistically significant differences between the two surgical procedures (p>0.05). Conclusions: CCMIC is an effective and safe technique that offers an excellent alternative for cataract surgery, with a smaller incision and postoperative outcomes comparable to the standard technique. Prospective studies with more patients and longer follow-ups are needed to establish if there really are statistically significant and clinically relevant differences between both techniques.

  5. Comparação de acuidade visual final: cirurgias de catarata com intercorrências versus sem intercorrências / Comparison of final visual acuity: cataract surgery with intraoperative complications versus non intraoperative complications

    Scientific Electronic Library Online (English)

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

    2015-06-01

    Full Text Available Objetivo Comparar a acuidade visual (AV) final dos pacientes submetidos à cirurgia de catarata com e sem complicações intraoperatórias e possíveis fatores que contribuíram para o resultado ao final do pós-operatório. Métodos Análise dos prontuários de 179 pacientes, retrospectivo, longitudinal, ope [...] rados de fevereiro a julho de 2013 no Instituto Dr. Suel Abujamra, pela técnica de facoemulsificação (FACO), divididos em dois grupos: com e sem complicações intraoperatórias. Os dados obtidos foram analisados pelos métodos teste-t para duas amostras ou Análise de Variância (ANOVA). Os critérios de exclusão foram pacientes com cirurgia ocular prévia, retinopatia diabética proliferativa ou não proliferativa grave, outras retinopatias, escavação do disco óptico igual ou maior que 0,7x0,7 ou uso de mais de dois hipotensores oculares, olho único, catarata secundária à uveíte, traumática ou congênita. Resultados Dos 179 pacientes, 37 (20,7%) tiveram complicações intraoperatórias e 142 (79,3%) não tiveram complicações intraoperatórias. A média 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 complicação e 28,87% sem complicações. Do total, 77,65% atingiram uma AV final 20/40 ou melhor, sendo que nos pacientes com complicação a média para esta AV foi de 59,46% e no grupo sem complicações foi de 82,40%. A principal complicação foi ruptura de cápsula posterior. Conclusão Após toda a análise, verificamos que os fatores que implicaram com significância estatística em menor AV final foram as complicações intraoperatórias 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.

  6. Resultados facodinámicos del chopping inverso en la cirugía de catarata 2009 / Phacodynamic outcomes of the reversed chopping technique in the cataract surgery in 2009

    Scientific Electronic Library Online (English)

    Abel, Plasencia Blanco; Gilberto, Fernández Vázquez; Juan Raúl, Hernández Silva; Carlos Alberto, Perea Ruiz; Ledia, Perea Hevia.

    2011-12-01

    Full Text Available Objetivo: Evaluar los resultados facodinámicos alcanzados con la técnica de cirugía de catarata por facoemulsificación chopping inverso en el Instituto Cubano de Oftalmología “Ramón Pando Ferrer” en 2009. Métodos: Se realizó un estudio descriptivo y prospectivo en 182 pacientes (ojos) con diagnóstic [...] o de catarata presenil y senil, que aceptaron someterse a la técnica quirúrgica. Los resultados facodinámicos de la técnica se evaluaron según las siguientes variables: dureza del cristalino, mejor agudeza visual con y sin corrección, poder de ultrasonido, tiempo de facoemulsificación, tiempo efectivo de facoemulsificación, densidad de células endoteliales y complicaciones. Estos datos se analizaron a través de tablas de contingencia con frecuencias absolutas y relativas, se aplicó la prueba t de Student para su comparación. Resultados: La agudeza visual con corrección obtenida significó cinco líneas en la escala de Snellen. El tiempo de ultrasonido aplicado estuvo dentro de valores normales en relación con la dureza del núcleo. La pérdida de células endoteliales no fue importante. La complicación operatoria no fue significativa. Conclusión: La técnica se consideró efectiva con resultados muy favorables. Es perfectamente aplicable para todos los grados de dureza de la catarata, evitándose con ella un gran número de complicaciones. Esto le permite al paciente una rápida incorporación a su vida social. Abstract in english Objectives: To assess the phacodynamic outcomes of the reversed chopping phacoemulsification technique applied in cataract surgery at “Ramon Pando Ferrer” Cuban Institute of Ophthalmology between January and December, 2009. Methods: A prospective and descriptive study was performed on 182 patients ( [...] eyes) diagnosed with pre-senile and senile cataract, who agreed to be operated on with this procedure. The phacodynamic outcomes were evaluated according to the following variables: lens hardness, best visual acuity with/without glasses, ultrasound power, time of phacoemulsification, effective time of phacoemulsification, endothelial cell density and complications. The results were analyzed through contingency tables with absolute and relative frequencies, in addition to applying Student’s t test for comparison. Results: The visual acuity with glasses increased by five lines in the Snellen chart, the ultrasound time applied was within the normal values and correlated with the hardness of the core. The loss of endothelial cells and the surgical complications were irrelevant. Conclusions: The technique was considered very effective and perfectly applicable for all sorts of cataract hardness. This allows avoiding a large number of complications and rapid recovery of patients to be reinserted into their social life.

  7. Resultados facodinámicos del chopping inverso en la cirugía de catarata 2009 Phacodynamic outcomes of the reversed chopping technique in the cataract surgery in 2009

    Directory of Open Access Journals (Sweden)

    Abel Plasencia Blanco

    2011-12-01

    Full Text Available Objetivo: Evaluar los resultados facodinámicos alcanzados con la técnica de cirugía de catarata por facoemulsificación chopping inverso en el Instituto Cubano de Oftalmología “Ramón Pando Ferrer” en 2009. Métodos: Se realizó un estudio descriptivo y prospectivo en 182 pacientes (ojos con diagnóstico de catarata presenil y senil, que aceptaron someterse a la técnica quirúrgica. Los resultados facodinámicos de la técnica se evaluaron según las siguientes variables: dureza del cristalino, mejor agudeza visual con y sin corrección, poder de ultrasonido, tiempo de facoemulsificación, tiempo efectivo de facoemulsificación, densidad de células endoteliales y complicaciones. Estos datos se analizaron a través de tablas de contingencia con frecuencias absolutas y relativas, se aplicó la prueba t de Student para su comparación. Resultados: La agudeza visual con corrección obtenida significó cinco líneas en la escala de Snellen. El tiempo de ultrasonido aplicado estuvo dentro de valores normales en relación con la dureza del núcleo. La pérdida de células endoteliales no fue importante. La complicación operatoria no fue significativa. Conclusión: La técnica se consideró efectiva con resultados muy favorables. Es perfectamente aplicable para todos los grados de dureza de la catarata, evitándose con ella un gran número de complicaciones. Esto le permite al paciente una rápida incorporación a su vida social.Objectives: To assess the phacodynamic outcomes of the reversed chopping phacoemulsification technique applied in cataract surgery at “Ramon Pando Ferrer” Cuban Institute of Ophthalmology between January and December, 2009. Methods: A prospective and descriptive study was performed on 182 patients (eyes diagnosed with pre-senile and senile cataract, who agreed to be operated on with this procedure. The phacodynamic outcomes were evaluated according to the following variables: lens hardness, best visual acuity with/without glasses, ultrasound power, time of phacoemulsification, effective time of phacoemulsification, endothelial cell density and complications. The results were analyzed through contingency tables with absolute and relative frequencies, in addition to applying Student’s t test for comparison. Results: The visual acuity with glasses increased by five lines in the Snellen chart, the ultrasound time applied was within the normal values and correlated with the hardness of the core. The loss of endothelial cells and the surgical complications were irrelevant. Conclusions: The technique was considered very effective and perfectly applicable for all sorts of cataract hardness. This allows avoiding a large number of complications and rapid recovery of patients to be reinserted into their social life.

  8. Perfil socioeconômico e epidemiológico dos pacientes submetidos à cirurgia de catarata em um hospital universitário Socioeconomic and epidemiologic profile of patients submitted to cataract surgery at a university hospital

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    Beatriz de Abreu Fiuza Gomes

    2008-10-01

    Full Text Available OBJETIVO: Determinar as características sócioeconômicas dos pacientes operados de catarata em hospital universitário, avaliar o acesso à unidade terciária e determinar o tempo de espera até o tratamento cirúrgico. MÉTODOS: Estudo transversal, realizado através da revisão de prontuários 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 prevalência de mulheres (60,1%, da raça branca (48,0%, com baixo grau de instrução (ensino fundamental incompleto, 50,7%, acuidade visual igual ou pior a 20/200 (57,4% e diagnóstico realizado em consulta regular no hospital universitário (47,8%. Apenas 9,4% dos pacientes operados foram diagnosticados na campanha de catarata. O tempo médio entre o diagnóstico e a cirurgia foi 3,5 meses e relacionou-se principalmente à realização dos exames oftalmológicos e clínicos pré-operatórios. CONCLUSÃO: Os pacientes com baixa renda familiar são os principais usuários do Sistema Único de Saúde (SUS e o acesso ao tratamento cirúrgico é demorado, resultando em visão subnormal incapacitante. Ressalta-se a importância 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.

  9. Perfil socioeconômico e epidemiológico dos pacientes submetidos à cirurgia de catarata em um hospital universitário / Socioeconomic and epidemiologic profile of patients submitted to cataract surgery at a university hospital

    Scientific Electronic Library Online (English)

    Beatriz de Abreu Fiuza, Gomes; Ana Luiza, Biancardi; Camila, Fonseca Netto; Fernanda Ferreira Pires, Gaffree; Haroldo Vieira de, Moraes Junior.

    2008-10-01

    Full Text Available OBJETIVO: Determinar as características sócioeconômicas dos pacientes operados de catarata em hospital universitário, avaliar o acesso à unidade terciária e determinar o tempo de espera até o tratamento cirúrgico. MÉTODOS: Estudo transversal, realizado através da revisão de prontuários de 148 pacien [...] tes operados de catarata escolhidos aleatoriamente durante o primeiro semestre de 2007. RESULTADOS: Os pacientes apresentaram idade mediana de 70,5 anos, com maior prevalência de mulheres (60,1%), da raça branca (48,0%), com baixo grau de instrução (ensino fundamental incompleto, 50,7%), acuidade visual igual ou pior a 20/200 (57,4%) e diagnóstico realizado em consulta regular no hospital universitário (47,8%). Apenas 9,4% dos pacientes operados foram diagnosticados na campanha de catarata. O tempo médio entre o diagnóstico e a cirurgia foi 3,5 meses e relacionou-se principalmente à realização dos exames oftalmológicos e clínicos pré-operatórios. CONCLUSÃO: Os pacientes com baixa renda familiar são os principais usuários do Sistema Único de Saúde (SUS) e o acesso ao tratamento cirúrgico é demorado, resultando em visão subnormal incapacitante. Ressalta-se a importância da campanha de catarata no ingresso de pacientes carentes ao hospital de alta complexidade. Abstract in english 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 c [...] harts 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.

  10. Influencia de la cirugía de catarata en la adaptación biopsicosocial del adulto mayor: antídoto universal para la aterosclerosis / Influence of cataract surgery in biopsychosocial adaptation in the elderly

    Scientific Electronic Library Online (English)

    Leonor, Diaz Alfonso; Elvira, Machado Héctor; Bárbara, Suárez Rodríguez; Mariela, Curbelo Gómez.

    2010-10-01

    Full Text Available 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 d [...] el 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. Abstract in english 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 adapta [...] tion 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. Influence of cataract surgery in biopsychosocial adaptation in the elderly Influencia de la cirugía de catarata en la adaptación biopsicosocial del adulto mayor

    Directory of Open Access Journals (Sweden)

    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.

  12. Measuring benefits and patients' satisfaction when glasses are not needed after cataract and presbyopia surgery: scoring and psychometric validation of the Freedom from Glasses Value Scale (FGVS©)

    OpenAIRE

    Arnould Benoit; Meunier Juliette; Berdeaux Gilles; Viala-Danten Muriel

    2010-01-01

    Abstract Background The purpose of this study was to reduce the number of items, create a scoring method and assess the psychometric properties of the Freedom from Glasses Value Scale (FGVS), which measures benefits of freedom from glasses perceived by cataract and presbyopic patients after multifocal intraocular lens (IOL) surgery. Methods The 21-item FGVS, developed simultaneously in French and Spanish, was administered by phone during an observational study to 152 French and 152 Spanish pa...

  13. Neuropatía óptica isquémica anterior no arterítica simulando un edema macular posterior a cirugía de catarata / Nonarteritic anterior ischemic optic neuropathy masquerading as macular edema after cataract surgery

    Scientific Electronic Library Online (English)

    Yoel, Rodríguez Martín; Tamara, Juvier Riesgo; Lester, Pola Alvarado; Eliecer, Pérez García; Adrianne M, Suñet Álvarez; Raúl, Rúa Martínez.

    2013-08-01

    Full Text Available Introducción: la neuropatía óptica isquémica anterior no arterítica y el edema macular son con frecuencia causas de pérdida visual después de una cirugía ocular no complicada. Objetivo: identificar estas dos entidades es muy importante, ya que la conducta a seguir y el pronóstico de ambos es bien di [...] ferente. Caso clínico: se reporta una paciente femenina de 74 años con pérdida visual aguda en el posoperatorio de cirugía de catarata. El Servicio de Retina lo reporta como edema macular que responde a la terapia esteroidea, a pesar de esto la visión no mejora. Al realizar el estudio neuro-oftalmológico se constata atrofia óptica parcial secundaria a una neuropatía óptica isquémica anterior no arterítica. Conclusiones: la asociación de estos eventos es infrecuente, pero en estas circunstancias el edema macular que puede ocurrir en la isquemia del nervio óptico, puede simular el de la respuesta inflamatoria a una cirugía. Abstract in english Introduction: nonarteritic anterior ischemic optic neuropathy and macular edema are frequent causes of loss of vision after uncomplicated ocular surgery. Objective: to identify these two conditions is very important since the behaviors to be adopted and the prognosis are quite different. Clinical ca [...] se: a 74 years-old female patient with acute loss of vision during the postoperative period of a cataract surgery. The Retinal Service classified it as macular edema which had to be treated with steroid therapy, but her vision did not improve. After the corresponding neurophthalmologic study, it is confirmed that there is partial optic atrophy secondary to nonarteritic anterior ischemic optic neuropathy. Conclusions: the association of these events is uncommon; however under these circumstances, the macular edema that may occur in the optic nerve ischemia can masquerade as inflammatory reaction to surgery.

  14. Desperdício de exames complementares na avaliação pré-operatória em cirurgias de catarata / Waste of medical tests in preoperative evaluation for cataract surgery

    Scientific Electronic Library Online (English)

    Carlos Eduardo Leite, Arieta; Maurício Abujamra, Nascimento; Rodrigo Pessoa Cavalcanti, Lira; Newton, Kara-José.

    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 aprese [...] ntasse 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. Abstract in english 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.

  15. 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

    International Nuclear Information System (INIS)

    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(122(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)

  16. Desperdício de exames complementares na avaliação pré-operatória em cirurgias de catarata Waste of medical tests in preoperative evaluation for cataract surgery

    Directory of Open Access Journals (Sweden)

    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.

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

    Scientific Electronic Library Online (English)

    Fernando, Barría von-B; Henriette, Chabouty; René, Moreno; Freddy, Ortiz; Fernando, Barría M.

