WorldWideScience

Sample records for cataract surgery review

  1. Cataract Surgery

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Rajiv Khandekar

    2015-01-01

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

  3. Small incision cataract surgery: Complications and mini-review

    Directory of Open Access Journals (Sweden)

    Gogate Parikshit

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Majid Moshirfar

    2011-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  6. Small incision cataract surgery: Complications and mini-review

    OpenAIRE

    Gogate Parikshit

    2009-01-01

    This article reviews the literature on manual small incision cataract surgery (MSICS) and its complications. Various articles on MSICS published in indexed journals were reviewed, as well as the sections on complications of MSICS. The Pubmed search engine on the Internet was used to find out articles published since 1985 on MSICS in any language in indexed journals. Books published by Indian authors and the website of Indian Journal of Ophthalmology were also referred to. MSICS has become ver...

  7. Cataract surgery - series (image)

    Science.gov (United States)

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

  8. Cataract Surgery

    Science.gov (United States)

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

  9. 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 PubMed...

  10. Risk of Fungal Endophthalmitis Associated with Cataract Surgery: A Mini-Review.

    Science.gov (United States)

    Smith, Tonya C; Benefield, Russell J; Kim, Jong Hun

    2015-12-01

    Fungal endophthalmitis is a rare complication after cataract surgery and is associated with significant morbidity including vision loss. The common causative fungal pathogens implicated in fungal endophthalmitis after cataract surgery include Candida species (spp.) and molds such as Aspergillus spp. and Fusarium spp. Early diagnosis and effective antifungal treatment after a high index of clinical suspicion are required to reduce unfavorable complications and to preserve eye function. This review discusses epidemiology, pathogenesis, clinical features, diagnosis, management, and outcomes associated with fungal endophthalmitis after cataract surgery. PMID:26318595

  11. Cataract Surgery to Lower Intraocular Pressure

    OpenAIRE

    Berdahl John

    2009-01-01

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

  12. Surgery for Congenital Cataract

    OpenAIRE

    David Yorston FRCS FRCOphth

    2004-01-01

    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.

  13. Advances in hard nucleus cataract surgery

    Directory of Open Access Journals (Sweden)

    Wei Cui

    2013-11-01

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

  14. Femtosecond laser cataract surgery.

    Science.gov (United States)

    Nagy, Zoltan Z; McAlinden, Colm

    2015-01-01

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

  15. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  16. 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.

  17. 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

  18. Cataract Surgery Tool

    Science.gov (United States)

    1977-01-01

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

  19. Cataract surgery and quality of life implications

    OpenAIRE

    Morris, Daniel; Fraser, Scott G; Gray, Christopher

    2007-01-01

    Cataract surgery in the developed world has undergone a revolution over the last 20 years. An operation which used to require a stay in hospital and long visual rehabilitation is now a quick day-case procedure with immediate benefits. As with any surgery there is an associated morbidity, but there is now the potential to provide cataract surgery at an earlier stage of cataract maturation and save patients from a period of severe visual impairment. This article reviews the new techniques avail...

  20. Bimanual microincisional cataract surgery technique and clinical outcome

    OpenAIRE

    Al-Muammar, Abdulrahman

    2009-01-01

    Bimanual microincisional cataract surgery has been introduced recently as a technique for cataract surgery and it is gaining interest of many cataract surgeons in the world. Over the last few years many changes were made in the phacoemulsification machines and the intraocular lenses design which allowed bimanual microincisional cataract surgery to be safer and more efficient. The purpose of this review is to introduce the technique of bimanual microincisional cataract surgery and to review al...

  1. Immediate Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis

    Science.gov (United States)

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

    2015-01-01

    The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient. PMID:26351576

  2. [Postoperative care after cataract surgery].

    Science.gov (United States)

    Cordes, Andreas K; Degenring, Robert F; Schrage, Norbert F

    2012-04-01

    The postoperative treatment of cataract surgery is an important element for success of the surgery. The postoperative therapy primarily aims at the prevention of intraocular bacterial infection by administration of antibiotics. Anti-inflammatory drugs can suppress the operation-related inflammation. In addition to fundamental risks of topical eye drop application, this review article discusses the current therapeutic strategies for the prevention of postoperative bacterial infection and suppression of surgically induced inflammation. PMID:22582516

  3. 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.

  4. Paediatric cataract implant surgery outcome

    OpenAIRE

    Istiantoro Istiantoro

    2003-01-01

    This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1). 2. Extracapsular cataract extraction with intraocular lens i...

  5. Recent advances in congenital cataract surgery

    Directory of Open Access Journals (Sweden)

    Zhou Zhou

    2014-11-01

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

  6. Pediatric Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Farid Karimian

    2008-12-01

    Full Text Available

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

  7. Cataract Surgery in Eyes with Shallow Anterior Chamber

    OpenAIRE

    Hüseyin Bayramlar; Remzi Karadağ; Ünsal Sarı

    2014-01-01

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

  8. Daily tonometric curves after cataract surgery

    OpenAIRE

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

    2001-01-01

    AIM—To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma.?METHODS—108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primary open angle glaucoma (POAG). All patients underwent extracapsular cataract extraction (ECCE) (manual technique with long wound), phacoemulsification (automated technique with short wound), or nucl...

  9. Cataracts

    Science.gov (United States)

    ... Risk for Cataracts? Cataract Causes Cataract Diagnosis Cataract Treatment Cataract Surgery IOL Implants: Lens Replacement Cataract Vision Simulator ... make cataracts go away—surgery is the only treatment. The top lens is ... lens shows clouding by cataract. A cataract may not need to be removed ...

  10. 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

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

    Science.gov (United States)

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

  12. [Keratoplasty combined with cataract surgery].

    Science.gov (United States)

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

    2012-09-01

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

  13. 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.

  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. Outcome after surgery of congenital cataract

    OpenAIRE

    Lundvall, Anna

    2002-01-01

    The visual outcome in infants undergoing surgery for bilateral congenital cataract has improved considerably because of improved surgical methods and the realisation that early detection, allowing early cataract extraction and immediate optical correction, can prevent otherwise irreversible deprivation amblyopia. The management of unilateral congenital cataract is still of the most difficult problems in paediatric ophtalmology. In unilateral congenital cataract, interven...

  16. Paediatric cataract implant surgery outcome

    Directory of Open Access Journals (Sweden)

    Istiantoro Istiantoro

    2003-03-01

    Full Text Available This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1. 2. Extracapsular cataract extraction with intraocular lens implantation and posterior capsulorhexis (PCCC and optic capture which was performed on 24 eyes (group 2. 3. Extracapsular cataract extraction with intra­ocular lens implantation, posterior capsulorhexis and anterior vitrectomy which was performed on 24 eyes (group 3. All patients were followed up more than one year. Our results showed that posterior capsule opacity (PCO was developed in 20 eyes with intact capsules in group 1. All eyes had a clear visual axis in group 2. PCO developed only in one eye in group 3. In conclusion,  PCCC and optic capture with or without anterior vitrectomy are effective methods in preventing PCO in infant and children. (Med J Indones 2003; 12: 21-6Keywords: posterior capsule opacification, posterior capsulorhexis, optic capture, anterior vitrectomy

  17. Cataract surgery after Descemet stripping endothelial keratoplasty

    OpenAIRE

    Chaurasia, Sunita; Ramappa, Muralidhar; Sangwan, Virender

    2012-01-01

    Management of endothelial dysfunction in phakic patients is sometimes a dilemma for corneal surgeons. Phakic patients with visually significant cataract and endothelial dysfunction are preferably managed by performing combined cataract surgery with endothelial keratoplasty. However, combined surgery may be deferred in eyes with early incipient cataract, younger age and where anterior chamber is poorly visualized. As cataract formation may be accelerated after endothelial keratoplasty, these e...