    2015-04-01

    Full Text Available Introducción: La endoftalmitis post-cirugía de cataratas es una de las complicaciones post-operatorias más temidas y devastadoras, pudiendo ocasionar secuelas graves, con un pronóstico visual incierto. La profilaxis antimicrobiana de esta complicación debe basarse en el conocimiento acabado de la mi [...] crobiota presente en el territorio conjuntival. Objetivo: Establecer bases microbiológicas para una mejor profilaxis antimicrobiana de la endoftalmitis en cirugía de cataratas. Materiales y Métodos: Estudio descriptivo, de corte transversal, prospectivo. A 118 pacientes se les tomó muestra conjuntival pre-operatoria del fondo de saco inferior, sembrándola de inmediato en medios de cultivo. Las colonias desarrolladas se identificaron por métodos manuales y método de microdilución y difusión en disco. Resultados: De 118 cultivos pre-operatorios, 106 (89,8%) desarrollaron colonias bacterianas. Se aislaron 159 bacterias conjuntivales como especie única o cultivo mixta, siendo 95% grampositivas. El género Staphylococcus representó 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 generación. Conclusiones: Considerando nuestros resultados, recomendaríamos a nuestros pacientes tobramicina tópica como antibioprofilaxis, asociada a povidona yodada como antiséptico. Una quinolona de cuarta generación podría usarse cuando existan factores de riesgo de infección. 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.

  18. A millennium review of skull base surgery.

    Science.gov (United States)

    Goodrich, J T

    2000-11-01

    Skull base surgery is a recent development in our history, in as much as most of the surgical techniques involved have been described within the last century. To provide an historical prospective the author reviews the development of this specialty, arbitrarily dating its beginning some five centuries ago with the work of Leonardo da Vinci. By picking this period we include the origin of scientific anatomy and personages interested in developing new ideas and concepts who were able to leave the stagnant period of the Middle Ages behind. In 1900 surgeons worked alone, with the concept of a skull base "team" not yet existing. Endotracheal intubation and controlled respiration was just being introduced. Intraoperative monitoring of blood pressure, pulse rate and respiration was not yet known. Harvey Cushing was to introduce this concept in the first decade of the last century. This survey traces the origins of modern skull base surgery from its antecedents in the Renaissance to the beginning of this century. A paper of this length can only provide a sampling of themes and personalities; nevertheless, it will give the reader an impressive overview of how far we have come and some ideas of what the future holds. PMID:11151716

  19. Resultados analgésicos de anestesia tópica-intracameral en cirugía de catarata senil / Analgesic results of topical- intracamera anesthesia in the surgery of senile cataract

    Scientific Electronic Library Online (English)

    Belmary, Aragonés Cruz; Yanet, Cortina Molina; Sandra Milagros, Borges Pérez; Abel, Pernas González; Evaristo, Febles Piñar.

    2012-08-01

    Full Text Available Introducción: La catarata es la causa más frecuente de ceguera prevenible y su tratamiento es quirúrgico y aunque se perfeccionó la técnica con una incisión más pequeña y sin puntos, algunos pacientes refieren dolor, por tanto al cooperar menos puede haber mayor incidencia de complicaciones peripost [...] operatorias inmediatas en la extracción extracapsular del cristalino. Objetivos: Evaluar los resultados analgésicos de la anestesia tópica-intracameral en la extracción extracapsular de cristalino por técnica tunelizada de mininúcleo con implante de lente intraocular en catarata senil. Material y métodos: Se realizó estudio descriptivo prospectivo de corte longitudinal en una muestra de 333 pacientes con diagnóstico de catarata senil, que se les realizó extracción extracapsular de cristalino por técnica tunelizada de mininúcleo e implante de lente intraocular, bajo anestesia tópica-intracameral, desde marzo del 2009 hasta marzo del 2010. Se determinó la percepción de dolor durante el tratamiento quirúrgico mediante la Escala Análoga Visual. Se describieron las complicaciones intraoperatorias y postoperatorias inmediatas y la satisfacción del cirujano y el paciente durante el acto quirúrgico. La información fue recopilada en una hoja de encuesta y se resumió todos los datos mediante estadística descriptiva. Resultados: La media de la edad fue de 69 años, 213 pacientes (64 %) no tuvo ningún dolor y solo ocurrieron 19 (5.7 %) complicaciones oculares 17 (5.1%) que se asociaron a hipertensión arterial intraoperatoria. Conclusiones: La anestesia tópica-intracameral es una técnica segura para realizar cirugía tunelizada de catarata senil por extracción extracapsular de cristalino. Abstract in english Introduction: The cataract is the more frequent cause of preventable blindness and its treatment is surgical and although the technique was improved using an smaller incision and no sutures, some patients feel pain, thus with less cooperation more incidence of immediate perioperative complications c [...] ould be present in the extracapsular extraction of crystalline lens. Objectives: To assess the analgesic results of the topical-intracamera anesthesia in the crystalline lens extraction by tunnel of mini-nucleus technique with intraocular implant in cases of senile cataract. Material and Methods: A longitudinal, prospective and descriptive study was conducted in 333 patients diagnosed with senile cataract underwent crystalline extracapsular extraction by tunnel of mini-nucleus technique and implant of ocular lens under topical-intra-camera anesthesia from March, 2009 to March, 2010. Authors determined the pain perception during surgical treatment according to Visual Analogue Scale. The immediate intraoperative and postoperative complications were described as well as the satisfaction of the surgeon and the patient during the surgical act. The information was registered in survey sheet grouping all data by descriptive statistics. Results: The mean age was of 69 years, 213 patients (64%) had not pain and only occurred 19 ocular complications (5,7%) 17 (5.1%) that were associated with an intraoperative high blood pressure. Conclusions: The topical-intra-camera anesthesia is a safe technique to carry out the tunnel surgery of senile cataract by extracapsular extraction of crystalline lens.

  20. Preoperative visual acuity among cataract surgery patients and countries' state of development: a global study / Acuité visuelle pré-opératoire des patients subissant une opération de la cataracte et état de développement des pays: une étude mondiale / Agudeza visual preoperatoria en los pacientes sometidos a cirugía de cataratas y estado de desarrollo de los países: un estudio global

    Scientific Electronic Library Online (English)

    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 quirúrgicos preoperatorios en pacientes sometidos a extracción de cataratas y examinar las asociaciones existentes entre la variedad de casos, el nivel de desarrollo del país (de conformidad con la medición del Índice de desarrollo humano [IDH]) y las tasas d [...] e cirugía de catarata (TCC). MÉTODOS: Se invitó a oftalmólogos de 50 países a que se unieran a la recién creada Red Internacional de Investigación Ocular y se les solicitó que completaran un cuestionario basado en web sobre sus hospitales oftalmológicos. Aquellos profesionales que cumplieron lo solicitado recibieron un formulario de recopilación de datos para el registro de datos demográficos y clínicos de 100 pacientes consecutivos que se iban a someter a una cirugía de cataratas. Se clasificó a los países en cinco categorías de IDH y se utilizó una regresión multivariable para evaluar las asociaciones. RESULTADOS: En el año 2008, oftalmólogos de 112 hospitales oftalmológicos (el 54% de ellos no gubernamentales) de 50 países proporcionaron datos sobre 11.048 cirugías de catarata durante 9 meses. Los pacientes cuya agudeza visual (AV) antes de la intervención 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

  1. Phacoemulsification in subluxated cataract.

    Directory of Open Access Journals (Sweden)

    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.

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

    LENUS (Irish Health Repository)

    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.

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

    Science.gov (United States)

    Lalys, F; Riffaud, L; Bouget, D; Jannin, P

    2012-04-01

    The need for a better integration of the new generation of computer-assisted-surgical 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 and hidden Markov models 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

  4. Delayed Descemet's membrane detachment after successful cataract surgery: a case report / Descolamento tardio da membrana de Descemet após cirurgia de catarata sem intercorrências: relato de caso

    Scientific Electronic Library Online (English)

    Aileen, Walsh; Ana Luiza, Biancardi; Armando Stefano, Crema.

    2012-10-01

    Full Text Available O descolamento da membrana de Descemet pode ser uma complicação grave após a cirurgia de catarata, resultando em edema de córnea e redução da acuidade visual. Este relato descreve um caso raro de descolamento da membrana de Descemet seis meses após cirurgia de catarata com facoemulsificação sem inte [...] rcorrências, documentado com tomografia de coerência óptica do segmento anterior (OCT; RTVue, Optovue). Foram realizadas descemetopexia pneumática e sutura corneana, com resolução do descolamento e recuperação visual. Este relato procura alertar os médicos que o edema de córnea tardio pode estar relacionado ao descolamento tardio da membrana de Descemet, que exige tratamento adequado para evitar descompensação corneana permanente. Abstract in english 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 seg [...] ment 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.

  5. Delayed Descemet's membrane detachment after successful cataract surgery: a case report Descolamento tardio da membrana de Descemet após cirurgia de catarata sem intercorrências: relato de caso

    Directory of Open Access Journals (Sweden)

    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.O descolamento da membrana de Descemet pode ser uma complicação grave após a cirurgia de catarata, resultando em edema de córnea e redução da acuidade visual. Este relato descreve um caso raro de descolamento da membrana de Descemet seis meses após cirurgia de catarata com facoemulsificação sem intercorrências, documentado com tomografia de coerência óptica do segmento anterior (OCT; RTVue, Optovue. Foram realizadas descemetopexia pneumática e sutura corneana, com resolução do descolamento e recuperação visual. Este relato procura alertar os médicos que o edema de córnea tardio pode estar relacionado ao descolamento tardio da membrana de Descemet, que exige tratamento adequado para evitar descompensação corneana permanente.

  6. A neutralização do astigmatismo corneano durante a cirurgia da catarata por meio de lente intraocular tórica: resultados The neutralization of corneal astigmatism during cataract surgery using toric intraocular lens: results

    Directory of Open Access Journals (Sweden)

    Virgilio Centurion

    2009-04-01

    Full Text Available OBJETIVO: apresentar os resultados refracionais da utilização de lente intra-ocular tórica na correção do astigmatismo corneano durante a cirurgia da catarata. MÉTODOS: Foram estudados prospectivamente 27 olhos de 18 pacientes portadores de catarata com astigmatismo corneano topográfico maior que 1,0DC e menor que 3,0DC, submetidos à cirurgia de catarata pelo sistema de facoemulsificação no período de julho a dezembro de 2007. RESULTADOS: A acuidade visual não corrigida foi de > 20/40 em 92,59% (25 olhos; a refração pós-operatória foi plana em 66,61% e entre ± 0,50 em 92,60%. CONCLUSÃO: a utilização da LIO tórica se apresenta como uma boa opção para a neutralização do astigmatismo corneano entre 1,0 e 3,0 dioptrias.PURPOSE: To present refraction results using toric intraocular lens for correcting corneal astigmatism during cataract surgery. METHODS: The study comprised 27 eyes of 18 cataract patients with topographic corneal astigmatism higher than 1.0D and lower than 3.0D, submitted to cataract surgery using the phacoemulsification system, during the period of july to december 2007. RESULTS: Non-corrected visual acuity was >20/40 in 92.59% (25 eyes; post-surgical refraction was plana in 66.61% and + 0.50 in 92.60%. CONCLUSION: the use of toric IOL is a good option to neutralize corneal astigmatism between 1.0 and 3.0 diopters.

  7. Cystoid macular edema after cataract surgery in a patient with previous severe iritis following argon laser peripheral iridoplasty

    OpenAIRE

    Bagnis A; Sc, Sacc Amp Agrave; Iester M; Ce, Traverso

    2011-01-01

    Alessandro Bagnis1, Sergio Claudio Saccà2, Michele Iester1, Carlo Enrico Traverso11Centro di Ricerca Clinica e Laboratorio per il Glaucoma e la Cornea, Clinica Oculistica Di NOG, University of Genova, 2Division of Ophthalmology, St. Martino Hospital, Genova, ItalyAbstract: This report describes a patient who had exaggerated responses to different inflammatory stimuli represented by laser and incisional surgery, respectively. These separate episodes should have a common link represe...

  8. Conjunctival bacterial flora and antibiotic resistance pattern in patients undergoing cataract surgery / Flora bacteriana conjuntival e padrão de resistência a antibióticos em pacientes submetidos à cirurgia de catarata

    Scientific Electronic Library Online (English)

    Tiago Eugênio Faria e, Arantes; Ronald Fonseca, Cavalcanti; Maria de Fátima Alves, Diniz; Maiara Santos, Severo; João, Lins Neto; Célia Maria Machado Barbosa de, Castro.

    2006-02-01

    Full Text Available OBJETIVO: Avaliar a flora bacteriana conjuntival e seu padrão de resistência a antibióticos em olhos de pacientes a serem submetidos a cirurgias de catarata. MÉTODOS: Foram avaliados, prospectivamente, os olhos de 50 pacientes a serem submetidos a facectomias na Fundação Altino Ventura, Recife (PE), [...] durante o período de agosto a outubro de 2004. Foi coletado material para cultura da conjuntiva no dia da cirurgia, antes da aplicação de anestésicos, antibióticos ou iodo povidona tópicos. A partir do material coletado foram realizados bacterioscopias e semeio. Em caso de crescimento bacteriano, foram realizadas culturas para isolamento e identificação das bactérias e preparação de antibiogramas. RESULTADOS: Entre os 50 olhos estudados, sete (14,0%) apresentaram culturas negativas e 43 (86,0%) culturas positivas. A bactéria mais freqüentemente isolada foi o Staphylococcus coagulase-negativo, encontrada em 27 olhos (54,0%). Entre os isolados desta bactéria, mais de 90% foram sensíveis a cefalotina, vancomicina, cloranfenicol, ofloxacino e gatifloxacino; 70 a 90% destes microrganismos foram sensíveis a gentamicina, cefotaxima, oxacilina e ciprofloxacino; menos que 70% deles foram sensíveis à neomicina. Encontrou-se quatro (10,5%) isolados de bactérias resistentes a quatro ou mais antibióticos, sendo que dois deles foram de Staphylococcus coagulase-negativo (7,4% dos isolados desta bactéria). CONCLUSÃO: A bactéria mais freqüentemente encontrada na conjuntiva foi o Staphylococcus coagulase-negativo, sendo que estes isolados mostraram alta resistência aos aminoglicosídeos, principalmente à neomicina, com alta suscetibilidade à cefalotina, vancomicina, cloranfenicol, ofloxacino e gatifloxacino. Abstract in english 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. C [...] onjunctival 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.

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

    Scientific Electronic Library Online (English)

    Zucell Ana, Veitia Rovirosa; Alinson C, Gómez Agostopa; Juan Raúl, Hernández Silva; Yaumary, Bauza Fortunato; Iván, López Hernández.

    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. Abstract in english 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Non-invasive ventilation in cardiac surgery: a concise review

    OpenAIRE

    Cabrini, L; Plumari, V P; L. Nobile; Olper, L; Pasin, L; Bocchino, S; Landoni, G; Beretta, L.; Zangrillo, A

    2013-01-01

    Mild to severe respiratory dysfunction is still a common issue after cardiac surgery. Postoperative respiratory complications are associated with prolonged hospitalization and worse survival. In this high-risk surgery, non-invasive ventilation could have relevant positive effects. The present narrative concise review aims to summarize available data on the role of non-invasive ventilation before and after cardiac surgery. Non-invasive ventilation exerts its main effects on the pulmonary and o...

  12. Resultados clínicos de la cirugía combinada de catarata con vitrectomía 23-gauge / Clinical outcomes of cataract surgery combined with 23-gauge vitrectomy

    Scientific Electronic Library Online (English)

    M.C., Morales; J., Araiz; I., Herrera; G., Castiella; I., Corcóstegui; G., Corcóstegui.