  18. Managing residual refractive error after cataract surgery.

    Science.gov (United States)

    Sáles, Christopher S; Manche, Edward E

    2015-06-01

    We present a review of keratorefractive and intraocular approaches to managing residual astigmatic and spherical refractive error after cataract surgery, including laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), arcuate keratotomy, intraocular lens (IOL) exchange, piggyback IOLs, and light-adjustable IOLs. Currently available literature suggests that laser vision correction, whether LASIK or PRK, yields more effective and predictable outcomes than intraocular surgery. Piggyback IOLs with a rounded-edge profile implanted in the sulcus may be superior to IOL exchange, but both options present potential risks that likely outweigh the refractive benefits except in cases with large residual spherical errors. The light-adjustable IOL may provide an ideal treatment to pseudophakic ametropia by obviating the need for secondary invasive procedures after cataract surgery, but it is not widely available nor has it been sufficiently studied. PMID:26096522

  19. Simulation-based certification for cataract surgery

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  20. 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

  1. Manual small incision cataract surgery in eyes with white cataracts

    OpenAIRE

    Venkatesh Rengaraj; Das Manoranjan; Prashanth Sadasivam; Muralikrishnan Radhakrishnan

    2005-01-01

    PURPOSE: To assess the safety and efficacy of Manual Small Incision Cataract Surgery (MSICS) in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorthexis (CCC). MATERIALS AND METHODS: Prospective observational study on 100 consecutive eyes of 100 patients with white cataract who had undergone MSICS with trypan blue assisted CCC. The nucleus was prolapsed into anterior chamber by using a sinskey hook and extracted out of the eye u...

  2. Effect of cataract surgery on regulation of circadian rhythms

    DEFF Research Database (Denmark)

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

    2015-01-01

    UNLABELLED: This review looked at the effect of cataract surgery on the regulation of circadian rhythms and compared the effect of blue light-filtering and clear intraocular lenses (IOLs) on circadian rhythms. A systematic review and metaanalysis were performed, and the level of evidence was...... Trials web site. Trials that reported the effect of cataract surgery on circadian rhythms were included. Outcomes were the Pittsburgh Sleep Quality Index (PSQI) global score, number of poor sleepers, Epworth Sleepiness Score, sleep efficiency, and mean concentration of melatonin. Cataract surgery...

  3. Recombinant tissue plasminogen activator following paediatric cataract surgery

    OpenAIRE

    Mehta, J.; Adams, G.

    2000-01-01

    BACKGROUND—The use of recombinant tissue plasminogen activator (r-TPA) has been advocated in the treatment of postsurgical fibrinous membrane formation following cataract surgery in adults. Its use in paediatric cases is not well documented.?METHOD—A retrospective review of paediatric cataract extractions performed at Moorfields Eye Hospital between 1 January 1997 and 4 April 1999 was carried out.?RESULTS—Cataract extractions were performed in 37 patients, 22 in males 15 in females. Four (9.2...

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

    Science.gov (United States)

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

    2016-02-01

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

  5. Glaucoma after Congenital Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Mahmoodreza Panahi Bazaz

    2014-05-01

    Full Text Available Purpose: To determine the incidence and risk factors associated with glaucoma following congenital cataract surgery (CCS in children under age of 15 Methods: This prospective cohort (since 2006 consisted of children less than 15 years of age who underwent cataract surgery with or without intraocular lens (IOL implantation. The role of the following factors on the development of glaucoma after CCS including age at surgery, gender, laterality of the cataract, IOL implantation, congenital ocular anomalies, intra- and postoperative complications, length of follow-up, central corneal thickness (CCT as well as the effect of the age of onset, time to development of glaucoma, and response to treatment were evaluated. Results: Overall, 161 eyes of 96 patients were included in this study of which 28 eyes developed glaucoma. Incidence of glaucoma was 17.4%. Mean±SD age at surgery was 9.3±6.9 (range, 1-24 months in glaucomatous and 40.4±41.1 (range, 1 m-13.6 year months in non-glaucomatous group (p<0.001. All glaucoma patients had the operation under two years of age. In group 1, 9 (60% and in group 2, 24 (30% patients were female (p=0.001. In group 1, 17 eyes (60.7% and in the group 2, 41 eyes (30.8% were aphakic (p=0.001. Mean time to diagnosis of glaucoma was 111.2 days (range 30-1200 days. Mean follow-up time was 3.1 years (range, 1-6 years. In 22 (78.6% eyes glaucoma was diagnosed within six months after surgery. Glaucoma was controlled with medications in 23 eyes (82% and with surgery in five eyes. Conclusion: In this study the incidence of glaucoma after CCS was 17.4% over a follow-up period of six years. Younger age at the time of lensectomy increases the risk of secondary glaucoma. IOL implantation may protect against glaucoma. Female gender was affected more than male.

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

    OpenAIRE

    Bunce Catey; Michaelides Michel; Adams Gillian GW

    2007-01-01

    Abstract Background To determine the rate of glaucoma following congenital cataract surgery at Moorfields Eye Hospital (MEH), and to investigate potential risk factors for glaucoma in our case series. Methods A retrospective case notes review was undertaken of all congenital cataract lensectomies performed at MEH between 1994 and 2000. The following parameters were ascertained: age at surgery, unilateral or bilateral cataract, whether a posterior capsulotomy (PC) was performed at the time of ...

  7. New technology update: femtosecond laser in cataract surgery

    OpenAIRE

    Nagy ZZ

    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...

  8. Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery

    OpenAIRE

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

    2010-01-01

    PURPOSE: To investigate the effects of alpha-1 adrenergic receptor antagonists for the treatment of benign prostatic hyperplasia (BPH) regarding potential risks of complications in the setting of cataract surgery. AIM: To address recommendations, optimal control therapy, voiding symptoms and safety within the setting of cataract surgery. MATERIALS AND METHODS: A comprehensive literature review was performed using MEDLINE with MeSH terms and keywords "benign prostatic hyperplasia", "intraopera...

  9. Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery

    Scientific Electronic Library Online (English)

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

    2010-10-01

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

  10. 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.

  11. Simultaneous pterygium and cataract surgery.

    OpenAIRE

    Gulani A; Dastur Y

    1995-01-01

    In our country both pterygium and cataract have a high incidence. Hence in this study, thirty patients with pterygium and cataract were treated with a simultaneous pterygium excision and cataract extraction procedure. These patients after pterygium excision were treated intra-operatively with 500 rads of beta radiation over the pterygium site. Then, the cataract was extracted and the patients were treated post-operatively with topical betamethasone 0.1% for a duration of three months. ...

  12. 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.

  13. Manual small incision cataract surgery in eyes with white cataracts

    Directory of Open Access Journals (Sweden)

    Venkatesh Rengaraj

    2005-01-01

    Full Text Available PURPOSE: To assess the safety and efficacy of Manual Small Incision Cataract Surgery (MSICS in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorthexis (CCC. MATERIALS AND METHODS: Prospective observational study on 100 consecutive eyes of 100 patients with white cataract who had undergone MSICS with trypan blue assisted CCC. The nucleus was prolapsed into anterior chamber by using a sinskey hook and extracted out of the eye using irrigating vectis. Intraoperative and postoperative findings (according to OCTET classification as well as postoperative visual outcomes were used as main measures to report the safety and efficacy of the surgery. RESULTS: Of the 100 eyes, 16 had intumescent, 67 had mature and 17 had hypermature cataract. Intraoperatively CCC was incomplete in 4 eyes (4% and had to be converted to canopener capsulotomy. None of the eyes had posterior capsular rupture or zonular dialysis and no eyes were converted to conventional Extra Capsular Cataract Extraction (ECCE. Postoperatively, 6 eyes (6% developed corneal oedema with >10 Descemets folds and 7 eyes (7% had corneal oedema with < 10 Descemets folds. Mild iritis was seen in 6 eyes (6% and moderate iritis with fibrin membrane was seen in 3 eyes (3%. Iridodialysis was observed in 1 eye (1%. Of the 99 patients (99% categorised under good visual outcomes category, 94 patients (94% had a best-corrected visual acuity of 6/9 or better on the 40th post-operative day. CONCLUSION: In developing countries like India where phacoemulsification may not be affordable to a majority of those requiring cataract surgery, MSICS proves to be a safe and efficacious alternative for white cataracts especially with the adjunctive use of trypan blue dye.

  14. Risk of Retinal Detachment After Pediatric Cataract Surgery

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  15. Intraocular adrenaline maintains mydriasis during cataract surgery.

    OpenAIRE

    Corbett, M C; Richards, A B

    1994-01-01

    Cataract surgery is performed more easily if mydriasis can be maintained until the intraocular lens has been inserted. Intraocular irrigation with adrenaline is thought to be of benefit in this respect, and is used by some surgeons but not others. This prospective double blind controlled trial assessed the efficacy and safety of using perioperative adrenaline during extracapsular cataract surgery, as an adjunct to preoperative topical mydriatics. Seventy patients were randomised to receive in...

  16. Cataract

    Science.gov (United States)

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

  17. Intraocular lens employed for cataract surgery

    International Nuclear Information System (INIS)

    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.

  18. 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.

  19. Acute Endophthalmitis Following Cataract Surgery via Contaminated Phaco Needle

    OpenAIRE

    Bozkurt, Ä°lkay

    2014-01-01

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

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

    OpenAIRE

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

    2014-01-01

    In this article we review essentials of diagnosis and management of ocular surface disease in patients who undergo cataract surgery. It is clearly shown that dry eye disease worsens following the cataract surgery in patients with prior history of ocular surface disease, Also new cases of dry eye might appear. Current strategies for the timely diagnosis and proper management of dry eye syndrome in the face of cataract surgery patients are mainly emphasized. To achieve the best outcome in catar...

  1. 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.

  2. Posterior polar cataract: A review

    OpenAIRE

    Kalantan, Hatem

    2011-01-01

    Posterior polar cataract is a rare form of congenital cataract. It is usually inherited as an autosomal dominant disease, yet it can be sporadic. Five genes have been attributed to the formation of this disease. It is highly associated with complications during surgery, such as posterior capsule rupture and nucleus drop. The reason for this high complication rate is the strong adherence of the opacity to the weak posterior capsule. Different surgical strategies were described for the handling...

  3. Prevention of complications in pediatric cataract surgery

    OpenAIRE

    Kugelberg, Maria

    2004-01-01

    This thesis was performed to find ways to lessen the complications to pediatric cataract surgery, which is an increasingly safe procedure, also in infants. However, there are some complications to the surgery, which threatens the visual development. The most common complication is aftercataract. The most feared complication is secondary glaucoma, which is hard to manage, and can lead to blindness and a cosmetically disturbing eye. The younger the infant is at surgery, the hi...

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

    OpenAIRE

    Ahmed A. Abdelghany; Alio, Jorge L

    2014-01-01

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

  5. Partially coherent interferometric biometry in cataract surgery

    Science.gov (United States)

    Drexler, Wolfgang; Findl, Oliver; Menapace, Rupert; Hitzenberger, Christoph K.; Fercher, Adolf F.

    1999-02-01

    In an earlier study we showed that precise axial eye length measurement on cataract eyes is possible with the dual beam partial coherence interferometry technique (PCI). A high correlation with the standard ultrasound technique has been obtained. Recently, in a prospective study, partially coherent interferometry and ultrasound biometry were compared in cataract surgery using the SRK II formula based on US applanation biometry. Three months after surgery PCI was repeated and refractive outcome was determined. The use of PCI would have improved refractive outcome by about 30%.

  6. Outsourced cataract surgery and postoperative endophthalmitis

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  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. Outsourced cataract surgery and postoperative endophthalmitis

    DEFF Research Database (Denmark)

    Solborg Bjerrum, SØren; Kiilgaard, Jens F

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-04-01

    The number of people coming for cataract surgery in Madagascar remains low and most ophthalmologists could do many more surgeries than currently done. Knowing why people identified with cataract do not accept surgery will help to design programs that use existing resources more effectively. The study was carried out in Sava Region of Madagascar. People with blinding (cataract were identified by cataract case finders in the community, interviewed, and given a referral card for surgery at the hospital. We then monitored uptake of surgery at the hospital. Overall, 142 people were identified, interviewed and referred. Among the referrals, 35 (24.6%) presented at the hospital for surgery. The most important factors associated with acceptance were proximity to hospital (people from Sambava district were twice as likely to present as people from more distant districts) and perceived price of transport and food (being higher for people not accepting). The actual price of surgery was not the main barrier to acceptance of surgery; instead it appears that distance to the hospital and the willingness to pay are important predictors. Strategies to improve uptake need to be revised in order to ensure that people have access to and use cataract surgical services. PMID:22430293

  12. 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

  13. Small incision cataract surgery: tips for avoiding surgical complications

    OpenAIRE

    Reeta Gurung; Albrecht Hennig

    2008-01-01

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

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

    Science.gov (United States)

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

    2014-07-01

    In this article we review essentials of diagnosis and management of ocular surface disease in patients who undergo cataract surgery. It is clearly shown that dry eye disease worsens following the cataract surgery in patients with prior history of ocular surface disease, Also new cases of dry eye might appear. Current strategies for the timely diagnosis and proper management of dry eye syndrome in the face of cataract surgery patients are mainly emphasized. To achieve the best outcome in cataract surgery, a healthy ocular surface is crucial. While ocular surface preparation is indispensable in patients with established ocular surface disease, it is also helpful in those with minimal signs or symptoms of surface disease. The current approach begins with early diagnosis and drastic management of ocular surface disease before cataract surgery using a stepwise regimen customized to each patient and disease severity. These measures are continued throughout and after the surgery. PMID:25278791

  15. 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)

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

    OpenAIRE

    Singh, Ajay; Strauss, Glenn H.

    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-ba...

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

    DEFF Research Database (Denmark)

    Bjerrum, Søren Solborg

    The main purpose of this thesis was to examine whether the Danish National Patient Registry (NPR) could be used to monitor and assess the quality of cataract surgery in Denmark by studying the risks of two serious postoperative complications following cataract surgery - retinal detachment (RD) and......-operated fellow eyes up to 10 years after cataract surgery. The epidemiology of RD in the non-operated fellow eyes was different from the epidemiology of RD in the background population as young men had the highest risk of RD in the non-operated fellow eyes. This means that the absolute risk of PRD was highest...... for young men because they had a higher risk of RD before they underwent cataract surgery. In the second study (paper II), we used data from the NPR and reviewed patient charts to assess the risk of PE after cataract surgery performed in public eye departments and private hospitals/clinics in the...

  18. 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

  19. Socioeconomic barriers to cataract surgery in Nepal: the south Asian cataract management study

    OpenAIRE

    Snellingen, T; Shrestha, B.; Gharti, M; Shrestha, J; Upadhyay, M; Pokhrel, R

    1998-01-01

    BACKGROUND—Previous studies have shown that, despite an increasing availability of cataract surgery, important socioeconomic barriers exist in the acceptance of surgery in many rural areas of south Asia. Nepal has developed a comprehensive national network of eye hospitals but the surgical coverage for the treatment of cataract blind is still low.?AIMS—To determine the utilisation of cataract surgery and the level of physical and psychosocial impairment and the socioeconomic barriers to surge...

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

    Directory of Open Access Journals (Sweden)

    Lawuyi LE

    2015-07-01

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

  1. Cataract

    OpenAIRE

    Allen, David

    2011-01-01

    Cataracts are cloudy or opaque areas in the lens of the eye that can impair vision. Age-related cataracts are defined as those occurring in people >50 years of age, in the absence of known mechanical, chemical, or radiation trauma. Cataract accounts for over 47% of blindness worldwide, causing blindness in about 17.3 million people in 1990.Surgery for cataract in people with glaucoma may affect glaucoma control.There is contradictory evidence about the effect of cataract surgery on the dev...

  2. Cataract

    OpenAIRE

    Allen, David

    2008-01-01

    Cataracts are cloudy or opaque areas in the lens of the eye that can impair vision. Age-related cataracts are defined as occurring in people over 50 years of age, in the absence of known mechanical, chemical, or radiation trauma. Cataract accounts for over 47% of blindness worldwide, causing blindness in about 17.3 million people in 1990.Surgery for cataract in people with glaucoma may affect glaucoma control.