    2012-11-01

    Full Text Available Objetivo: Describir los resultados clínicos de la cirugía combinada de catarata (facoemulsificación e implante de lente intraocular) y vitrectomía 23-gauge, y evaluar la eficacia y la seguridad de esta técnica. Métodos: Estudio retrospectivo, consecutivo y no comparativo. Se incluyeron 105 ojos a lo [...] s que se realizó cirugía combinada de catarata (facoemulsificación e implante de lente intraocular en el saco capsular) y vitrectomía 23-gauge por diversas indicaciones. Se midió la mejor agudeza visual corregida (AV logMAR) y la presión intraocular (PIO) previa y posteriormente a la cirugía, y se registraron las complicaciones postoperatorias. Resultados: El periodo de seguimiento posquirúrgico medio fue de 16,6±9,9 meses. La media de la AV logMAR preoperatoria fue 0,83±0,4 y la postoperatoria 0,44 ± 0,38 en la visita final (1 mes), con una mejoría en el 83% de los ojos. La PIO media preoperatoria fue 16,7 ± 3,7 mmHg. En el postoperatorio, la PIO media fue 22,5 ± 12,8 el primer día, 17,5 ± 6,8 tras una semana y 15,3 ± 3,8 mmHg al mes. Las complicaciones postoperatorias incluyeron: opacificación capsular posterior (n=5), edema macular (n=4), desepitelización corneal (n=3), desprendimiento de retina (n=2), vitreorretinopatía proliferativa (n=2), desprendimiento coroideo (n=1), agujero macular (n=1), hemorragia vítrea (n=1) y membrana epirretiniana (n=1). Conclusiones: Los resultados obtenidos en este estudio demuestran que la cirugía combinada de catarata con vitrectomía 23-gauge es una técnica segura y eficaz. Entre otras ventajas ofrece una rápida rehabilitación, una escasa incidencia de complicaciones y evita una nueva intervención. Abstract in english Purpose: To report the clinical outcomes of cataract surgery (phacoemulsification and intraocular lens implantation) combined with 23-gauge vitrectomy, and to evaluate the effectiveness and safety of this technique. Methods: A retrospective, consecutive, non-comparative study which included 105 eyes [...] . Phacoemulsification and intraocular lens implantation (in the capsular sac) combined with 23-gauge vitrectomy were performed. Indications for undergoing surgery were varied. Best corrected logMAR visual acuity (VA) and intraocular pressure (IOP) were measured pre- and postoperatively, and postoperative complications were recorded. Results: Patients were followed-up for a mean of 16.6 ± 9.9 months. The mean preoperative VA was 0.83±0.40 logMAR, and mean postoperative VA one month after surgery was 0.44 ± 0.38 logMAR. The postoperative visual acuity improved in 83.8% of cases. The mean preoperative IOP was 16.6 ± 3.7mmHg, while the mean postoperative IOP was 22.5 ± 12.8 mmHg (1 day after surgery), 17.5 ± 6.8 mmHg (after 1 week), and 15.3 ± 3.8 mmHg (after 1 month). Postoperative complications included posterior capsular opacification (n=5), macular edema (n=4), corneal de-epithelization (n=3), retinal detachment (n=2), proliferative vitreoretinopathy (n=2), choroidal detachment (n=1), macular hole (n=1), vitreous hemorrhage (n=1), epiretinal membrane (n=1), and transient elevated intraocular pressure (n=36). Conclusions: The surgery reported in this study involving phacoemulsification combined with 23-gauge vitrectomy was found to be safe and effective, and was associated with improved clinical features, including rapid rehabilitation, a low incidence of complications, and avoids repeat surgery.

  13. Incisões relaxantes limbares durante a cirurgia de catarata: resultados após seguimento de um ano / Limbal relaxing incisions during cataract surgery: one-year follow-up

    Scientific Electronic Library Online (English)

    João Carlos, Arraes; Fernando, Cunha; Tatiana Azevedo, Arraes; Ronald, Cavalvanti; Marcelo, Ventura.

    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 cirurg [...] ia 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. Abstract in english 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 phacoemulsi [...] fication 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.

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

    Scientific Electronic Library Online (English)

    Abrahão da Rocha, Lucena; David da Rocha, Lucena; Emília Lucena, Macedo; Juliana de Lucena Martins, Ferreira; Aristóteles Rolim de, 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. Abstract in english 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.

  15. Incisões relaxantes limbares durante a cirurgia de catarata: resultados após seguimento de um ano Limbal relaxing incisions during cataract surgery: one-year follow-up

    Directory of Open Access Journals (Sweden)

    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.

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

    Scientific Electronic Library Online (English)

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

    2015-04-01

    Full Text Available O edema macular cistoide é uma das principais causas de baixa de visão após cirurgia de catarata. O processo inflamatório parece ser o principal fator causal do edema. São considerados fatores de risco complicações cirúrgicas, doenças retinianas prévias, diabetes, uveítes e uso de colírios de prosta [...] glandinas. O diagnóstico é feito clinicamente, mas a angiografia fluoresceínica e a tomografia de coerência óptica também são ferramentas importantes para detectar o edema e auxiliar no diagnóstico diferencial. Apesar da profilaxia pré-operatória não ter evidência científica, ela é preconizada especialmente nos casos com fatores de risco. O tratamento inicial é realizado com associação de corticoide e anti-inflamatório não hormonais tópicos. Os casos crônicos e refratários têm diversas alternativas de tratamento, sendo o uso de triancinolona e antiangiogênicos intravítreos as mais utilizadas. Este artigo se propõe a discutir diversos aspectos do edema macular cistoide pseudofácico. 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.

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

    Scientific Electronic Library Online (English)

    Enyr Saran, Arcieri; Camila Naves, Mendonça; Daniela Borges, Barra; Ticiana, Corrêa; Rafael Saran, Arcieri.

    2008-10-01

    Full Text Available OBJETIVO: Avaliar prospectivamente com o uso da tomografia de coerência óptica se o uso tópico de latanoprosta induz alterações retinianas em pacientes submetidos à cirurgia de catarata. MÉTODOS: Estudo clínico randomizado, com observador mascarado e um mês de duração. Pacientes pseudofácicos foram [...] tratados com latanoprosta (n=10) ou lubrificante ocular uma vez ao dia (grupo controle - placebo) (n=10). Metade dos pacientes de cada grupo possuía capsulotomia posterior (Nd:YAG laser). Avaliamos o status da barreira hemato-retiniana pela medida da espessura retiniana na fóvea com a tomografia de coerência óptica. Exames de tomografia de coerência óptica e medida da acuidade visual foram realizados antes do início do estudo e com 15 e 30 dias de tratamento. RESULTADOS: Não foi observada alteração significante na média da espessura foveal do grupo controle (p>0,0610). Houve aumento significante na média da espessura foveal nos pacientes tratados com latanoprosta (p Abstract in english PURPOSE: 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 lubrican [...] t 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

  18. Cataract research using electronic health records

    Directory of Open Access Journals (Sweden)

    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.

  19. Historical review of the thyroid gland surgery

    Directory of Open Access Journals (Sweden)

    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 today’s 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.

  20. Resultados de la cirugía de catarata por técnica de Blumenthal en el Hospital de Ojos “José Martí” Uruguay 2009 / Results of cataract surgery by using Blumenthal tchnique at "José Martí" Eye Hospital Uruguay 2009

    Scientific Electronic Library Online (English)

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

    2011-12-01

    Full Text Available Objetivo: Determinar el comportamiento de la cirugía de catarata por técnica de Blumenthal en el Hospital de Ojos “José Martí”, Uruguay, 2009. Métodos: Se realizó un estudio descriptivo longitudinal y retrospectivo. El universo estuvo constituido por 7 800 pacientes sometidos a la cirugía de catarat [...] a en el periodo estudiado. La muestra se conformó por 780 pacientes seleccionados mediante un muestreo probabilístico sistemático. Resultados: El 54,4 % de los pacientes operados de catarata presentó una edad mayor a los 75 años, 71,5 % perteneció al sexo femenino. Prevaleció la catarata senil (94,6 %) y el glaucoma fue el antecedente ocular más frecuente encontrado en el 10,4 % de los casos. El resultado visual fue favorable al comparar antes de la cirugía y después: la agudeza visual (0,12 a 0,66 como promedio), la esfera refractiva (-2,2 a -0,93) y el astigmatismo inducido (0,41 dioptrías). Las complicaciones transoperatorias estuvieron presentes en el 3,6 % de los pacientes y el edema corneal transitorio fue la complicación posoperatoria más encontrada (8,8 %), seguido de la opacidad de cápsula posterior (4,7 %). Conclusión: Se constató una mejoría en los resultados visuales y refractivos con un bajo número de complicaciones transoperatorias y posoperatorias. Por esto podemos concluir que la técnica de Blumenthal es una opción quirúrgica segura. Abstract in english Objective: To determine behavior of cataract surgery using the Blumenthal technique in “José Martí” Eye Hospital in Uruguay. 2009 Methods: A longitudinal descriptive study was retrospectively carried out. The universe of study was 7800 patients operated on from cataract during the study period and 7 [...] 80 of them were the sample selected by systematic probability sampling. Results: Among the surgical patients, 54.4% were over 75 years old and the 71.5% were females. Senile cataract (94.6%) prevailed and glaucoma was the most frequent ocular antecedent (10.4%). Visual recovery was favorable when comparing results before and after surgery: visual acuity (0.12 to 0.66), refractive sphere (-2.2 to 0.93) and induced astigmatism (0,41D). Transoperative complications were present in 3.6% of patients. Few postoperative complications were encountered, being the most frequent transient corneal edema (8,8%) followed by posterior capsular opacification (4.7%). Conclusions: Visual acuity also improves after surgery with a little number of transoperative and postoperative complications. Cataract surgery performed by Blumenthal technique has proven to be effective and safe.

  1. Cirurgia de catarata: características e opiniões de pacientes com visão mono versus binocular / Cataract surgery: characteristics and opinions of patients with monocular versus binocular vision

    Scientific Electronic Library Online (English)

    Roberta Ferrari, Marback; Edméa Rita, Temporini; Newton, Kara Júnior.

    2010-10-01

    Full Text Available OBJETIVO: Verificar em dois grupos de pacientes com visão monocular (grupo 1) e com visão binocular (grupo 2), a serem submetidos à cirurgia de catarata num hospital universitário, opiniões em relação ao problema ocular, à qualidade da visão e à cirurgia de catarata. MÉTODOS: Foi realizado estudo tr [...] ansversal e comparativo, de forma consecutiva, por meio de questionário estruturado, aplicado por entrevista a pacientes, elaborado a partir de estudo exploratório e medidas acuidade visual e causa da perda visual. RESULTADOS: A amostra foi constituída por 96 indivíduos do grupo 1 (50,0% homens; 50,0% mulheres, com idade entre 41 e 91 anos, média 69,3 anos ± 10,4 anos) e 110, do grupo 2 (40,9% homens; 59,1% mulheres, com idade entre 40 e 89 anos, média 68,2 anos ± 10,2 anos). A maioria dos indivíduos de ambos os grupos apresentava baixa escolaridade. Não houve diferença estatisticamente significante entre os grupos em relação ao sexo (p=0,191), à idade (p=0,702) e à escolaridade (p=0,245). Não exerciam atividade laboral 95,8% dos indivíduos do grupo 1 e 83,6%, do grupo 2 (p=0,005) e 30,4% do grupo 1 mencionaram não ter possibilidade de trabalhar por causa da deficiência visual. Observou-se acuidade visual do olho a ser operado menor que 0,05 em 40,6% (grupo 1) e 33,6% (grupo 2), entre 0,25 e 0,05. Quase a totalidade dos indivíduos de ambos os grupos afirmou ter dificuldade para realização das atividades de vida diária e qualificou como insuficiente a respectiva acuidade visual; 71,9% dos entrevistados do grupo 1 e 71,6%, do grupo 2 mencionaram saber a causa da visão fraca; desses, 87,1% do grupo 1 e 83,3% do grupo 2 referiram a catarata como causa da baixa acuidade visual. CONCLUSÃO: Os indivíduos de ambos os grupos tiveram acesso à cirurgia de catarata com acuidade visual menor do que a idealmente indicada; os pacientes com visão monocular apresentaram acuidade visual significativamente menor em relação aos com visão binocular; a maioria dos entrevistados de ambos os grupos referiu dificuldades para realizar atividades cotidianas como consequência da baixa visão; muitos indivíduos de ambos os grupos desconheciam a causa da dificuldade visual ou a atribuíram a outra causa que não a catarata. Abstract in english PURPOSE: To verify in two groups of patients: monocular (group 1) and binocular vision (group 2) to be submitted to cataract surgery at an University Hospital, opinions, expectances and emotional reactions related to the ocular problem, to the quality of vision and to cataract surgery. METHODS: A tr [...] ansversal comparative and consecutive study was performed using a structured questionnaire applied by patients interview. The questionnaire was elaborated from a previous exploratory study; visual acuity and cause of the visual loss were evaluated. RESULTS: The sample was constituted by 96 persons of group 1 (50.0% male; 50.0% female, ages ranging from 41 to 91 years; average 69.3 years ± 10.4 years) and 110 persons of group 2 (40.9% male; 59.1% female, ages ranging from 40 to 89 years; average 68.2 years ± 10.2 years). The majority of persons of both groups presented low educational level. There was no statistically significant difference between the groups in relation to gender (p=0.191), age (p=0.702) and educational level (p=0.245). No work activity was mentioned in 95.8% of the persons of group 1 and 83.6% of group 2 (p=0.005) and 30.4% of group 1 informed the impossibility to work due the visual impairment. Visual acuity of the eye to be operated was less than 0.05 in 40.6% (group 1) and in 33,6% (group 2), presented visual acuity ranging from 0.05 to 0.25. Almost the totality of the persons of both groups informed difficulties to perform activities of daily life and qualified as insufficient their visual acuities; 71.9% of the patients of group 1 and 71.6% of group 2 informed to know the reason of low vision; among these, 87.1% of group 1 and 83.3% of group 2 mentioned cataract as the reason of low visual acuity. CONCLUSION: It was concl

  2. Principles and paradigms of pediatric cataract management

    OpenAIRE

    Basti Surendra; Greenwald Mark

    1995-01-01

    Propensity for increased postoperative inflammation and capsular opacification, a refractive state that is constantly in a state of flux due to growth of the eye, difficulty in documenting anatomic and refractive changes due to poor compliance, and a tendency to develop amblyopia, makes management of cataract in the child different from that in the adult. The recent past has unraveled several caveats of pediatric cataract management - the importance of atraumatic surgery and complete removal ...

  3. Cataract Extraction in High Myopic Eyes

    OpenAIRE

    Wan-Chen Ku; Lan-Hsin Chuang; Chi-Chun Lai

    2002-01-01

    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, extracapsular...

  4. Dificuldades de acesso ao tratamento de pacientes com indicação de cirurgia de catarata nos Sistemas de Saúde Público e Privado / Difficulties in access to treatment for patients undergoing cataract surgery in public and private health systems

    Scientific Electronic Library Online (English)

    Newton, Kara-Júnior; Roberto, Dellapi Jr; Rodrigo França de, Espíndola.