  3. The Tear Osmolarity Changes After Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Banu Öncel

    2012-01-01

    Full Text Available Pur po se: To determine the tear osmolarity changes in patients who had undergone phacoemulsification surgery. Ma te ri al and Met hod: Tear osmolarity measurements were performed in 30 eyes of 30 patients who had undergone cataract surgery without any complication. Measurements were performed before surgery and consecutively at 1st month, 3rd month, and 6th month after the surgery. TearLab osmometer (TearLab Corporation, San Diego, CA, USA device was used for the measurements and paired ttest was used for statistical analysis. Re sults: The mean age of the patients was 72.3±3.7 (67-78 years. Thirteen patients were men and 17 patients were women. The mean osmolarity values were 305.8±6.5 mOsm/L before the surgery and 312.3±6.4 mOsm/L at 1st month, 307.5±5.1 mOsm/L at 3rd month and 305.1±5.7 at 6th month after the surgery. The difference between the values before surgery and at 1st month was found statistically significant (p=0.001. Dis cus si on: The tear osmolarity increases at the first month after surgery but decreases to the levels measured before surgery at the 3rd month. The increase at the first month may be due to the corneal incisions and medication used after the surgery. We think that we have to take into account this similarity increase in all cataract patients, especially in those who also have dry eye disease. (Turk J Ophthalmol 2012; 42: 35-7

  4. The pattern of cataract surgery in India: 1992

    OpenAIRE

    Gupta A; Ellwein Leon

    1995-01-01

    Surgery for cataract blindness, a major health problem, is undergoing a rapid transition. This study characterizes cataract surgery in India in terms of practice setting and surgical procedure. A survey questionnaire was mailed in December 1992 to 4356 members of the All India Ophthalmological Society, resident in India, requesting data on cataract surgery cases within the past 12 months. Two thousand one hundred thirty-four (49%) ophthalmologists responded to the survey. Of the 1,023,...

  5. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    OpenAIRE

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

    2007-01-01

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

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

    Science.gov (United States)

    Ogawa, Tomoichiro; Shiba, Takuya; Tsuneoka, Hiroshi

    2016-01-01

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

  7. Outcomes of Cataract Surgery in Vitrectomized Eyes

    Directory of Open Access Journals (Sweden)

    Nilüfer Koçak

    2013-01-01

    Full Text Available Pur po se: To evaluate the intraoperative complications and postoperative visual outcomes of phacoemulsification surgery for the secondary cataract in vitrectomized eyes. Ma te ri al and Met hod: We retrospectively evaluated 51 previously vitrectomized eyes of 51 patients who had undergone phacoemulsification and intraocular lens (PHACO+IOL implantation surgery. PHACO+IOL surgery was performed in our clinic between October 2008 and May 2011. Intraoperative complications and postoperative best-corrected visual acuity (BCVA outcomes were analyzed. Re sults: In this study, 31 out of 51 eyes had posterior subcapsular cataract. Cataract surgery was performed after a mean of 21.39±26.4 (6- 120, median 10.75 months following PPV. Mean preoperative and postoperative BCVA was measured to be 1.52±0.88 logMAR and 0.74±0.73 logMAR, respectively. In 25 eyes which had been filled with silicon oil, mean BCVA was 1.95±0.91 logMAR preoperatively and 1.15±0.84 logMAR postoperatively. In 18 (35.3% eyes which had been filled with sulfur hexafluoride tamponade, mean BCVA was 1.17±0.47 logMAR preoperatively and 0.38±3.6 logMAR postoperatively. Peroperative zonular dialysis with instable deep anterior chamber occurred in two eyes, and posterior capsular tear occurred in one eye. Four eyes had Nd:YAG capsulotomy due to the posterior capsular opacity during the follow-up period. Dis cus si on: Despite the well-known difficulties encountered in vitrectomized eyes such as zonular weakness, increased mobility of the lens-iris diaphragm, posterior capsular instability and posterior capsular plaques, phacoemulsification in vitrectomized eyes proved to be a safe surgery, and increase in visual acuity can be achieved. (Turk J Ophthalmol 2013; 43: 23-6

  8. 42 CFR 1001.1701 - Billing for services of assistant at surgery during cataract operations.

    Science.gov (United States)

    2010-10-01

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

  9. Changing trends in barriers to cataract surgery in India.

    OpenAIRE

    Vaidyanathan, K.; Limburg, H.; Foster, A; Pandey, R. M.

    1999-01-01

    Cataract is a major cause of blindness in Asia. Efforts in India to provide cataract surgical services have had limited success in reaching the cataract-blind population. Earlier studies identified the major barriers to cataract surgery as poverty, lack of transportation or felt need, or sex related; and the critical barriers in rural areas as lack of awareness, difficult access, and cost. Compared with these earlier data, the results of the present study in Karnataka State indicate a shift i...

  10. VISUAL OUTCOME FOLLOWING SURGERY OF TRAUMATIC CATARACT

    Directory of Open Access Journals (Sweden)

    Prasad Rao

    2015-04-01

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

  11. Posterior polar cataract: A review.

    Science.gov (United States)

    Kalantan, Hatem

    2012-01-01

    Posterior polar cataract is a rare form of congenital cataract. It is usually inherited as an autosomal dominant disease, yet it can be sporadic. Five genes have been attributed to the formation of this disease. It is highly associated with complications during surgery, such as posterior capsule rupture and nucleus drop. The reason for this high complication rate is the strong adherence of the opacity to the weak posterior capsule. Different surgical strategies were described for the handling of this challenging entity, most of which emphasized the need for gentle maneuvering in dealing with these cases. It has a unique clinical appearance that should not be missed in order to anticipate, avoid, and minimize the impact of the complications associated with it. PMID:23960967

  12. Visual experience during phacoemulsification cataract surgery under topical anaesthesia

    OpenAIRE

    Newman, D

    2000-01-01

    BACKGROUND/AIMS—Visual awareness during phacoemulsification cataract surgery is an important determinant of patient satisfaction with any anaesthetic technique. Topical anaesthesia could be associated with significant visual awareness because it does not affect optic nerve function.?METHODS—The visual experience during phacoemulsification cataract surgery under topical anaesthesia (without sedation) was assessed for 106 consecutive unselected patients. Patients were interviewed immediately af...

  13. The Effect of Cataract Surgery on Circadian Photoentrainment

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: Cataract decreases blue light transmission. Because of the selective blue light sensitivity of the retinal ganglion cells governing circadian photoentrainment, cataract may interfere with normal sleep-wake regulation and cause sleep disturbances. The purpose was to investigate the effect...... of cataract surgery on circadian photoentrainment and to determine any difference between blue-blocking and neutral intraocular lenses (IOLs). DESIGN: The study was a single-center, investigator-driven, double-masked, block-randomized clinical trial. PARTICIPANTS: One eye in 76 patients with...... bilateral age-related cataract eligible for cataract surgery was included. METHODS: Intervention was cataract surgery by phacoemulsification. Patients were randomized to receive a blue-blocking or neutral IOL. MAIN OUTCOME MEASURES: Primary outcome was activation of intrinsic photosensitive ganglion cells...

  14. Microbiologic spectrum and susceptibility of isolates in delayed post-cataract surgery endophthalmitis

    OpenAIRE

    Jindal, Animesh; Pathengay, Avinash; Jalali, Subhadra; Mathai, Annie; Pappuru, Rajeev Reddy; Narayanan, Raja; Chhablani, Jay; Sharma, Savitri; Das, Taraprasad; Flynn, Harry W

    2015-01-01

    The objective of this study was to evaluate the microbiological spectrum and antimicrobial susceptibility of isolates in delayed post-cataract surgery endophthalmitis. A retrospective review of 33 consecutive patients with culture proven delayed post-cataract surgery endophthalmitis was done from January 2006 to March 2013. There were 22 bacterial and eleven fungal cases. Common isolates were Streptococci (seven cases), coagulase-negative staphylococci (five), Gram-negative bacilli (seven), N...

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

    OpenAIRE

    Baltussen Rob; Sylla Mariame; Mariotti Silvio P.

    2004-01-01

    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 operative 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 primar...

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

    OpenAIRE

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

    2013-01-01

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

  17. Causes of low vision after small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Pei-Pei Zhou

    2013-11-01

    Full Text Available AIM: To investigate the causative factors of low vision after small incision cataract surgery. METHODS: A retrospective study was made of 291 cataract patients(291 eyeswho received small incision cataract surgery combined with intraocular lens implantation from July 2011 to July 2012. Best corrected vision lower than 0.3 was diagnosed as low vision, and its causes were analyzed. RESULTS: After surgery, low vision was diagnosed in 49 eyes. Of these cases, 17(34.7%were due to surgical complications and 32(65.3%were due to preoperative conditions, including age-related macular degeneration(8 eyes, diabetic retinopathy(14 eyes, high myopia(6 eyesand other diseases(4 eyes. CONCLUSION: In our study, presence of diseased conditions before surgery is the most important cause of low vision after small incision cataract surgery. Close examination before surgery can improve the predictability of the surgery.

  18. Visual outcome following cataract surgery in rural punjab.

    OpenAIRE

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

    2000-01-01

    In a cluster sample survey in rural areas of Punjab visual outcome after cataract surgery was assessed. Three hundred patients (428 cataract operated eyes) were included in the study from 24 sampled villages. The mean age at cataract extraction was 61.70 +/- 9.82 years. The average interval since the cataract surgery was 7.05 +/- 5.86 years (range 0.11-32 years). Of the 428 operated eyes, 72 (16.82%) were blind (VA < 3/60), 162 (37.85%) had low visual acu...

  19. Results of cataract surgery in young children in east Africa

    OpenAIRE

    YORSTON, D.; Wood, M.; Foster, A

    2001-01-01

    BACKGROUND—Cataract is the leading cause of blindness in children in east Africa. The results of surgery are poor, partly because of inadequate correction of aphakia.?METHODS—A retrospective survey of 118 eyes in 71 children with bilateral cataract. All eyes had implantation of an IOL at the time of cataract surgery. The average age at surgery was 3.5 years. 28 patients(39%) were less than 2 years old at the time of surgery on their first eye.?RESULTS—Preoperatively, 75.4% of eyes and 76.1% o...

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

    OpenAIRE

    Joshi RS

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bunce Catey

    2007-09-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

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

    OpenAIRE

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

    2007-01-01

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

  6. Modified Small Incision Cataract Surgery and Intraocular Lens Implantation in HIV Patients

    Science.gov (United States)

    Giles, Kagmeni; Domngang, Christelle; Nguefack-Tsague, Georges; Come, Ebana Mvogo; Wiedemann, Peter

    2015-01-01

    AIM To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. METHODS We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. Student’s paired t-test was carried out to compare continuous variables, and P-values <0.05 were considered statistically significant. RESULTS Twenty patients were included in the study, 13 males (65%) and seven females (35%). The mean age was 46.3 ± 13.6 years (range 22–70 years). The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS (P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well (P < 0.001). CONCLUSION Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time.

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

    OpenAIRE

    Albrecht Hennig

    2003-01-01

    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, usu...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: Age-related macular degeneration (AMD) and cataract often coexist in patients and concerns that cataract surgery is associated with an increased risk of incidence or progression of existing AMD has been raised. This systematic review and meta-analysis is focused on presenting the evidence...... concerning progression of AMD in patients undergoing cataract surgery. METHODS: We performed a systematic literature search in the PubMed, Medline, Cochrane Library and CINAHL databases. Two randomized trials and two case-control trials were identified. Quality of the studies was assessed using the Cochrane...... risk of bias tool, data were extracted, and meta-analyses were performed. Quality of the available evidence was evaluated using the GRADE system. RESULTS: We found that visual acuity at 6-12 months follow-up was significantly better (6.5-7.5 letters) in eyes that had undergone cataract surgery than in...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  10. Abdominal Pain after Cataract Surgery with Remifentanil Based Anesthesia

    OpenAIRE

    Alireza Bameshki; Saeid Jahanbakhsh

    2009-01-01

    Remifentanil is an ultra short acting opioid that is suitable for many operations and is wildly used for induction and maintenance of anesthesia. In this article we have reported the incidence of abdominal pain after cataract surgery in patients with remifentanil based anesthesia. This study is a randomized single blind clinical trial on 300 patients who were candidates for elective cataract surgery under general anesthesia. Patients were randomly divided into two groups. In the control group...

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

    OpenAIRE

    Mandal Anil; Netland Peter

    2004-01-01

    Glaucoma is one of the most common causes of visual loss despite successful congenital cataract surgery. The overall incidence does not appear to have decreased with modern microsurgical techniques. The onset of glaucoma may be acute or insidious and notoriously refractory to treatment. Angle closure glaucoma may occur in the early postoperative period; but the most common type of glaucoma to develop after congenital cataract surgery is open angle glaucoma. Several risk factors have been iden...

  12. Diabetic versus non-diabetic colour vision after cataract surgery

    OpenAIRE

    Van Kessel, L.; Alsing, A.; Larsen, M.

    1999-01-01

    AIMS—To examine whether the colour vision abnormalities found in phakic patients with diabetes mellitus is preserved after removal of the lens by cataract surgery.?METHODS—21 diabetic (16 IDDM and five NIDDM) and 19 non-diabetic patients of comparable age, postoperative visual acuity, and sex distribution, all aphakic or pseudophakic following cataract surgery, had their monocular colour vision examined using the Farnsworth-Munsell 100 hue test. The fundus status of the diabetic patients rang...

  13. Changing trends in barriers to cataract surgery in India.

    Science.gov (United States)

    Vaidyanathan, K; Limburg, H; Foster, A; Pandey, R M

    1999-01-01

    Cataract is a major cause of blindness in Asia. Efforts in India to provide cataract surgical services have had limited success in reaching the cataract-blind population. Earlier studies identified the major barriers to cataract surgery as poverty, lack of transportation or felt need, or sex related; and the critical barriers in rural areas as lack of awareness, difficult access, and cost. Compared with these earlier data, the results of the present study in Karnataka State indicate a shift in the character of the barriers. They now appear to be more related to case selection and service provision. These shifts are analysed and alternative strategies to increase the uptake to cataract surgery are recommended. PMID:10083707

  14. Role of cataract surgery in lowering intraocular pressure

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Thevi Thanigasalam

    2014-08-01

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

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

    OpenAIRE

    Lindfield, Robert; Vishwanath, Kalluru; Ngounou, Faustin; Khanna, Rohit C.

    2012-01-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Baltussen Rob

    2004-01-01

    Full Text Available 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 operative 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.

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

    Science.gov (United States)

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

    2004-01-01

    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 operative 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 (1 dollar) per DALY in the WHO South-East Asia Region where there is high overall child and adult mortality to 1 dollar 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. PMID:15298224

  19. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

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    Tien-En Huang

    2007-04-01

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

  20. Sutureless Cataract Surgery: Principles and Steps

    OpenAIRE

    John Sandford-Smith

    2003-01-01

    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 ...

  1. Oxidative stress as a predictor of cataract surgery outcomes

    Directory of Open Access Journals (Sweden)

    M. A. Kovalevskaya

    2015-03-01

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

  2. Controversies in NSAIDs Use in Cataract Surgery.

    Science.gov (United States)

    Tsangaridou, Mikaella-Anthia; Grzybowski, Andrzej; Gundlach, Enken; Pleyer, Uwe

    2015-01-01

    Pseudophakic cystoid macular edema (PCME) remains the most common cause of poor visual outcome following cataract surgery. Whereas acute PCME may resolve itself spontaneously, some patients will suffer from vision impairment and will be difficult to treat. Although PCME has already been described approximately 50 years ago, its pathophysiology remains uncertain and a multitude of mechanisms have been suggested. As broad as the mechanisms, as many are the treatment options. Topical nonsteroidal anti-inflammatory agents (NSAIDs) and corticosteroids either as mono- or combined therapy are a commonly used first line approach. When ineffective, systemic treatment with these agents may be an option. Alternatively, intravitreal application of corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) may offer an effective option, if first-line treatment fails. A critical evaluation of the current literature revealed that the optimal treatment of PCME remains unclear and requires further investigation. In addition, prevention should be of foremost importance and remains an open issue. Identification of risk factors, application of NSAIDs and consequent follow-up are potential essential steps in the avoidance of this complication. PMID:26350525

  3. Investigation of cataract surgery in Leshan, Sichuan Province

    Directory of Open Access Journals (Sweden)

    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.