    2011-10-01

    Full Text Available OBJETIVO: Estimar o valor dos Projetos Catarata para a comunidade, identificando características e dificuldades de acesso ao diagnóstico e ao tratamento da catarata na rotina de atendimento de diversos Sistemas de Saúde. MÉTODOS: Durante uma campanha de catarata realizada em um hospital universitári [...] o foi aplicado um questionário de múltipla escolha somente aos pacientes selecionados para a cirurgia de catarata. Foram avaliadas, dentre outras, as seguintes variáveis: acesso prévio à consulta oftalmológica (serviço público ou privado); motivo(s) para a não realização da cirurgia no serviço inicial. RESULTADOS: Foram avaliados 627 pacientes com diagnóstico de catarata. A maioria 595 (95%) já havia consultado um oftalmologista previamente, sendo que em 63% das situações (375 pacientes) a consulta havia sido realizada há menos de um ano. A última avaliação oftalmológica foi realizada pelo Sistema Único de Saúde (SUS) em 52% dos casos (307 pacientes), e entre estes, a fila de espera foi apontada pela maioria como sendo a causa da não realização da cirurgia. Com relação aos pacientes previamente atendidos em serviços privados, o motivo da não realização da cirurgia foi o custo da cirurgia e custo da lente intraocular. CONCLUSÃO: Os resultados deste estudo sugerem que a rotina de atendimento oftalmológico no SUS em São Paulo não está preparada para atender a demanda por cirurgias de catarata, e o sistema de saúde privado ainda exclui uma parcela da população que possuí acesso à consulta clínica da cirurgia de catarata. É importante a continuidade da realização de campanhas comunitárias para atender a população que não teria como acessar a cirurgia pelas vias convencionais. Abstract in english PURPOSE: To identify the difficulties in access to diagnosis and treatment of cataract in patients attended during a cataract campaign. METHODS: A questionnaire was administered to patients selected for cataract surgery. We evaluated, among others, the following variables: prior access to ophthalmol [...] ogists (public or private), reason(s) for not having surgery early in the initial service, the average cost charged by cataract surgery and intraocular lens (IOL) (private services and agreements). RESULTS: A total of 627 patients was evaluated. Most of them - 595 (95%) had previously attended an ophthalmologist, and in 63% of cases (375 patients) the consultation had been held for less than a year. The last evaluation was performed by the Brazilian Public Health System (SUS) in 52% of the cases (307 patients). Regarding the reason for not having surgery in the initial service, the high cost of the surgery (R$ 2.000 - R$ 4.000) and the cost of IOLs (R$ 1.000 - R$ 1.500) was the main obstacle for most attended services and private covenants. CONCLUSION: The results of this study suggest that the routine of ophthalmologic care in SUS at São Paulo is not prepared to answer the demand for cataract surgeries and private healthcare system still excludes a portion of the population. It is important to continue the implementation of community campaigns to serve the population that would be unable to access the surgery through conventional ways.

  5. Dexmedetomidine sedation in painful posterior segment surgery

    OpenAIRE

    Mansour A; Taha S

    2012-01-01

    Ahmad Mansour,1,2 Samar Taha31Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Rafik Hariri University Hospital, Beirut, Lebanon; 3Department of Anesthesiology, American University of Beirut, Beirut, LebanonPurpose: To present a case series on the use of dexmedetomidine (Precedex) sedation in painful posterior segment surgery performed under topical anesthesia, similar to its use in cataract surgery.Methods: A prospective review of cases that had posterior segment...

  6. Regional anesthesia for laparoscopic surgery: a narrative review.

    Science.gov (United States)

    Vretzakis, George; Bareka, Metaxia; Aretha, Diamanto; Karanikolas, Menelaos

    2014-06-01

    Laparoscopic surgery has advanced remarkably in recent years, resulting in reduced morbidity and shorter hospital stay compared with open surgery. Despite challenges from the expanding array of laparoscopic procedures performed with the use of pneumoperitoneum on increasingly sick patients, anesthesia has remained largely unchanged. At present, most laparoscopic operations are usually performed under general anesthesia, except for patients deemed "too sick" for general anesthesia. Recently, however, several large, retrospective studies questioned the widely held belief that general anesthesia is the best anesthetic method for laparoscopic surgery and suggested that regional anesthesia could also be a reasonable choice in certain settings. This narrative review is an attempt to critically summarize current evidence on regional anesthesia for laparoscopic surgery. Because most available data come from large, retrospective studies, large, rigorous, prospective clinical trials comparing regional vs. general anesthesia are needed to evaluate the true value of regional anesthesia in laparoscopic surgery. PMID:24197290

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

    DEFF Research Database (Denmark)

    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 six of the studies included

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

    Directory of Open Access Journals (Sweden)

    Enyr Saran Arcieri

    2008-10-01

    Full Text Available OBJETIVO: Avaliar prospectivamente com o uso da tomografia de coerência óptica se o uso tópico de latanoprosta induz alterações retinianas em pacientes submetidos à cirurgia de catarata. MÉTODOS: Estudo clínico randomizado, com observador mascarado e um mês de duração. Pacientes pseudofácicos foram tratados com latanoprosta (n=10 ou lubrificante ocular uma vez ao dia (grupo controle - placebo (n=10. Metade dos pacientes de cada grupo possuía capsulotomia posterior (Nd:YAG laser. Avaliamos o status da barreira hemato-retiniana pela medida da espessura retiniana na fóvea com a tomografia de coerência óptica. Exames de tomografia de coerência óptica e medida da acuidade visual foram realizados antes do início do estudo e com 15 e 30 dias de tratamento. RESULTADOS: Não foi observada alteração significante na média da espessura foveal do grupo controle (p>0,0610. Houve aumento significante na média 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.

  9. Revisión sistemática de estudios poblacionales de prevalencia de catarata Systematic review of population-based studies of the prevalence of cataracts

    Directory of Open Access Journals (Sweden)

    R. Acosta

    2006-09-01

    Full Text Available Objetivo: El envejecimiento de la población ha provocado un aumento de la prevalencia de cataratas afectando a una amplia y creciente proporción de la población. El objetivo del presente estudio es describir la prevalencia de catarata a partir de estudios poblacionales mediante una revisión bibliográfica sistemática y exhaustiva. Métodos: Se realizó una búsqueda sistemática de estudios poblacionales de prevalencia e incidencia de cataratas, realizados en población sana no institucionalizada, mayor de 40 años, de raza blanca, con una muestra superior a 1.000 individuos y cuyo año de publicación estuviera entre 1980 y 2002. Resultados: Diez estudios cumplieron con los criterios de inclusión (3 europeos, 5 de Estados Unidos y 2 australianos, realizados entre 1984 y 2001. La prevalencia de catarata según opacificación del cristalino en los estudios que la describen estaba entre el 15 y 19%. Cuando se define catarata como opacificación y nivel de agudeza visual conjuntamente los estudios describen prevalencias entre el 15 y 30%. La prevalencia aumenta con la edad, alcanzando entre un 40% y más del 60% de la población a partir de los 70/75 años. Las mujeres tienen una prevalencia mayor que los hombres, con un aumento más pronunciado en edades más avanzadas. Conclusiones: No existe una forma estandarizada de medir la prevalencia de catarata, lo que dificulta la comparación entre los estudios. La prevalencia de catarata fue mayor en los grupos de mayor edad y entre las mujeres, en especial en edades mayores. La creciente prevalencia asociada a la edad muestra el aumento de la carga poblacional de las cataratas asociada al envejecimiento de la población.Objective: The prevalence of cataracts has increased due to the progressive ageing of the population and the fact that cataracts affect a wide and increasing proportion of the population. The goal of the present study was to describe the prevalence of cataracts through a systematic and exhaustive review of population-based studies. Methods: A systematic review of population-based studies of the prevalence and incidence of cataracts was performed. Inclusion criteria were: a healthy non- institutionalised population, older than 40 years of age, of white race, with a sample size of greater than 1,000 and published between 1980 and 2002. Results: Ten studies met the inclusion criteria (3 European, 5 from the United States and 2 from Australia, and were performed between 1984 and 2001. The cataract prevalence, according to lens opacity criteria, ranged between 15% and 19%. When the cataract was defined as a lens opacity combined with a decreased visual acuity, the prevalence ranged from 15% to 30%. The overall prevalence increased with age, reaching 40% and more than 60% in populations older than 70 and 75 years respectively. The prevalence among women was higher than that among men, with a more marked increase being evident at older ages than for men. Conclusions: There were variations among the criteria used to measure the prevalence of cataract, which made it difficult to compare all the studies. Overall the prevalence was higher in the older population, especially among women. The increasing prevalence associated with age predicts an increasing burden of cataract to health services, this being particularly related to the ageing of the population.

  10. Meta-analysis of clinical randomized controlled trials comparing ReZOOM with ReSTOR multifocal intraocular lenses in cataract surgery

    Directory of Open Access Journals (Sweden)

    De-Wang Shao

    2014-06-01

    Full Text Available AIM: To systematic review the effectiveness of refractive multifocal intraocular lens(MIOLReZOOM vs diffractive MIOL ReSTOR in the treatment of cataract.METHODS: Randomized controlled trials comparing refractive MIOL ReZOOM with diffractive MIOL ReSTOR were identified by searching CENTRAL, MEDLINE, EMbase, WANFANG MED ONLINE, CMJD, SinoMed, and CNKI. Related journals also were hand-searched. Methodological quality of randomized controlled trials(RCTswas evaluated by simple evaluate method that recommended by the Cochrane Collaboration. Data extracted by two reviewers with designed extraction form. RevMan software(release 5.2was used for data management and analysis.RESULTS:A total of 7 trials(846 eyeswere included for systematic review. Subgroup analyses were used according to different model comparison of ReSTOR MIOL. The results showed a significant difference in the mean of the best distance corrected intermediate visual acuity(BDCIVAin the ReZOOM MIOL group with WMD= -0.11, 95% CI(-0.16, -0.06(PCI(0.05, 0.14(PCI(1.76, 3.91(PCI(1.15, 1.60(P=0.0004and WMD= 1.29, 95% CI(1.09, 1.53(P=0.003. There was no significant difference between the two groups in the mean of the uncorrected distance visual acuity(UCDVA, the uncorrected intermediate visual acuity(UCIVA, the best corrected distance visual acuity(BCDVAand the best distance corrected near visual acuity(BDCNVAwith WMD -0.03, 95% CI(-0.06, 0.01(P=0.15, WMD= -0.04, 95% CI(-0.09, 0.01(P=0.10, WMD= -0.01, 95%CI(-0.04, 0.02(P=0.55and WMD= 0.06, 95% CI(-0.06, 0.17(P=0.32. CONCLUSION: Patients implanted with ReZOOM MIOL can provide better BDCIVA; patients implanted with ReSTOR MIOL show better UCNVA, are less likely to appear light halo, glare and other visual adverse reactions; correction in spectacles cases, patients implanted with ReZOOM or ReSTOR MIOL have considerable performances in the far and near visual acuity.

  11. Alterações da microbiota conjuntival e palpebral após uso tópico de lomefloxacina e tobramicina na cirurgia de catarata e cirurgia refrativa Changes in conjunctival and lid flora after topical use of lomefloxacin and tobramycin in cataract and refractive surgery

    Directory of Open Access Journals (Sweden)

    Ana Luisa Höfling - Lima

    2002-01-01

    Full Text Available Objetivo: Avaliar as alterações da microbiota conjuntival e palpebral após o uso tópico de colírios de lomefloxacina ou tobramicina a 0,3% no preparo de pacientes a serem submetidos à cirurgia de catarata e cirurgia refrativa e avaliar a sensibilidade das bactérias isoladas da conjuntiva e pálpebra a estes antibióticos. Métodos: Realizou-se um estudo prospectivo de análise da microbiota conjuntival e palpebral de pacientes submetidos à cirurgia de catarata e cirurgia refrativa (PRK ou LASIK. O estudo da microbiota conjuntival e palpebral foi realizado antes das cirurgias, sem uso de agentes para profilaxia, no período pós-operatório durante o uso de profilaxia, e após a suspensão dos antibióticos. Resultados: O uso tópico de tobramicina e lomefloxacina reduziu o número de colheitas positivas na conjuntiva e pálpebra nos indivíduos submetidos à cirurgia de catarata e cirurgia refrativa. Em ambos os grupos de pacientes ocorreu maior resistência dos microrganismos à tobramicina. No grupo submetido à cirurgia de catarata, pacientes tratados profilaticamente com tobramicina tiveram uma recuperação da microbiota mais lenta após a suspensão do antibiótico do que com a lomefloxacina, ocorrendo o oposto no grupo submetido à cirurgia refrativa. Conclusão: Tanto a lomefloxacina quanto a tobramicina foram eficazes em diminuir o número de culturas positivas da conjuntiva e da pálpebra enquanto estavam sendo administrados, sendo esta diminuição mais acentuada na conjuntiva. Houve maior resistência à tobramicina na maioria das colheitas realizadas. A lomefloxacina apresentou número menor de bactérias resistentes do que a tobramicina durante o uso da antibioticoterapia tópica profilática. O uso de antibiótico reduziu o número de amostras positivas.Purpose: To determine the changes in the conjunctival and palpebral flora after topical use of 0.3% lomefloxacin and 0.3% tobramycin eye drops in the preoperative management of patients submitted to cataract and refractive surgery and to assess the chemosensitivity of bacterial isolates from the conjunctiva and eyelid to these antibiotics. Methods: A prospective study of the conjunctival and palpebral flora of patients submitted to cataract or to refractive (PRK or LASIK surgery was performed. An analysis of the conjunctival and palpebral flora was carried out in patients before surgery without prophylaxis, after surgery during the use of prophylaxis (0.3% lomefloxacin or 0.3% tobramycin qid and after discontinuation of the antibiotic. Results: Tobramycin and lomefloxacin reduced the number of positive cultures in specimens from the conjunctiva and eyelid of individuals submitted to cataract and refractive surgery. In both groups, isolated microorganisms displayed a greater resistance to tobramycin. In the group submitted to cataract surgery, patients treated with prophylactic tobramycin showed a slower recovery of the flora after discontinuation of the antibiotic than those treated with lomefloxacin, with the opposite occurring in the group submitted to refractive surgery. Conclusion: Both lomefloxacin and tobramycin were effective in reducing conjunctival and palpebral flora during drug administration. This reduction was more marked in the conjunctiva. Among the various bacterial isolates, there was a greater resistance to tobramycin than to lomefloxacin. The use of antibiotics reduced the incidence of positive cultures more for the conjunctiva than the eyelids.

  12. 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

    Directory of Open Access Journals (Sweden)

    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.

  13. Preoperative automatic visual behavioural analysis as a tool for intraocular lens choice in cataract surgery / Análise comportamental visual automática pré-operatória como ferramenta para escolha de lente intraocular em cirurgia de catarata

    Scientific Electronic Library Online (English)

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

    2015-04-01

    Full Text Available Objetivo: A catarata é a principal causa de cegueira e acomete 18 milhões de pessoas no mundo, com maior incidência na população acima de 50 anos. A baixa acuidade visual causada pela catarata gera um impacto negativo na qualidade de vida de pacientes. O tratamento atual é feito por meio de cirurgi [...] a com a substituição 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 satisfação 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 propôs a avaliação de uma ferramenta adicional à anamnese na a escolha da lente intraocular. Método: Com o uso de uma câmera programada para realizar o registro automático de fotos, foi documentanda a rotina visual do paciente, a fim de se obterem maiores informações sobre a frequência com que o mesmo utiliza a visão para longe, meia distância ou para perto. Resultados: Os resultados indicaram uma estimativa em porcentagem dessa frequência, sugerindo que a análise dos registros fotográficos 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 estratégia de reabilitação visual após a cirurgia de catarata e, inclusive, despertar o interesse pela confecção 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 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.