  4. 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

  5. Visual outcome following cataract surgery in rural punjab.

    Directory of Open Access Journals (Sweden)

    Anand R

    2000-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    surgery. To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of...... a patient has been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery....

  8. 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.

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

    OpenAIRE

    Kanthamani; Narendra P.; Prashanth; Deepankar; Nagesha

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Selçuk S?zmaz

    2013-10-01

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

  11. Orbital cellulits following cataract surgery under peribulbar anaesthesia

    OpenAIRE

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

    2015-01-01

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

  12. Effect of Cataract Surgery With Phacoemulsification on Diabetic Retinopathy

    OpenAIRE

    B?R?NC?, H.; SEZG?N, S.; OGE, I.

    2009-01-01

    To asses the influence of cataract surgery and posterior chamber intraocular lens implantation on retinopathy progression, and visual acuity in patients with different stages of diabetic retinopathy (DR). Ninety-three eyes of 76 patients with or without diabetic retinopathy were evaluated prospectively following cataract extraction with posterior chamber intraocular lens implantation between January 1995 and December 2000. The ocular findings were recorded on each follow-up visits for at l...

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

    OpenAIRE

    Udaya Kumar; Satyavathi; Khadari

    2015-01-01

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

  14. Sutureless Cataract Surgery: Principles and Steps

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

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

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Joshi RS

    2013-08-01

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

  18. Results of cataract surgery in elderly people from Jatibonico municipality.

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    Arelys Caraballo Díaz

    2012-03-01

    Full Text Available A cataract is considered a disease of great magnitude and importance due to the decrease of visual acuity it causes and because it is widespread in the world. A descriptive study was conducted in order to describe the results of cataract surgery by extracting the extracapsular lens and placing an intraocular lens in elderly people operated on at the "Camilo Cienfuegos" General Hospital in the province of Sancti Spiritus, belonging to Jatibonico municipality in the period from January 3 to December 31, 2008. The population consisted of all cataract surgery patients aged 60 and over. 187 patients. The following variables were used: sex, age, eye diseases associated complications and visual results after placing an intraocular lens. Age between 60 and 69 years (78%, and female sex (29% were predominant. Posterior capsule rupture (34% and its opacity (34% were the main intraoperative and postoperative complications. Despite complications, there was an improvement of visual acuity evident after the completion of surgery.

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

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    Newton Kara-Junior

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Application of intraocular lens in infant cataract surgery

    Directory of Open Access Journals (Sweden)

    Jin-Yan Qi

    2015-10-01

    Full Text Available Cataract extraction and the intraocular lens(IOLimplantation are the first choice to cure children cataract both domestic and overseas so far. However, IOL implantation in the eyes of children, especially in infant, has always been cared by ophthalmologists. Timely implanting IOL after the cataract extraction has played a significant role in terms of the refractive correction, the establishment of visual function, the prevention of amblyopia and the reconstruction of binocular vision. However, on the issue of IOL implantation after cataract extraction, there is always controversy on cataract treatment programs for children, and the focus of the controversy is when the IOL should be implanted. Theoretically, the principle of pediatric cataract surgery is the sooner the better, aiming to remove deprivation factor, open the visual pathway, implant IOL timely, and promote the visual development. How to find both “early” and safe IOL implantation time point is undoubtedly helpful for the rehabilitation of visual function of these children. The issues on the IOL implantation after children cataract extraction both at home and abroad are summarized below.

  2. Outcome of cataract surgery in patients with retinitis pigmentosa

    OpenAIRE

    Jackson, H.(Physics Division, Argonne National Laboratory, Argonne, Illinois, 60439-4843, USA); GARWAY-HEATH, D; Rosen, P.; Bird, A.; Tuft, S.

    2001-01-01

    AIM—To determine the visual benefit of cataract extraction in patients with retinitis pigmentosa and to identify risk factors for poor outcome.?METHODS—A retrospective analysis was undertaken of a continuous series of 142 eyes of 89 patients with retinitis pigmentosa undergoing cataract surgery between 1985 and 1997.?RESULTS—Mean age at surgery was 47.5 years (range 24-81 years). In 100 eyes there was posterior subcapsular lens opacity alone, 37 eyes also had moderate nuclear sclerosis, and f...

  3. Evolving trends in cataract surgery techniques and timing.

    Science.gov (United States)

    Koch, P S

    1997-02-01

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

  4. Results of cataract surgery in young children in east Africa

    Science.gov (United States)

    Yorston, D.; Wood, M.; Foster, A.

    2001-01-01

    BACKGROUND—Cataract is the leading cause of blindness in children in east Africa. The results of surgery are poor, partly because of inadequate correction of aphakia.?METHODS—A retrospective survey of 118 eyes in 71 children with bilateral cataract. All eyes had implantation of an IOL at the time of cataract surgery. The average age at surgery was 3.5 years. 28 patients(39%) were less than 2 years old at the time of surgery on their first eye.?RESULTS—Preoperatively, 75.4% of eyes and 76.1% of patients were blind. A follow up of at least 3 months was available in 91 (77.1%) eyes. In these eyes, 44% had a latest corrected vision of 6/18 or better and 91.2% had a latest corrected vision of 6/60 or better. Eyes with zonular cataract, and eyes operated after the age of 2 years were more likely to obtain a vision of 6/18 or better. 3.3% of eyes and 1.8% of patients had an acuity of less than 3/60. Nystagmus was present in 42.3% of patients before surgery. In those patients followed up for a minimum of 6 months, 10.2% still had nystagmus. The most frequent complication was severe fibrinous uveitis, which occurred in 36 (30.5%) eyes. 62 (52.5%) eyes had a posterior capsulotomy at the time of cataract extraction. Of the remaining 56 eyes, 20 (35.7%) had so far required a posterior capsulotomy. The leading cause of poor visual outcome was amblyopia. Two patients developed severe complications related to the intraocular lens.?CONCLUSIONS—Insertion of a lens implant at the time of cataract extraction appears to be well tolerated in the short term, and may offer significant advantages in an African setting.?? PMID:11222328

  5. Combined 23-Gauge Transconjunctival Sutureless Vitrectomy and Cataract Surgery in Cases with Cataract and Posterior Segment Diseases

    OpenAIRE

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

    2010-01-01

    Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. Settings and Design: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. Materials and Methods: In this study, 28 eyes of 28 patients underwent combine...

  6. The effect of cataract surgery on ocular dominance

    Science.gov (United States)

    Schwartz, Roy; Yatziv, Yossi

    2015-01-01

    Purpose The aim of this study is to assess whether eye dominance may change after cataract surgery. Methods This is a prospective case series. Cataract surgery candidates were examined prior to surgery for best-corrected visual acuity, eye dominance, and handedness. Patients with ocular conditions that may affect visual acuity were excluded from the study. A month following surgery, best-corrected visual acuity and eye dominance examinations were repeated. Results The study included 33 patients with a mean age of 70.5±9.4 years. Eighteen patients (54.5%) had right eye dominance. Following surgery, seven patients (21.2%) had a change in eye dominance. The change in dominance was linked to improved visual acuity in the operated eye and to a younger age, although with no statistical significance. Conclusion This is the first study reported in the literature to show that ocular dominance is a plastic characteristic following cataract surgeries. The results may change the importance given to eye dominance measurement prior to surgeries that rely on this examination, such as monovision surgeries. PMID:26715837

  7. Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery.

    Science.gov (United States)

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

    2013-07-01

    This study was done to compare the results of posterior continuous curvilinear capsulorhexis created using forceps with those created using vitrector in eyes suffering from congenital cataract. Vitrectorhexis term was first used by Wilson et al in 1999. [1] Fifty eyes with congenital and developmental cataract were included in this study. The posterior capsulorhexis was created using utrata forceps in 17 eyes or through a vitrector in 33 eyes. Forceps capsulorhexis was performed before IOL implantation, while vitrectorhexis was performed after IOL implantation in the bag. The results of both the surgery were compared using the following criteria: incidence of extension of rhexis, ability to achieve posterior rhexis of appropriate size, ability to implant the IOL in the bag, the surgical time, and learning curve. Vitrectorhexis after IOL implantation was an easy to learn alternative to manual posterior continuous curvilinear capsulorhexis in pediatric cataract surgery. It was more predictable and reproducible, with a short learning curve and lesser surgical time. PMID:23571249

  8. Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery

    Directory of Open Access Journals (Sweden)

    Lav Kochgaway

    2013-01-01

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

  9. A prospective study on postoperative pain after cataract surgery

    Directory of Open Access Journals (Sweden)

    Porela-Tiihonen S

    2013-07-01

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

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

    OpenAIRE

    Ming Chen; Christian Swinney; Mindy Chen

    2015-01-01

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

  11. 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  13. Visual outcomes after cataract surgery and cataract surgical coverage in India.