  14. Revisión sistemática de estudios poblacionales de prevalencia de catarata / Systematic review of population-based studies of the prevalence of cataracts

    Scientific Electronic Library Online (English)

    R., Acosta; L., Hoffmeister; R., Román; M., Comas; M., Castilla; X., Castells.

    2006-09-01

    Full Text Available Objetivo: El envejecimiento de la población ha provocado un aumento de la prevalencia de cataratas afectando a una amplia y creciente proporción de la población. El objetivo del presente estudio es describir la prevalencia de catarata a partir de estudios poblacionales mediante una revisión bibliogr [...] áfica sistemática y exhaustiva. Métodos: Se realizó una búsqueda sistemática de estudios poblacionales de prevalencia e incidencia de cataratas, realizados en población sana no institucionalizada, mayor de 40 años, de raza blanca, con una muestra superior a 1.000 individuos y cuyo año de publicación estuviera entre 1980 y 2002. Resultados: Diez estudios cumplieron con los criterios de inclusión (3 europeos, 5 de Estados Unidos y 2 australianos), realizados entre 1984 y 2001. La prevalencia de catarata según opacificación del cristalino en los estudios que la describen estaba entre el 15 y 19%. Cuando se define catarata como opacificación y nivel de agudeza visual conjuntamente los estudios describen prevalencias entre el 15 y 30%. La prevalencia aumenta con la edad, alcanzando entre un 40% y más del 60% de la población a partir de los 70/75 años. Las mujeres tienen una prevalencia mayor que los hombres, con un aumento más pronunciado en edades más avanzadas. Conclusiones: No existe una forma estandarizada de medir la prevalencia de catarata, lo que dificulta la comparación entre los estudios. La prevalencia de catarata fue mayor en los grupos de mayor edad y entre las mujeres, en especial en edades mayores. La creciente prevalencia asociada a la edad muestra el aumento de la carga poblacional de las cataratas asociada al envejecimiento de la población. Abstract in english Objective: The prevalence of cataracts has increased due to the progressive ageing of the population and the fact that cataracts affect a wide and increasing proportion of the population. The goal of the present study was to describe the prevalence of cataracts through a systematic and exhaustive re [...] view of population-based studies. Methods: A systematic review of population-based studies of the prevalence and incidence of cataracts was performed. Inclusion criteria were: a healthy non- institutionalised population, older than 40 years of age, of white race, with a sample size of greater than 1,000 and published between 1980 and 2002. Results: Ten studies met the inclusion criteria (3 European, 5 from the United States and 2 from Australia), and were performed between 1984 and 2001. The cataract prevalence, according to lens opacity criteria, ranged between 15% and 19%. When the cataract was defined as a lens opacity combined with a decreased visual acuity, the prevalence ranged from 15% to 30%. The overall prevalence increased with age, reaching 40% and more than 60% in populations older than 70 and 75 years respectively. The prevalence among women was higher than that among men, with a more marked increase being evident at older ages than for men. Conclusions: There were variations among the criteria used to measure the prevalence of cataract, which made it difficult to compare all the studies. Overall the prevalence was higher in the older population, especially among women. The increasing prevalence associated with age predicts an increasing burden of cataract to health services, this being particularly related to the ageing of the population.

  15. Valoración de técnicas intraoperatorias para la prevención de la opacificación del eje visual en la cirugía de cataratas congénitas Assessment of intra-operative techniques to prevent visual axis opacification in congenital cataract surgery

    Directory of Open Access Journals (Sweden)

    R. Borghol-Kassar

    2012-10-01

    Full Text Available Objetivo: Evaluar la efectividad de varios procedimientos quirúrgicos en el manejo de la cápsula posterior y del vítreo anterior sobre la prevención de la opacificación del eje visual. Sujetos, material y métodos: Realizamos un estudio retrospectivo sobre 120 ojos intervenidos de cataratas congénitas unilaterales con una mediana de edad en el momento de la cirugía de 21 meses (rango intercuartílico, 6-52 meses. La población se divide en 3 grupos: grupo 1 (ojos con cápsula posterior íntegra, n=39, grupo 2 (ojos con capsulorrexis posterior circular continua, n=38 y grupo 3 (ojos con capsulorrexis posterior circular continua y vitrectomía anterior, n=43. Resultados: Respecto al efecto de la capsulorrexis posterior circular sobre la opacificación del eje visual se comparan el grupo 2 con el grupo 1 (chi-cuadrado de Pearson, p=0,281, por tanto, la realización de la capsulorrexis posterior circular no ha demostrado en este trabajo disminuir la incidencia de opacificación del eje visual. En cuanto al efecto de la capsulorrexis posterior circular asociada a la vitrectomía anterior, se comparan el grupo 3 con el grupo 1 (chi-cuadrado de Pearson, p=0,014, lo que demuestra que la unión de ambas técnicas (capsulorrexis posterior circular y vitrectomía anterior sí disminuye la incidencia de opacificación del eje visual. Conclusiones: La capsulorrexis posterior circular como única técnica no ha demostrado disminuir la incidencia de la opacificación del eje visual, siendo necesaria la realización de la capsulorrexis posterior circular asociada a la vitrectomía anterior para prevenir la opacificación del eje visual y disminuir la tasa de reintervenciones.Objective: To evaluate the effectiveness of various surgical procedures in the management of posterior capsule and anterior vitreous on the prevention of visual axis opacification. Subjects, material and methods: We retrospectively reviewed 120 eyes operated for unilateral congenital cataracts, with a median age at the time of cataract surgery of 21 months (interquartile range, 6-52 months. The eyes were divided into 3 groups: group 1 (eyes with intact posterior capsule, n=39, group 2 (eyes with posterior continuous curvilinear capsulorhexis, n=38, group 3 (eyes with posterior continuous curvilinear capsulorhexis and anterior vitrectomy, n=43. Results: To determine the effect of posterior continuous curvilinear capsulorhexis on visual axis opacification we compared group 2 with group 1 (chi-square Pearson test,P=.281, therefore in this study the implementation of the posterior continuous curvilinear capsulorhexis did not show any decreases in the incidence of visual axis opacification. To study the effect of posterior continuous curvilinear capsulorhexis associated anterior vitrectomy, we compared group 3 with group 1 (chi-square Pearson test,P=.014, demonstrating that the combination of both techniques (posterior continuous curvilinear capsulorhexis and anterior vitrectomy decreases the incidence of visual axis opacification. Conclusion: Posterior continuous curvilinear capsulorhexis as a single technique did not show any decrease in the incidence of visual axis opacification. Posterior continuous curvilinear capsulorhexis together with anterior vitrectomy are required to prevent visual axis opacification and to decrease reoperation rate.

  16. Valoración de técnicas intraoperatorias para la prevención de la opacificación del eje visual en la cirugía de cataratas congénitas / Assessment of intra-operative techniques to prevent visual axis opacification in congenital cataract surgery

    Scientific Electronic Library Online (English)

    R., Borghol-Kassar; J.L., Menezo-Rozalén; M.A., Harto-Castaño; M.C., Desco-Esteban.

    2012-10-01

    Full Text Available Objetivo: Evaluar la efectividad de varios procedimientos quirúrgicos en el manejo de la cápsula posterior y del vítreo anterior sobre la prevención de la opacificación del eje visual. Sujetos, material y métodos: Realizamos un estudio retrospectivo sobre 120 ojos intervenidos de cataratas congénita [...] s unilaterales con una mediana de edad en el momento de la cirugía de 21 meses (rango intercuartílico, 6-52 meses). La población se divide en 3 grupos: grupo 1 (ojos con cápsula posterior íntegra, n=39), grupo 2 (ojos con capsulorrexis posterior circular continua, n=38) y grupo 3 (ojos con capsulorrexis posterior circular continua y vitrectomía anterior, n=43). Resultados: Respecto al efecto de la capsulorrexis posterior circular sobre la opacificación del eje visual se comparan el grupo 2 con el grupo 1 (chi-cuadrado de Pearson, p=0,281), por tanto, la realización de la capsulorrexis posterior circular no ha demostrado en este trabajo disminuir la incidencia de opacificación del eje visual. En cuanto al efecto de la capsulorrexis posterior circular asociada a la vitrectomía anterior, se comparan el grupo 3 con el grupo 1 (chi-cuadrado de Pearson, p=0,014), lo que demuestra que la unión de ambas técnicas (capsulorrexis posterior circular y vitrectomía anterior) sí disminuye la incidencia de opacificación del eje visual. Conclusiones: La capsulorrexis posterior circular como única técnica no ha demostrado disminuir la incidencia de la opacificación del eje visual, siendo necesaria la realización de la capsulorrexis posterior circular asociada a la vitrectomía anterior para prevenir la opacificación del eje visual y disminuir la tasa de reintervenciones. Abstract in english Objective: To evaluate the effectiveness of various surgical procedures in the management of posterior capsule and anterior vitreous on the prevention of visual axis opacification. Subjects, material and methods: We retrospectively reviewed 120 eyes operated for unilateral congenital cataracts, with [...] a median age at the time of cataract surgery of 21 months (interquartile range, 6-52 months). The eyes were divided into 3 groups: group 1 (eyes with intact posterior capsule, n=39), group 2 (eyes with posterior continuous curvilinear capsulorhexis, n=38), group 3 (eyes with posterior continuous curvilinear capsulorhexis and anterior vitrectomy, n=43). Results: To determine the effect of posterior continuous curvilinear capsulorhexis on visual axis opacification we compared group 2 with group 1 (chi-square Pearson test,P=.281), therefore in this study the implementation of the posterior continuous curvilinear capsulorhexis did not show any decreases in the incidence of visual axis opacification. To study the effect of posterior continuous curvilinear capsulorhexis associated anterior vitrectomy, we compared group 3 with group 1 (chi-square Pearson test,P=.014), demonstrating that the combination of both techniques (posterior continuous curvilinear capsulorhexis and anterior vitrectomy) decreases the incidence of visual axis opacification. Conclusion: Posterior continuous curvilinear capsulorhexis as a single technique did not show any decrease in the incidence of visual axis opacification. Posterior continuous curvilinear capsulorhexis together with anterior vitrectomy are required to prevent visual axis opacification and to decrease reoperation rate.

  17. Enhanced recovery after vascular surgery: protocol for a systematic review

    Directory of Open Access Journals (Sweden)

    Gotlib Conn Lesley

    2012-11-01

    Full Text Available Abstract Background The enhanced recovery after surgery (ERAS programme is a multimodal evidence-based approach to surgical care which begins in the preoperative setting and extends through to patient discharge in the postoperative period. The primary components of ERAS include the introduction of preoperative patient education; reduction in perioperative use of nasogastric tubes and drains; the use of multimodal analgesia; goal-directed fluid management; early removal of Foley catheter; early mobilization, and early oral nutrition. The ERAS approach has gradually evolved to become the standard of care in colorectal surgery and is presently being used in other specialty areas such as vascular surgery. Currently there is little evidence available for the implementation of ERAS in this field. We plan to conduct a systematic review of this literature with a view to incorporating ERAS principles into the management of major elective vascular surgery procedures. Methods We will search EMBASE (OVID, 1947 to June 2012, Medline (OVID, 1948 to June 2012, and Cochrane Central Register of Controlled Trials (Wiley, Issue 1, 2012. Searches will be performed with no year or language restrictions. For inclusion, studies must look at adult patients over 18 years. Major elective vascular surgery includes carotid, bypass, aneurysm and amputation procedures. Studies must have evaluated usual care against an ERAS intervention in the preoperative, perioperative or postoperative period of care. Primary outcome measures are length of stay, decreased complication rate, and patient satisfaction or expectations. Only randomized controlled trials will be included. Discussion Most ERAS approaches have been considered in the context of colorectal surgery. Given the increasing use of multiple yet different aspects of this pathway in vascular surgery, it is timely to systematically review the evidence for their independent or combined outcomes, with a view to implementing them in this clinical setting. Results from this review will have important implications for vascular surgeons, anaesthetists, nurses, and other health care professionals when making evidenced-based decisions about the use of ERAS in daily practice.

  18. Complexities and challenges of surgical data collection from cataract patients: comparison of cataract surgery rates between 2001 and 2008 in all provinces of Argentina / Complexidades e desafios da coleta de dados cirúrgicos de catarata: comparação das taxas de cirurgia de catarata em todas as províncias da Argentina de 2001 em relação a 2008

    Scientific Electronic Library Online (English)

    Van C., Lansingh; Maria E., Nano; Marissa J., Carter; Natalia, Zárate; Serge, Resnikoff; Kristen A., Eckert.

    2014-01-01

    Full Text Available Objetivo: Comparar a taxa de cirurgia de catarata (TCC) em todas as províncias da Argentina entre 2001 e 2008, utilizando métodos de relatórios convencionais e verificar a precisão da TCC por meio do cruzamento desses métodos com o número de lentes intraoculares (LIOs) vendidas no país. Métodos: [...] Estudo longitudinal realizado em clínicas públicas e privadas, com a participação de 40 oftalmologistas de 22 províncias, que forneceram dados sobre cirurgias de catarata para 2001 e 2008. Outros dados foram obtidos a partir do Ministério da Saúde. As observações foram cruzadas com os dados de mercado para LIOs no período de 2008 a 2010. Resultados: O número de cirurgias de catarata aumentaram 2,7 vezes, de 62.739 em 2001 para 169.762 em 2008, com aumentos em todas as províncias, exceto Mendoza. Embora a população também tenha aumentado 9,4 % durante o mesmo período de tempo, a aparente TCC saltou de 1.744 para 4.313 por milhão de população. O número de LIOs vendidas na Argentina em 2008 foi de 186.652, o que pode significar que tenham sido realizadas um pouco mais de cirurgias de catarata do que o estimado. Verificações cruzadas com outros países que utilizam dados de vendas de LIOs não apresentam discrepâncias quando comparado a TCC anteriormente relatadas. Conclusões: De 2001 a 2008, a TCC na Argentina aumentou consideravelmente por várias razões mas, principalmente, porque foi revelada, por meio do cruzamento de dados sobre cirurgias relatadas com o número de LIOs vendidas, que o número de cirurgias realizadas anualmente foi hipoestimado no passado, como resultado de relatórios incompletos feitos por médicos privados. Há também várias sociedades de oftalmologia no país, o que dificulta a obtenção de dados precisos. Abstract in english 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.

  19. Cambios en el espesor de la capa de fibras nerviosas tras cirugía de cataratas medidos con OCT: Un estudio piloto Retinal nerve fiber layer changes after cataract surgery measured by OCT: A pilot study

    Directory of Open Access Journals (Sweden)

    J. Pareja-Esteban

    2009-06-01

    Full Text Available Objetivos: Analizar cambios en el espesor de la capa de fibras nerviosas de la retina (CFNR peripapilar tras cirugía de cataratas. Métodos: Medición del espesor medio de la CFNR de pacientes sometidos a cirugía de cataratas utilizando tomografía de coherencia óptica (OCT III Stratus® antes de la cirugía, un día después de la intervención y transcurrido un mes. Los datos fueron analizados mediante el programa informático SPSS 12.0. Los resultados fueron comparados empleando el test pareado de dos colas t de Student. Resultados: El grupo de estudio estaba compuesto de 74 ojos de 74 pacientes. El espesor medio de la CFNR antes de la cirugía de cataratas (AVGT0 fue 90,71 µm (DE: 19,93, el día después de la cirugía (AVGT1 fue 88,30 µm (DE: 20,59; y un mes después (AVGT2 97,45 µm (DE: 14,30. No se encontraron diferencias estadísticamente significativas entre AVGT0 y AVGT1 (P=0,37; sin embargo, dicha diferencia sí se encontró entre AVGT1 y AVGT2 (P= 0,002. También se encontró diferencia estadísticamente significativa en la calidad de señal de la señal entre AVGT0 y AVGT2 (P=0,0001. Conclusiones: El espesor medio de la capa de fibras nerviosas experimenta un incremento cuando es medido mediante OCT III Stratus® un mes tras la cirugía de cataratas. Este fenómeno se acompaña de una mejoría en la calidad de la señal.Purpose: To analyze changes in peripapillary retinal nerve fiber layer (RNFL after cataract surgery. Methods: The average RFNL thickness of patients who underwent cataract surgery was measured using the optical coherence tomography (OCT III Stratus® before surgery, the day after and one month later. The data were analyzed using the SPSS 12.0 software. We used paired two tail student´s t test for comparisons. Results: The study group was composed by 74 eyes of 74 patients. The RNFL thickness average was 90.71 µm (SD: 19.93, 88.30 µm (SD: 20.59 and 97.45 µm (SD: 14.30, before cataract surgery (AVGT0, the day after surgery (AVGT1 and one month later (AVGT2 respectively. We did not find statistically significant difference between AVGT0 and AVGT1 (P=0.37; however, statistically significant difference between AVGT1 and AVGT2 (P= 0.002 as well as in the image signal quality between AVGT0 and AVGT2 (P= 0.0001. Conclusions: The RNFL average thickness measured by OCT III Stratus® showed an increase one month after cataract surgery. This phenomenon is accompanied with an improvement in signal quality.

  20. Cambios en el espesor de la capa de fibras nerviosas tras cirugía de cataratas medidos con OCT: Un estudio piloto / Retinal nerve fiber layer changes after cataract surgery measured by OCT: A pilot study

    Scientific Electronic Library Online (English)

    J., Pareja-Esteban; M.A., Teus-Guezala; P., Drake-Casanova; I., Dapena-Sevilla.

    2009-06-01

    Full Text Available Objetivos: Analizar cambios en el espesor de la capa de fibras nerviosas de la retina (CFNR) peripapilar tras cirugía de cataratas. Métodos: Medición del espesor medio de la CFNR de pacientes sometidos a cirugía de cataratas utilizando tomografía de coherencia óptica (OCT) III Stratus® antes de la c [...] irugía, un día después de la intervención y transcurrido un mes. Los datos fueron analizados mediante el programa informático SPSS 12.0. Los resultados fueron comparados empleando el test pareado de dos colas t de Student. Resultados: El grupo de estudio estaba compuesto de 74 ojos de 74 pacientes. El espesor medio de la CFNR antes de la cirugía de cataratas (AVGT0) fue 90,71 µm (DE: 19,93), el día después de la cirugía (AVGT1) fue 88,30 µm (DE: 20,59); y un mes después (AVGT2) 97,45 µm (DE: 14,30). No se encontraron diferencias estadísticamente significativas entre AVGT0 y AVGT1 (P=0,37); sin embargo, dicha diferencia sí se encontró entre AVGT1 y AVGT2 (P= 0,002). También se encontró diferencia estadísticamente significativa en la calidad de señal de la señal entre AVGT0 y AVGT2 (P=0,0001). Conclusiones: El espesor medio de la capa de fibras nerviosas experimenta un incremento cuando es medido mediante OCT III Stratus® un mes tras la cirugía de cataratas. Este fenómeno se acompaña de una mejoría en la calidad de la señal. Abstract in english Purpose: To analyze changes in peripapillary retinal nerve fiber layer (RNFL) after cataract surgery. Methods: The average RFNL thickness of patients who underwent cataract surgery was measured using the optical coherence tomography (OCT) III Stratus® before surgery, the day after and one month late [...] r. The data were analyzed using the SPSS 12.0 software. We used paired two tail student´s t test for comparisons. Results: The study group was composed by 74 eyes of 74 patients. The RNFL thickness average was 90.71 µm (SD: 19.93), 88.30 µm (SD: 20.59) and 97.45 µm (SD: 14.30), before cataract surgery (AVGT0), the day after surgery (AVGT1) and one month later (AVGT2) respectively. We did not find statistically significant difference between AVGT0 and AVGT1 (P=0.37); however, statistically significant difference between AVGT1 and AVGT2 (P= 0.002) as well as in the image signal quality between AVGT0 and AVGT2 (P= 0.0001). Conclusions: The RNFL average thickness measured by OCT III Stratus® showed an increase one month after cataract surgery. This phenomenon is accompanied with an improvement in signal quality.

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

    OpenAIRE

    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...

  2. Resultados de la técnica de facoemulsificación "Divide y Vencerás" en la cirugía de catarata / Results of the "Divide and Conquer"phacoemulsification technique in the cataract surgery

    Scientific Electronic Library Online (English)

    Juan Raúl, Hernández Silva; Ada Sonia, Villasol López; Meisy, Ramos López; Luis, Curbelo Cunill; Gilberto, Fernández Vásquez; Marcelino, Rio Torres.

    Full Text Available OBJETIVO: Valorar la técnica de facoemulsificación de "Divide y Vencerás" en la cirugía del cristalino en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer". MÉTODOS: Se realizó una investigación aplicada retrospectiva y descriptiva en 102 ojos con diagnóstico [...] de cataratas presenil y senil, de 52 pacientes que se les realizó facoemulsificación por la técnica de "Divide y Vencerás"en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el período comprendido entre junio del 2006 a febrero del 2009. RESULTADOS: Se encontró que los mayores de 60 años representaron más de 75 % del total del universo estudiado. La mejor agudeza visual corregida en el posoperatorio mejoró a más de 0,7 en la escala de Snellen en el 85 % de los ojos. La diferencia del astigmatismo preoperatorio y posoperatorio fue 0,13 dioptrías. En la microscopia endotelial los cambios encontrados fueron de un 8,2 %, las complicaciones presentadas fueron de 2,8 %, ocurriendo con mayor frecuencia la rotura de cápsula posterior. CONCLUSIONES: Los mayores de 60 años representaron más de 75 % del total del universo estudiado, la agudeza visual corregida en el posoperatorio mejoró cuatro líneas en la escala de Snellen, el astigmatismo posoperatorio fue mínimo sin repercusión en la calidad visual de los pacientes, en la microscopia endotelial los cambios encontrados fueron mínimos y no tuvieron repercusión clínica para los pacientes, las complicaciones presentadas fueron muy bajas y se produjo con mayor frecuencia la rotura de cápsula posterior. Abstract in english OBJECTIVE:To assess the use of "Divide and Conquer" phacoemulsification technique in the lens surgery at the Ocular Microsurgery of "Ramón Pando Ferrer" Cuban Institute of Ophthalmology. METHODS: Retrospective and descriptive applied research was conducted in 102 eyes diagnosed with presenile and se [...] nile cataract from 52 patients who underwent "Divide and Conquer" phacoemulsification technique at the Ocular Microsurgery Center of "Ramón Pando Ferrer"from June 2006 to February 2009. RESULTS: It was found that patients over 60 years accounted for 75% of the universe of study; the best corrected visual acuity in the postoperative stage improved to more than 0,7 in the Snellen´s chart in 85% of the eyes, the difference between the preoperative and the postoperative astigmatism was 0,13 dioptries, the changes found in the endothelial microscopy represented 8,2%, the complications were observed in 2,8% of cases, being the most frequent the posterior capsule rupture. Ç CONCLUSIONS: The patients aged over 60 years accounted for 75% of the whole universe of study, the corrected visual acuity improved by four lines in the Snellen´s chart in the postoperative period, the postoperative astigmatism was minimal without any impact on the visual quality of the patients, there were minimal changes in the endothelial microscopy and no clinical impact was recorded. Complications were very low and the most frequent was the posterior chamber capsule rupture.

  3. Resultados de la técnica de facoemulsificación "Divide y Vencerás" en la cirugía de catarata Results of the "Divide and Conquer"phacoemulsification technique in the cataract surgery

    Directory of Open Access Journals (Sweden)

    Juan Raúl Hernández Silva

    2010-01-01

    Full Text Available OBJETIVO: Valorar la técnica de facoemulsificación de "Divide y Vencerás" en la cirugía del cristalino en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer". MÉTODOS: Se realizó una investigación aplicada retrospectiva y descriptiva en 102 ojos con diagnóstico de cataratas presenil y senil, de 52 pacientes que se les realizó facoemulsificación por la técnica de "Divide y Vencerás"en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el período comprendido entre junio del 2006 a febrero del 2009. RESULTADOS: Se encontró que los mayores de 60 años representaron más de 75 % del total del universo estudiado. La mejor agudeza visual corregida en el posoperatorio mejoró a más de 0,7 en la escala de Snellen en el 85 % de los ojos. La diferencia del astigmatismo preoperatorio y posoperatorio fue 0,13 dioptrías. En la microscopia endotelial los cambios encontrados fueron de un 8,2 %, las complicaciones presentadas fueron de 2,8 %, ocurriendo con mayor frecuencia la rotura de cápsula posterior. CONCLUSIONES: Los mayores de 60 años representaron más de 75 % del total del universo estudiado, la agudeza visual corregida en el posoperatorio mejoró cuatro líneas en la escala de Snellen, el astigmatismo posoperatorio fue mínimo sin repercusión en la calidad visual de los pacientes, en la microscopia endotelial los cambios encontrados fueron mínimos y no tuvieron repercusión clínica para los pacientes, las complicaciones presentadas fueron muy bajas y se produjo con mayor frecuencia la rotura de cápsula posterior.OBJECTIVE:To assess the use of "Divide and Conquer" phacoemulsification technique in the lens surgery at the Ocular Microsurgery of "Ramón Pando Ferrer" Cuban Institute of Ophthalmology. METHODS: Retrospective and descriptive applied research was conducted in 102 eyes diagnosed with presenile and senile cataract from 52 patients who underwent "Divide and Conquer" phacoemulsification technique at the Ocular Microsurgery Center of "Ramón Pando Ferrer"from June 2006 to February 2009. RESULTS: It was found that patients over 60 years accounted for 75% of the universe of study; the best corrected visual acuity in the postoperative stage improved to more than 0,7 in the Snellen´s chart in 85% of the eyes, the difference between the preoperative and the postoperative astigmatism was 0,13 dioptries, the changes found in the endothelial microscopy represented 8,2%, the complications were observed in 2,8% of cases, being the most frequent the posterior capsule rupture. Ç CONCLUSIONS: The patients aged over 60 years accounted for 75% of the whole universe of study, the corrected visual acuity improved by four lines in the Snellen´s chart in the postoperative period, the postoperative astigmatism was minimal without any impact on the visual quality of the patients, there were minimal changes in the endothelial microscopy and no clinical impact was recorded. Complications were very low and the most frequent was the posterior chamber capsule rupture.

  4. Efectividad de la lente intraocular ACRI. SMART 46-S en la cirugía de catarata por microincisiones / Effectiveness of the intraocular lens ACRI SMART 46-S in micro-incision cataract surgery

    Scientific Electronic Library Online (English)

    Juan Raúl, Hernández Silva; Carlos David, Navarrete Rebolledo; Marcelino, Rio Torres; Meisy, Ramos López; Luis, Curbelo Cunill; Gilberto, Fernández Vásquez; Belkys, Rodríguez Suárez< a name=autor> < /a> .

    2007-12-01

    Full Text Available El perfeccionamiento y aplicación de una industria destinada a modernizar las lentes intraoculares y el instrumental quirúrgico ha impulsado un conjunto de adelantos que han permitido optimizar, corregir y refinar las técnicas quirúrgicas para la cirugía de la catarata y en especial la facoemulsific [...] ación. El punto más importante en esta cadena de adelantos está enmarcado y encaminado a disminuir el tamaño de la incisión quirúrgica que permita solucionar un número importante de complicaciones que con relativa frecuencia se presentan con la aplicación de las técnicas quirúrgicas convencionales extracapsular e intracapsular con incisiones mayores a los 10 mm. Actualmente se han desarrollado técnicas quirúrgicas conocidas como cirugía de la catarata por microincisiones .Se realizó un estudio descriptivo y retrospectivo, cuyo universo estuvo constituido por 27 pacientes (ojos) con diagnóstico de catarata presenil y senil, que recibieron tratamiento quirúrgico con la técnica de facoemulsificación por microinsiciones e implante de lente intraocular de cámara posterior de una pieza, plegable de acrílico, de un tamaño de 11 x 6 mm de óptica, modelo Acri. Smart 46 S con inyector, en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología “Ramón Pando Ferrer”, en el período comprendido desde enero 2004 hasta enero 2005. Se encontró que la mayoría de los casos tenían más de 50 años, se alcanzó una recuperación significativa de la mejor agudeza visual corregida en el posoperatorio, el astigmatismo inducido fue bajo. En cuanto a los parámetros facodinámicos utilizados, el poder de ultrasonido fue como promedio bajo. Las complicaciones presentadas fueron pocas, salida de vítreo secundaria a rotura de la cápsula posterior ocurrió más frecuentemente. Se concluye que la técnica quirúrgica MICS con implante de lente Acri.Smart 46 S constituye una opción válida, segura y eficaz en el tratamiento de la catarata, también permitiría desarrollar en el futuro materiales y tecnologías que abrirían nuevos caminos para la cirugía oftalmológica, y la aplicación de parámetros facodinámicos óptimos conllevaría a un bajo porcentaje de complicaciones. Abstract in english Improvement and application of an industry devoted to modernize intraocular lenses and surgical tools have prompted a set of advances that allow optimizing, correcting and refining the surgical techniques for cataract surgery, particularly phacoemulsification. The most important aspect in this chain [...] of advacements is aimed at reducing the surgical incision size in order to avoid a significant number of complications that are relatively frequent when using conventional extracapsular and intracapsular surgeries with over 10mm incisions. At present, new surgical techniques such as microincision cataract surgery have been developed. A retrospective and descriptive study was performed in 27 patients (eyes) diagnosed with pre-senile and senile cataract, who were surgically treated with microincision phacoemulsification and received the implant of an ACRi Smart 46.S 11 x 6mm acrylic intraocular lens in the posterior chamber at the Ocular Microsurgery Center of “Ramón Pando Ferrer” Ophthalmology Institute in the period from January 2004 to January 2005. It was found that most of cases were older than 50 years; the best corrected visual acuity recovered significantly in the postoperative period and induced astigmatism was low. Regarding the used phacodynamic parameters, the ultrasound power was generally low. There were few complications, being vitreous detachment secondary to break in the posterior capsule. It was concluded that microincision cataract surgery with Acri Smart 46 S lens implant is a valid, safe and effective choice of catract treatment that will allow developing in the future materials and technologies which would open up new paths for eye surgery, and also the use of optimal phacodynamic parameters would lead to a low number of complications.