    Science.gov (United States)

    Bachani, D; Gupta, S K; Murthy, G V; Jose, R

    1999-01-01

    Visual outcomes of 2369 cataract operated persons(3655 eyes) across seven major Indian states were assessed in 1998. This is the largest ever study over the past decade in the country. 9.54 per cent of the examined population had undergone operation for cataract in one or both eyes. Intra-capsular cataract extraction was the commonest surgical modality adopted (91.62%). Intraocular lens implants resulted in better visual outcomes with 71.4 per cent of such patients achieving a good visual outcome (> or = 6/18 in operated eyes). Visual outcome was also good if ICCE operated patients were provided good quality aphakic spectacles. There were no gender differentials in surgical uptake rates. The risk of poor postsurgical visual outcome was strongly associated by type of surgery (Adjusted OR for ICCE-2.78; 95% CI: 1.41-5.49) and the non-availability or poor quality aphakic spectacles (Adjusted OR for poor/no spectacles 4.59-95% CI: 3.53-5.97). Duration since surgery and the source of surgery did not influence visual outcomes. Half the cataract blind remained unoperated in the study population. PMID:11008899

  14. Anterior chamber aspirate cultures in small incision cataract surgery.

    OpenAIRE

    Manners, T D; Chitkara, D K; Marsh, P J; Stoddart, M G

    1995-01-01

    BACKGROUND--Anterior chamber aspirates on completion of extracapsular cataract surgery contain significant numbers of organisms, particularly coagulase negative staphylococci, an important cause of endophthalmitis. METHODS--Culture rates were compared in 50 patients after phacoemulsification surgery, which allows the possible benefits of a small, self sealing wound and maintenance of positive intraocular pressure, with a similar number of extracapsular cases. RESULTS--A culture positive rate ...

  15. Conjunctival inclusion cysts following small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Evaluation of diopter after cataract surgery in high myopia combined cataract

    Directory of Open Access Journals (Sweden)

    Wan-Qi Zhang

    2015-02-01

    Full Text Available AIM: To observe the diopter after cataract surgery for vision gain in high myopia and its effect on visual outcomes. METHODS: Sixty(120 eyeshigh myopia combined with cataract cases received phacoemulsification and intraocular lens implantation in our hospital were retrospective studied. The patients were divided into three groups based on postoperative diopter: -1.0?-2.0D(group A, -2.25?-3.0D(group Band -3.25?-4.0D(group C. The uncorrected distance visual acuity(UCDVA, best corrected distant visual acuity(BCDVA, uncorrected near visual acuity(UCNVAand questionnaire of Activities of Daily Vision Scale(ADVSwere collected to assess the vision gain at 3mo after cataract surgery. RESULTS: At 3mo after surgery, UCDVA of group A was better than that of group B, and UCDVA of group B was better than that of group C. There were no differences in BCDVA among groups. There were significant differences between the three groups' UCNVA, it was best for the group C, followed by the group B, group A was the worst. For questionnaire, no difference was observed in patients' satisfactory for surgical results, but a significant difference was detected in postoperative glasses wearing frequency between groups. CONCLUSION:For cataract surgery in high myopia combined cataract, postoperative diopter should be calculated based on patients' daily requirements. For patients had not used to wearing glasses and near distant working condition, it's appropriated to reserve a minor degree of myopia. Conversely, for patients require near distant working and received wearing moderate and low hyperopia mirror, higher degree of myopia can be reserved.

  18. Maximal mydriasis evaluation in cataract surgery

    Directory of Open Access Journals (Sweden)

    Ho Tony

    1992-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Explicit criteria for prioritization of cataract surgery

    Directory of Open Access Journals (Sweden)

    Escobar Antonio

    2006-03-01

    Full Text Available Abstract Background Consensus techniques have been used previously to create explicit criteria to prioritize cataract extraction; however, the appropriateness of the intervention was not included explicitly in previous studies. We developed a prioritization tool for cataract extraction according to the RAND method. Methods Criteria were developed using a modified Delphi panel judgment process. A panel of 11 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the effect of all variables on the final panel score using general linear and logistic regression models. Priority scoring systems were developed by means of optimal scaling and general linear models. The explicit criteria developed were summarized by means of regression tree analysis. Results Eight variables were considered to create the indications. Of the 310 indications that the panel evaluated, 22.6% were considered high priority, 52.3% intermediate priority, and 25.2% low priority. Agreement was reached for 31.9% of the indications and disagreement for 0.3%. Logistic regression and general linear models showed that the preoperative visual acuity of the cataractous eye, visual function, and anticipated visual acuity postoperatively were the most influential variables. Alternative and simple scoring systems were obtained by optimal scaling and general linear models where the previous variables were also the most important. The decision tree also shows the importance of the previous variables and the appropriateness of the intervention. Conclusion Our results showed acceptable validity as an evaluation and management tool for prioritizing cataract extraction. It also provides easy algorithms for use in clinical practice.

  1. Prevalence of myopic shifts among patients seeking cataract surgery

    Directory of Open Access Journals (Sweden)

    Rafael Iribarren

    2013-06-01

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

  2. 42 CFR 1001.1701 - Billing for services of assistant at surgery during cataract operations.

    Science.gov (United States)

    2010-10-01

    ... cataract operations. 1001.1701 Section 1001.1701 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE... PROGRAMS Permissive Exclusions § 1001.1701 Billing for services of assistant at surgery during cataract... surgery during a cataract operation, or (ii) Charges that include a charge for an assistant at...

  3. 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.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    TOPIC: We performed a systematic review and meta-analysis to evaluate the benefit and harms associated with implantation of toric intraocular lenses (IOLs) during cataract surgery. Outcomes were postoperative uncorrected distance visual acuity (UCDVA) and distance spectacle independence. Harms were...... literature search in the Embase, PubMed, and CENTRAL databases within the Cochrane Library. We included randomized clinical trials (RCTs) if they compared toric with non-toric IOL implantation (± relaxing incision) in patients with regular corneal astigmatism and age-related cataracts. We assessed the risk...

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

    OpenAIRE

    Dhaliwal Upreet; Gupta Sunil

    2007-01-01

    Purpose: To assess the barriers for the acceptance of surgery among patients with cataract and visual disability. Materials and Methods: A short-term descriptive study was conducted in patients with cataract presenting to a hospital. Socio-demographic data were entered in a proforma. An interviewer-assisted questionnaire, surveying knowledge about cataract and barriers to cataract surgery, was administered by one of the authors (SKG) in the local language (Hindi). Results: There were 1...

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

    Science.gov (United States)

    Bhargava, Rahul; Kumar, Prachi; Sharma, Shiv Kumar; Kumar, Manoj; Kaur, Avinash

    2015-01-01

    AIM To compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic cataract. METHODS In a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of cataract under such circumstances. PMID:26558210

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

    Science.gov (United States)

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

    2012-09-01

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

  8. 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.

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

    OpenAIRE

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

    2012-01-01

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

  10. Postage stamp multiple anterior capsulorhexisotomies in pediatric cataract surgery

    OpenAIRE

    Sharma Namrata; Sinha Rajesh; Titiyal Jeewan S; Vajpayee Rasik B

    2005-01-01

    Abstract Background Capsule related complications are common following pediatric cataract surgery. We report a new technique of multiple anterior capsulorhexisotomies after lens aspiration and intraocular lens (IOL) implantation. Methods After performing automated lens aspiration, an IOL was implanted into the capsular bag. A bent 26 gauge needle was introduced through one side port and multiple small cuts were made in one half of the circumference of the anterior capsular rim by making a rad...