  5. Efectividad de la lente intraocular ACRI. SMART 46-S en la cirugía de catarata por microincisiones Effectiveness of the intraocular lens ACRI SMART 46-S in micro-incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Juan Raúl Hernández Silva

    2007-12-01

    Full Text Available El perfeccionamiento y aplicación de una industria destinada a modernizar las lentes intraoculares y el instrumental quirúrgico ha impulsado un conjunto de adelantos que han permitido optimizar, corregir y refinar las técnicas quirúrgicas para la cirugía de la catarata y en especial la facoemulsificación. El punto más importante en esta cadena de adelantos está enmarcado y encaminado a disminuir el tamaño de la incisión quirúrgica que permita solucionar un número importante de complicaciones que con relativa frecuencia se presentan con la aplicación de las técnicas quirúrgicas convencionales extracapsular e intracapsular con incisiones mayores a los 10 mm. Actualmente se han desarrollado técnicas quirúrgicas conocidas como cirugía de la catarata por microincisiones .Se realizó un estudio descriptivo y retrospectivo, cuyo universo estuvo constituido por 27 pacientes (ojos con diagnóstico de catarata presenil y senil, que recibieron tratamiento quirúrgico con la técnica de facoemulsificación por microinsiciones e implante de lente intraocular de cámara posterior de una pieza, plegable de acrílico, de un tamaño de 11 x 6 mm de óptica, modelo Acri. Smart 46 S con inyector, en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología “Ramón Pando Ferrer”, en el período comprendido desde enero 2004 hasta enero 2005. Se encontró que la mayoría de los casos tenían más de 50 años, se alcanzó una recuperación significativa de la mejor agudeza visual corregida en el posoperatorio, el astigmatismo inducido fue bajo. En cuanto a los parámetros facodinámicos utilizados, el poder de ultrasonido fue como promedio bajo. Las complicaciones presentadas fueron pocas, salida de vítreo secundaria a rotura de la cápsula posterior ocurrió más frecuentemente. Se concluye que la técnica quirúrgica MICS con implante de lente Acri.Smart 46 S constituye una opción válida, segura y eficaz en el tratamiento de la catarata, también permitiría desarrollar en el futuro materiales y tecnologías que abrirían nuevos caminos para la cirugía oftalmológica, y la aplicación de parámetros facodinámicos óptimos conllevaría a un bajo porcentaje de complicaciones.Improvement and application of an industry devoted to modernize intraocular lenses and surgical tools have prompted a set of advances that allow optimizing, correcting and refining the surgical techniques for cataract surgery, particularly phacoemulsification. The most important aspect in this chain of advacements is aimed at reducing the surgical incision size in order to avoid a significant number of complications that are relatively frequent when using conventional extracapsular and intracapsular surgeries with over 10mm incisions. At present, new surgical techniques such as microincision cataract surgery have been developed. A retrospective and descriptive study was performed in 27 patients (eyes diagnosed with pre-senile and senile cataract, who were surgically treated with microincision phacoemulsification and received the implant of an ACRi Smart 46.S 11 x 6mm acrylic intraocular lens in the posterior chamber at the Ocular Microsurgery Center of “Ramón Pando Ferrer” Ophthalmology Institute in the period from January 2004 to January 2005. It was found that most of cases were older than 50 years; the best corrected visual acuity recovered significantly in the postoperative period and induced astigmatism was low. Regarding the used phacodynamic parameters, the ultrasound power was generally low. There were few complications, being vitreous detachment secondary to break in the posterior capsule. It was concluded that microincision cataract surgery with Acri Smart 46 S lens implant is a valid, safe and effective choice of catract treatment that will allow developing in the future materials and technologies which would open up new paths for eye surgery, and also the use of optimal phacodynamic parameters would lead to a low number of complications.

  6. Cataract Vision Simulator

    Science.gov (United States)

    ... the Sun Eye Health News Consumer Alerts Cataract Vision Simulator Tweet How do cataracts affect your vision? A cataract is a clouding of the eye's ... or frozen vegetables instead. High Tech for Low Vision Today's smartphones, e-readers and tablets offer features ...

  7. Review of contemporary role of robotics in bariatric surgery

    Science.gov (United States)

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

    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 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. PMID:25598594

  8. Assessment of outcome in hypospadias surgery - a review.

    Science.gov (United States)

    Springer, Alexander

    2014-01-01

    Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Modern surgery claims that it is possible to create a functionally and cosmetically normal penis. Continuous re-evaluation and assessment of outcome may have a major impact on future clinical practice. Assessment of outcome includes: complication rate, cosmetic appearance of the penis, functional outcome (micturition, sexuality), and psychological factors such as quality of life and psychosexual life. This article briefly reviews current strategies of outcome assessment. Somehow in the future, we will be able to give an accurate estimation of the long-term consequences of being born with hypospadias. PMID:24479107

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

    Science.gov (United States)

    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

  10. Cataract surgery and primary intraocular lens implantation in children ?2 years old in the United Kingdom and Ireland: findings of national surveys

    OpenAIRE

    Solebo, Ameenat Lola; Russell-Eggitt, Isabelle; Nischal, Ken K; Moore, Anthony T; Cumberland, Phillippa; Rahi, Jugnoo; ., British Isles Congenital Cataract Interest Group

    2009-01-01

    Abstract Background: We have investigated the current patterns of practice relating to primary intraocular lens (IOL) implantation in children ?2 years old in the UK and Ireland. Methods: National postal questionnaire surveys of consultant ophthalmologists in the UK & Ireland. Results: 76% of 928 surveyed ophthalmologists replied. 47 (7%) of the respondents operated on children aged under ?2 with cataract. 41 (87%) of the 47 respondents performed...

  11. Oculoplastic surgery in Madagascar: a review

    OpenAIRE

    JH Norris; RP Gale; H Nkumbe; OC Backhouse; P Bernadin; 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...

  12. Oculoplastic surgery in Madagascar: a review

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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.

  14. At the frontiers of surgery: review

    LENUS (Irish Health Repository)

    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.

  15. Condylar positioning devices for orthognathic surgery: a literature review.

    Science.gov (United States)

    Costa, Fabio; Robiony, Massimo; Toro, Corrado; Sembronio, Salvatore; Polini, Francesco; Politi, Massimo

    2008-08-01

    In the past few years, many devices have been proposed for preserving the preoperative position of the mandibular condyle during bilateral sagittal split osteotomy. Accurate mandibular condyle repositioning is considered important to obtain a stable skeletal and occlusal result, and to prevent the onset of temporomandibular disorders (TMD). Condylar positioning devices (CPDs) have led to longer operating times, the need to keep intermaxillary fixation as stable as possible during their application, and the need for precision in the construction of the splint or intraoperative wax bite. This study reviews the literature concerning the use of CPDs in orthognathic surgery since 1990 and their application to prevent skeletal instability and contain TMD since 1995. From the studies reviewed, we can conclude that there is no scientific evidence to support the routine use of CPDs in orthognathic surgery. PMID:18417381

  16. Gender reassignment surgery - a 13 year review of surgical outcomes

    OpenAIRE

    Rossi Neto, R.; Hintz, F.; Krege, S.; Ru?bben, H.; Vom Dorp, F.

    2012-01-01

    PURPOSE: The aim of this study is to thoroughly report on surgical outcomes from 332 patients who underwent male to female gender reassignment surgery (GRS). MATERIAL AND METHODS: Records from 332 patients who underwent GRS from 1995 to 2008 were reviewed. All patients were submitted to penile inversion vaginoplasty with glans-derived sensate clitoroplasty. Mean age was 36.7 years (range 19-68 years). Surgical complications were stratified in 6 main groups: genital region, urinary tract, gast...

  17. Mediastinitis in cardiac surgery: A review of the literature

    OpenAIRE

    Kunal S; Vishal.K; Deepak K.S

    2012-01-01

    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 rem...

  18. Advances in pharmacological strategies for the prevention of cataract development

    Science.gov (United States)

    Gupta, S K; Selvan, V Kalai; Agrawal, S S; Saxena, Rohit

    2009-01-01

    Cataractous-opacification of the lens is one of the leading causes of blindness in India. The situation can be managed by surgical removal of the cataractous lens. Various pharmacological strategies have been proposed for the prevention and treatment of cataract. Information on possible benefits of putative anticataract agents comes from a variety of approaches, ranging from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients. This review deals with the various mechanisms, and possible pharmacological interventions for the prevention of cataract. The article also reviews research on potential anticataractous agents, including aldose reductase inhibitors, glutathione boosters, antiglycating agents, vitamins and various drugs from indigenous sources. PMID:19384010

  19. Algunos aspectos clínicoepidemiológicos en el preoperatorio de la catarata senil / Some clinical and epidemiological aspects of the preoperative period in the senile cataract surgery

    Scientific Electronic Library Online (English)

    Moraima Isas, Cordové; Idalia, Triana Casado; Lisset, Torres Martín; Lissette, Pérez Rodríguez; Armando H, Seuc.

    Full Text Available OBJETIVO: Identificar las principales características clínicas y epidemiológicas de los pacientes portadores de catarata senil en el periodo preoperatorio. MÉTODOS: Estudio descriptivo y retrospectivo en pacientes operados de catarata senil, seleccionados de forma aleatoria, entre junio 2006 y junio [...] 2007, en el Hospital Clinicoquirúrgico Docente «Dr. Salvador Allende». Se analizaron edad, sexo, enfermedades sistémicas y oculares asociadas, agudeza visual preoperatoria y ametropías asociadas. RESULTADOS: El 68,58 % de los casos tenía edades entre 70 y 79 años, sin diferencias de sexo. El 92,94 % presentaba alguna enfermedad sistémica asociada, con predominio de hipertensión arterial (44,9 %) y Diabetes Mellitus. Entre las oculares, fueron más frecuentes la lesión del nervio óptico (25,64 %) y el glaucoma crónico (21,15 %). La visión preoperatoria predominante fue 0,1 (25,64 %), mientras que la miopía (72,41 %) y el astigmatismo (61,64 %) fueron más frecuentes en pacientes con catarata nuclear (72,41 %) y la hipermetropía (66,66 %) en aquellos con catarata subcapsular. CONCLUSIONES: Predominó el grupo etario de 70 a 74 años, sin distinción por sexo. La hipertensión arterial fue la enfermedad sistémica más frecuente y, entre las oculares, las alteraciones del nervio óptico. La agudeza visual preoperatoria que predominó fue de 0,1. La miopía y el astigmatismo se asociaron con la catarata de tipo nuclear y la hipermetropía con la subcapsular. Abstract in english OBJECTIVE: To identify the main clinical and epidemic characteristics of the patient with senile cataract in the preoperative period. METHODS: A descriptive and retrospective study was conducted in patients operated from senile cataract, who were randomly selected in the period of June 2006 to June [...] 2007 at Dr. "Salvador Allende" teaching hospital. Age, sex, related systemic and ocular diseases, preoperative visual acuity and associated refraction errors were analyzed. RESULTS: The 70-79 years age prevailed in 68.58 % of the cases without sex differences. The associated systemic disease was seen in 92.94 % of patients, with blood hypertension (44.9 %) and diabetes mellitus being predominant. Among the ocular disorders, the optic nerve lesion (25.64 %) and the Chronic Glaucoma (21.15%) were the most frequent problems. The predominant preoperative vision was 0,1 (25.64 %) whereas myopia (72.41 %) and astigmatism (61,64 %) were more common in patients with nuclear Cataract (72.41 %) and hypermetropia (66.66 %) was mostly found in those affected by subcapsular cataract. CONCLUSIONS: The prevailing age group was 70 to 74 years regardless of sex. The blood hypertension was the most frequent systemic disease, and the optic nerve alterations in the ocular disorders. The preoperative visual acuity was 0.1. Myopia and astigmatism were associated to the nuclear cataract and hypermetropia to subcapsular cataract.

  20. Long term outcomes of bilateral congenital and developmental cataracts operated in Maharashtra, India. Miraj pediatric cataract study III

    Directory of Open Access Journals (Sweden)

    Parikshit M Gogate

    2014-01-01

    Full Text Available Aim : To study long term outcome of bilateral congenital and developmental cataract surgery. Subjects: 258 pediatric cataract operated eyes of 129 children. Materials and Methods: Children who underwent pediatric cataract surgery in 2004-8 were traced and examined prospectively in 2010-11. Demographic and clinical factors were noted from retrospective chart readings. All children underwent visual acuity estimation and comprehensive ocular examination in a standardized manner. L. V. Prasad Child Vision Function scores (LVP-CVF were noted for before and after surgery. Statistics: Statistical analysis was done with SPSS version 16 including multi-variate analysis. Results: Children aged 9.1 years (std dev 4.6, range 7 weeks-15 years at the time of surgery. 74/129 (57.4% were boys. The average duration of follow-up was 4.4 years (stddev 1.6, range 3-8 years. 177 (68.6% eyes had vision 6/18 and 157 (60.9% had BCVA >6/60 3-8 years after surgery. 48 (37.2% had binocular stereoacuity <480 sec of arc by TNO test. Visual outcome depended on type of cataract (P = 0.004, type of cataract surgery (P < 0.001, type of intra-ocular lens (P = 0.05, age at surgery (P = 0.004, absence of post-operative uveitis (P = 0.01 and pre-operative vision (P < 0.001, but did not depend on delay (0.612 between diagnosis and surgery. There was a statistically significant improvement for all the 20 questions of the LVP-CVF scale (P < 0.001. Conclusion : Pediatric cataract surgery improved the children?s visual acuity, stereo acuity and vision function. Developmental cataract, use of phacoemulsification, older children and those with better pre-operative vision had betterlong-termoutcomes.

  1. Computer-aided planning in orthognathic surgery-systematic review.

    Science.gov (United States)

    Haas Jr, O L; Becker, O E; de Oliveira, R B

    2014-11-25

    The aim of this study was to conduct a systematic review to evaluate the accuracy and benefits of computer-aided planning in orthognathic surgery. The search was performed in PubMed, EMBASE, Cochrane Library, LILACS, and SciELO. The articles identified were assessed independently and in a blinded manner by two authors using selection criteria and eligibility criteria. The database search yielded 375 studies. Following the application of search and eligibility criteria, a final nine studies were included in the systematic review. The level of agreement between the authors in the study selection process was substantial (?=0.767) and study eligibility was considered excellent (?=0.863). The accuracy of translation was <1.2mm in the maxilla (vertical) and <1.1mm in the mandible (sagittal), and for rotation was <1.5° in the maxilla (pitch) and <1.8° in the mandible (pitch). Two studies showed a medium potential risk of bias and six studies showed a high potential risk of bias. Computer-aided planning in orthognathic surgery was considered accurate for the studies included in this systematic review. However, the low quality of these studies means that randomized clinical trials are needed to compare computer-aided planning to conventional planning in orthognathic surgery. PMID:25432508

  2. Surgical treatment of patients with bilateral cataracts

    Directory of Open Access Journals (Sweden)

    I.E. Ioshin

    2013-02-01

    Full Text Available ABSTRACT The Determination of the tactics for surgical cataract treatment in the fellow eye in patients with bilateral cataracts did not received any unambiguous solution till now and the periods of operation performance are interpreted differently. The authors analyzed the results of treatment in 486 patients with bilateral cataracts. The authors identified a possible favorable interval between first and second operations in case of bilateral cataract, which was based on the clinical, functional and immunological parameters. Phacoemulsifications with peri-operative antibiotic prophylaxis were carried out not later than 4 days after the operation on the first eye, if there were no complications intra-operatively and in post-operative period in the first eye. Recommended time of surgery in the fellow eye in 114 patients of the main group allowed to reveal high functional results (0.7-1.0 in 90.4% in the first eye and in 85.1% of cases in the fellow eye, that promoted the restoration of binocular functions in 98 % of cases after surgery in the shortest possible time. In all patients of the main group the clear vision at different distances were achieved after surgery with bilateral implantation of multifocal IOLs in both eyes in the maximum shortest time. Selected dates of cataract surgery in both eyes taking into account the general and associated ocular pathology allows to reduce the emotional cost, time and organizational problems in preparation for the operation, adding the benefits of quality of early rehabilitation after surgery in both eyes.

  3. Cataract patients in a defined Swedish population 1986-90: VII Inpatient and outpatient standardised mortality ratios.

    OpenAIRE

    Ninn-pedersen, K.; Stenevi, U.

    1995-01-01

    AIMS--Cataract surgery has at times been said to correlate with an increased death risk. We have therefore analysed the standardised death ratio in a population based cohort of patients that had undergone cataract surgery. METHODS--Data for all patients undergoing cataract surgery from 1986 up to and including 1990 in the Lund Health Care District were prospectively recorded, and 5120 were retrieved for analysis. Death dates and primary death diagnoses for each patient were obtained from the ...

  4. Prevalencia de membranas epirretinianas mediante tomografía de coherencia óptica en pacientes remitidos para cirugía de cataratas / Use of optical coherence tomography to measure prevalence of epiretinal membranes in patients referred for cataract surgery

    Scientific Electronic Library Online (English)

    I., Contreras; S., Noval; J., Tejedor.

    2008-02-01

    Full Text Available Objetivo: Evaluar la prevalencia de membranas epirretinianas (MER) en pacientes remitidos para cirugía de cataratas y la frecuencia de aparición de nuevas MER en los primeros 6 meses tras la facoemulsificación mediante tomografía de coherencia óptica (OCT). Métodos: La prevalencia de MER en paciente [...] s referidos para cirugía de catarata se determinó a partir de una evaluación oftalmológica inicial completa que incluía una exploración con OCT. Todos los pacientes fueron operados mediante facoemulsificación sin complicaciones. Si existía una MER en un ojo, el contralateral era programado para cirugía de catarata. Si no se detectaba MER en ninguno, se operaba el ojo con peor agudeza visual. Los pacientes fueron seguidos durante 6 meses para estudiar la influencia de la facoemulsificación en el desarrollo de MER. Resultados: Cuarenta y cinco pacientes fueron incluidos en el estudio. En la evaluación inicial, se detectó la presencia de MER mediante OCT en siete pacientes (15,6%). Una paciente presentaba una MER en ambos ojos, siendo visible mediante funduscopia sólo en el ojo izquierdo. Las MER no eran evidentes en la exploración del fondo de ojo en los demás casos. Tras 6 meses de seguimiento, no se detectaron nuevos casos de MER en los ojos operados, ni mediante evaluación del fondo de ojo ni mediante OCT. Conclusión: Existe la posibilidad de que un elevado porcentaje de las MER que se consideran secundarias a la cirugía de cataratas estén presentes antes de la misma, pudiendo ser diagnosticadas mediante OCT. Abstract in english Purpose: To evaluate, using optical coherence tomography (OCT), the prevalence of epiretinal membranes (ERM) in patients referred for phacoemulsification, and the frequency of new ERM development in the first six months after surgery. Methods: Patients referred by general ophthalmologists for catara [...] ct surgery underwent a new, complete ophthalmological evaluation. OCT scanning was performed using the Macular Thickness Map acquisition protocol (StratusOCT, Carl Zeiss Meditec). This baseline examination was used to determine the prevalence of ERM in patients referred for cataract surgery. All patients underwent uneventful phacoemulsification. If an ERM was already present in one eye, the other eye was chosen for cataract surgery. If no ERM was present, the eye with the poorest visual acuity was operated. Operated eyes were followed-up for six months in order to study the influence of phacoemulsification on the development of ERM. Results: Forty-five patients were prospectively evaluated. In the baseline visit, ERM were detected by OCT in 7 patients (15.6%). Both eyes were affected in one patient, with the ERM being apparent on funduscopy only in her left eye. Fundus examination was unremarkable in all other cases. After six months follow-up, no new cases of epiretinal membranes were detected in the eyes that had undergone phacoemulsification, neither by fundus evaluation nor by OCT. Conclusions: Epiretinal membranes, previously thought to be secondary to cataract surgery, may be present before phacoemulsification and can be diagnosed by OCT.

  5. A review of psychosocial outcomes for patients seeking cosmetic surgery.

    Science.gov (United States)

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

    2004-04-01

    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 surgery. They identified 37 relevant studies of varying cosmetic procedures that utilized disparate methodologies. Overall, patients appeared generally satisfied with the outcome of their procedures, although some exhibited transient and some exhibited longer-lasting psychological disturbance. Factors associated with poor psychosocial outcome included being young, being male, having unrealistic expectations of the procedure, previous unsatisfactory cosmetic surgery, minimal deformity, motivation based on relationship issues, and a history of depression, anxiety, or personality disorder. Body dysmorphic disorder was also recognized by some studies as a predictor of poor outcome, a finding reinforced by reference to the psychiatric literature. The authors conclude that although most people appear satisfied with the outcome of cosmetic surgical procedures, some are not, and attempts should be made to screen for such individuals in cosmetic surgery settings. PMID:15083026

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

    Science.gov (United States)

    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

  7. Cataract from ultraviolet radiation

    OpenAIRE

    Löfgren, Stefan

    2001-01-01

    Cataract is the major cause of low vision and blindness in the world. Epidemiological and experimental studies link cataract to (solar) ultraviolet radiation (UVR) exposure. Current safety limits of UVR exposure are based on animal experiments, but many factors are less well known in UVR cataractogenesis. This thesis aims at strengthening the foundation for experimental UVR cataract research and to aid in future revisions of UVR safety limits. Using lactate as a marker o...

  8. Childhood Cataract: Home to Hospital

    Directory of Open Access Journals (Sweden)

    Mohammad A Muhit MBBS MSc(Ophth MSc(CEH

    2004-01-01

    Full Text Available Globally, there are 190,000 children who are blind from cataract.1 Cataract in children may be present at birth (congenital cataract or may appear anytime during the first few years of life (developmental cataract. Childhood cataract is the most common treatable cause of childhood blindness, being responsible for 10-30% of all childhood blindness. A recent national study in Bangladesh showed that 1 in every 3 blind children is unnecessarily blind from congenital/developmental cataract.

  9. Anestesia peribulbar com ropivacaína como alternativa ao bloqueio neuromuscular para facectomia em cães / Peribulbar anesthesia with ropivacaine as an alternative to neuromuscular blocking agents for cataract surgery in dogs

    Scientific Electronic Library Online (English)

    V.N.L.S., Oliva; A.L., Andrade; L., Bevilacqua; L.M., Matsubara; S.H.V., Perri.

    2010-06-01

    Full Text Available Desenvolveu-se uma técnica de bloqueio peribulbar comparando-a à técnica de anestesia oftálmica com bloqueio neuromuscular parcial em cães submetidos à facectomia extracapsular. Doze cães, de diferentes raças, foram alocados em dois grupos (G1 e G2) e anestesiados com acepromazina (0,05mg/kg, IV) e [...] propofol (5mg/kg, IV) e mantidos com isofluorano sob ventilação espontânea. Os cães do G1 receberam o bloqueio peribulbar com ropivacaína 0,75%, e os do G2 o bloqueio neuromuscular parcial com brometo de pancurônio (0,01mg/kg, IV). Utilizaram-se, como parâmetros comparativos, escores de posicionamento do globo ocular, controle do reflexo oculocardíaco e pressão intraocular (mmHg). Foi possível propor uma técnica eficaz para cães baseando-se na técnica de bloqueio peribulbar posterior realizada no homem. Em ambos os grupos, o globo ocular permaneceu centralizado. Não ocorreram alterações eletrocardiográficas atribuídas ao reflexo oculocardíaco. Houve redução significativa da pressão intraocular em G1 após o bloqueio (10,7±0,6 e 14,7±0,6). Conclui-se que o bloqueio peribulbar proporcionou condições cirúrgicas apropriadas para a realização da facectomia, com a vantagem de promover bloqueio sensitivo do olho. Abstract in english A peribulbar block technique was developed and its clinical efficacy was compared with neuromuscular blockade in dogs undergoing cataract surgery. Twelve dogs of different breeds were randomly and equally allocated in two groups. After given acepromazine (0.05mg/kg, IV), anesthesia was induced with [...] propofol (5mg/kg, IV) and maintained with isoflurane in oxygen during spontaneous breathing. A peribulbar block with 0.75% ropivacaine was performed in G1 dogs while partial neuromuscular blockade with pancuronium (0.01mg/kg IV) was provided in G2 dogs. Globe position scores, oculocardiac reflex, and intra-ocular pressure (mmHg) were evaluated at pre-defined intervals during surgery. Peribulbar blocks were successful performed according to posterior peribulbar block described in humans. In both groups, the globe was centralized and globe position scores did not differ between groups. The intra-ocular pressure was significantly lower in G1 after the block (10.7±0.6 vs 14.7±0.6). There were no electrocardiographycal changes attributed to the oculocardiac reflex. In conclusion, satisfactory surgical conditions were provided by the peribulbar block. This technique can be used as an alternative to the use of neuromuscular blocking agents in dogs undergoing cataract surgery, with the advantage of providing analgesia of the eye.

  10. Factores de riesgo ocular y experiencia del cirujano en las complicaciones de la cirugía de catarata / Ocular risk factors and the surgeon's experience to manage complications in the cataract surgery

    Scientific Electronic Library Online (English)

    Olga Beatriz, Mijenez Villate; Silvia, Martínez Quintana; Vivian, Aguilar González; Yaíma, Rodríguez Ricardo; Sara, Santos Veja; José Manuel, Sanjurjo Villate.

    2014-06-01

    Full Text Available Objetivo: determinar influencia de factores de riesgo ocular y experiencia del cirujano en las complicaciones de 158 pacientes operados de catarata en el Centro Oftalmológico de Holguín entre abril y octubre de 2010. Métodos: se realizó un estudio descriptivo de corte transversal donde se analizaron [...] variables como edad, sexo, factores de riesgo ocular, complicaciones transoperatorias y posoperatorias inmediatas relacionadas con factores de riesgo y experiencia del cirujano. Resultados: el grupo de edad que predominó fue el de 70-79 años con 38,6 % y el sexo femenino en 58,8 %. El factor de riesgo más frecuente fue la madurez e hipermadurez del cristalino en 51,2 %. La complicación transoperatoria que más incidió fue la ruptura de cápsula posterior con pérdida de vítreo en 8,2 % relacionada con madurez del cristalino y pupila pequeña. El edema corneal constituyó la complicación posoperatoria inmediata que predominó en 6,3 % relacionada fundamentalmente con pupila insuficiente y catarata madura. En la cirugía realizada por residentes predominaron las complicaciones en 15,8 %. Conclusiones: la intervención de cataratas en etapas de madurez e hipermadurez asociada a pupilas insuficientes expuso a estos ojos a un riesgo mayor de ruptura de cápsula posterior con o sin pérdida de vítreo y al edema corneal. La cirugía de catarata en pacientes con factores de riesgo oculares fue más propensa a complicaciones cuando la realizaron residentes y oftalmólogos con menos entrenamiento y experiencia. Abstract in english Objective: to determine the influence of ocular risk factors and the surgeon's experience on complications affecting 158 patients operated on for cataract at the Ophthalmologic Center in Holguin from April to October, 2010. Methods: cross-sectional descriptive study in which variables such as age, s [...] ex, ocular risk factors, immediate transoperative and postoperative complications related to risk factors and the surgeon's experience were analyzed. Results: the 70-79 years-old group prevailed with 38,6 %, and the females accounted for 58,8 % in the group. The most frequent risk factors were the maturity and hypermaturity of the crystalline lens in 51,2 % of cases. The transoperative complication that mostly affected the patients was the rupture of the posterior capsule with vitreous loss in 8,2 % of cases, associated with maturity of the crystalline lens and the small pupil. The corneal edema represented the predominant immediate postoperative complication in 6,3 % of cases, due to insufficient pupil and mature cataract. The complications were more frequent in surgeries performed by residents in 15,8 % of patients. Conclusions: operating cataracts at maturity and hypermaturity stages due to insufficient pupils meant higher risk of the posterior capsule rupture with or without vitreous loss and of corneal edema. Cataract surgery in patients with ocular risk factors was proner to complications when they are performed by residents or by ophthalmologists with less training and experience in this field.

  11. Refractive results of cataract surgery using optical biometry and Haigis formula in eyes with refractive keratotomy / Resultado refracional da cirurgia de catarata utilizando biômetro óptico e fórmula Haigis em olhos com ceratotomia refrativa

    Scientific Electronic Library Online (English)

    Juan Carlos Sánchez, Caballero; Virgilio, Centurion.

    2013-04-01

    Full Text Available OBJETIVO: Analisar os resultados refracionais no pós-operatório de cirurgia de catarata em olhos previamente submetidos à ceratotomia, utilizando a fórmula Haigis e os dados fornecidos pelo biômetro óptico IOL Master®. MÉTODOS: As medidas para o cálculo da LIO foram obtidas por meio da biometria ópt [...] ica por interferometria de coerência parcial (IOL Master® - Zeiss, versão 5.4 e 5.5) que nos fornece o comprimento axial, a ceratometria central de 2.5mm, o diâmetro branco-a-branco e a profundidade anatômica da câmara anterior. A fórmula escolhida foi a Haigis. A técnica cirúrgica aplicada foi com incisão escleral a 1.5mm do limbo, com túnel esclero-corneal de 2.2mm de largura, facoemulsificação com equipamento INFINITI Ozil® - Alcon e implante de lente intraocular acrílica hidrofóbica asférica - SN60WF® - Alcon. RESULTADOS: Foram estudados 20 olhos submetidos à ceratotomia no passado e atualmente portadores de catarata com indicação de facectomia com implante de lente intraocular por meio da facoemulsificação. O equivalente esférico pós-operatório foi plano em 40% dos olhos e menor que -1.00 em 85% dos olhos. CONCLUSÃO: A biometria óptica por interferometria de coerência parcial associada à fórmula Haigis se apresenta como uma alternativa válida no cálculo da LIO em olhos submetidos à ceratotomia. Os resultados refrativos são altamente previsíveis e reproduzíveis. Abstract in english OBJECTIVE: To analyze refractive results in postoperative cataract surgery in eyes previously submitted to keratotomy using Haigis formula and data provided by IOL Master®optical biometer. METHODS: The measurements for IOL calculation were obtained through optical biometry by partial coherence inter [...] ferometry (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.

  12. Unique advantage of gonioscopy for viewing an anterior pyramidal cataract.

    Science.gov (United States)

    Bitton, Etty

    2001-11-01

    Anterior polar cataracts (APC) are a relatively rare but well-documented form of congenital cataract. Occasionally, these white disc-shaped opacities protrude towards the anterior chamber with an inverse cone-like morphology and are known as anterior pyramidal cataracts. These represent three to four per cent of all types of congenital cataracts. APCs portray a dominant mode of inheritance and generally do not progress over time. Due to their small size, APCs generally have little effect on vision and are simply monitored clinically. Photodocumentation of pyramidal cataracts has traditionally shown biomicroscopic views of the opacities. In addition to a review of APC, this report describes how a gonioscope offers a unique observational advantage in viewing an anterior pyramidal cataract. PMID:12366362

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

    LENUS (Irish Health Repository)

    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