  11. Bilateral Pseudomonas aeruginosa endophthalmitis following bilateral simultaneous cataract surgery

    Directory of Open Access Journals (Sweden)

    Kashkouli Mohsen

    2007-01-01

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

  12. DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY

    OpenAIRE

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

    2014-01-01

    The purpose of this study is to show how a public eye care center in Turkey initiated Six Sigma principles to reduce the number of complications encountered during and after phacoemulsification cataract surgeries. To analyze the 3-year data, main tools of Six Sigma’s Define-Measure-Analyze-Improve-Control (DMAIC) improvement cycle such as SIPOC table, Fishbone Diagram and, Failure, Mode and Effect Analysis were implemented. Experience of the ophthalmic surgeon, patient’s anatomy, cooperation ...

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

    Directory of Open Access Journals (Sweden)

    Sonal S Khatavkar

    2009-01-01

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

  14. 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

  15. MRSA and cataract surgery – reflections for practice

    OpenAIRE

    LF Porter; RU Khan2; Hannan, A; et. al.

    2010-01-01

    LF Porter1, RU Khan2, A Hannan3, SP Kelly11Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Departments of Microbiology, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 3Haughton Thornley Medical Centers, NHS Tameside and Glossop, UKIntroduction: Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK) National H...

  16. Suppurative keratitis caused by Streptococcus pneumoniae after cataract surgery.

    OpenAIRE

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

    1994-01-01

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

  17. Endophthalmitis: controlling infection before and after cataract surgery

    OpenAIRE

    Nuwan Niyadurupola; Nick Astbury

    2008-01-01

    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 frequen...

  18. Prevalence of blindness and cataract surgery in Nepal

    OpenAIRE

    Pokharel, G; Regmi, G; Shrestha, S; Negrel, A; Ellwein, L

    1998-01-01

    BACKGROUND—A national eye care programme was launched in Nepal in the early 1980s. The impact of this programme on blindness and cataract surgery prevalence was evaluated in two geographic zones.?METHODS—People aged 45 years and older were sampled using a stratified cluster design. Within randomly selected clusters, door to door enumeration was followed by visual acuity measurement and eye examinations at conveniently located sites. The full survey was preceded by a pilot study where operatio...

  19. 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 taken a...

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Servet Cetinkaya

    2015-10-01

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

  2. Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

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

    Science.gov (United States)

    Chalfin, Steven

    1997-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Marcelo Carvalho Ventura

    2013-08-01

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

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

    OpenAIRE

    Reddy RK; Kim SJ

    2011-01-01

    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 af...

  7. Cataract in leprosy patients: cataract surgical coverage, barriers to acceptance of surgery, and outcome of surgery in a population based survey in Korea

    OpenAIRE

    Courtright, P; Lewallen, S; N Tungpakorn; Cho, B; Lim, Y; Lee, H., van der; Kim, S.

    2001-01-01

    BACKGROUND/AIMS—Cataract is the leading cause of blindness in leprosy patients. There is no population based information on the cataract surgical coverage, barriers to use of surgical services, and outcome of surgery in these patients. We sought to determine these measures of cataract programme effectiveness in a cured leprosy population in South Korea.?METHODS—The population consisted of residents of six leprosy resettlement villages in central South Korea. All residents were invited to part...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bellucci R

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Cannon Paul S

    2005-06-01

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

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

    Science.gov (United States)

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

    2013-04-01

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

  12. Preemptive analgesia in elective cataract surgery (Phacoemulcification

    Directory of Open Access Journals (Sweden)

    H Zahedi

    2005-03-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Automated surgical step recognition in normalized cataract surgery videos.

    Science.gov (United States)

    Charrière, Katia; Quellec, Gwénolé; Lamard, Mathieu; Coatrieux, Gouenou; Cochener, Béatrice; Cazuguel, Guy

    2014-01-01

    Huge amounts of surgical data are recorded during video-monitored surgery. Content-based video retrieval systems intent to reuse those data for computer-aided surgery. In this paper, we focus on real-time recognition of cataract surgery steps: the goal is to retrieve from a database surgery videos that were recorded during the same surgery step. The proposed system relies on motion features for video characterization. Motion features are usually impacted by eye motion or zoom level variations, which are not necessarily relevant for surgery step recognition. Those problems certainly limit the performance of the retrieval system. We therefore propose to refine motion feature extraction by applying pre-processing steps based on a novel pupil center and scale tracking method. Those pre-processing steps are evaluated for two different motion features. In this paper, a similarity measure adapted from Piciarelli's video surveillance system is evaluated for the first time in a surgery dataset. This similarity measure provides good results and for both motion features, the proposed preprocessing steps improved the retrieval performance of the system significantly. PMID:25571028

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

    OpenAIRE

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

    2015-01-01

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

  17. Impact of cataract surgery on vision-related life performances: the usefulness of Real-Life Vision Test for cataract surgery outcomes evaluation.

    Science.gov (United States)

    Ni, W; Li, X; Hou, Z; Zhang, H; Qiu, W; Wang, W

    2015-12-01

    PurposeReal-Life Vision Test (RLVT) is a newly developed performance-based measures of functional vision. This present study is designed to determine whether it could be a meaningful assessment for cataract surgery outcomes evaluation.Patients and methodsAge-related cataract patients (56) who scheduled for bilateral cataract surgery and 44 age-matched controls were evaluated by four types of measurements: (1) demographic, medical, cognitive and depressive evaluation, and the reaction time testing; (2) clinical measures (visual acuity, contrast sensitivity, stereopsis, and color perception); (3) the 25-item National Eye Institute's Visual Functioning Questionnaire (NEI-VFQ); (4) the RLVT. Spearman's coefficients and multiple regression analysis were conducted to investigate the relationship among RLVT, clinical measures, and self-report assessment of visual function.ResultsThe results of RLVT, clinical measures, and NEI-VFQ total scores were improved significantly after cataract surgery. There were no differences between control subjects and post-surgery patients with respect to NEI-VFQ-25 total scores, self-rating depression scale scores and three tasks of RLVT. Change of RLVT was significantly associated with the change of clinical measures in the cataract group. Multiple regression analysis demonstrated that change of distance, intermediate, and near visual acuity, and binocular contrast sensitivity were significant predictors of improvements of RLVT.ConclusionsCataract surgery could improve real-world visual ability effectively for cataract patients. Our study highlights the potential usefulness of RLVT as an adjunct to the current outcomes evaluation system for cataract surgery. The use of RLVT combined with clinical and self-survey methods may be the comprehensive strategy to manifest the impact of cataract surgery on patients' overall vision-related quality of life. PMID:26272444

  18. Strabismus and Nystagmus Following Cataract Surgeries in Childhood

    Directory of Open Access Journals (Sweden)

    Ay?e Ye?im Oral

    2012-03-01

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

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

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    Salman Amjad

    2006-01-01

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

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

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    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.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  4. 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)

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

    Science.gov (United States)

    Utman, Saqib Ali Khan

    2013-09-01

    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. PMID:24034192

  6. 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.

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

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    Hong-Fen Zhu

    2013-08-01

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

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

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    Gunvant P

    2011-09-01

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

  9. Incision influence of small incision cataract surgery on corneal topography

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    Fang Liu

    2015-06-01

    Full Text Available AIM: To explore the incision influence of small incision cataract surgery on corneal topography of patients, so as to provide a reference for the optimization of operation method. METHODS: Seventy-one patients(94 eyeswere divided into two groups, which were given straight(group Aand eyebrow arched incision(group B. Patients in both groups A and B were divided into three subgroups respectively, which were given incision with different length from corneal limbus(1.5mm, 2.0mm and 2.5mm. The visual acuity level and corneal topography indexes(ACP, CYL, SAI and SRIwere compared before and after treatment. RESULTS: There was influence on visual acuity level and corneal topography of incision morphology and length from corneal limbus(PPP>0.05. One week after surgery, the visual acuity level of all patients was higher than that before surgery, and 3mo after surgery, it was higher than that of 1wk after surgery too(PPP>0.05. Before surgery, there was no significant difference in visual acuity level and corneal topography between groups(P>0.05. One week after surgery, the visual acuity level of subgroup 2.0mm and 2.5mm in group B was higher than the others(PP>0.05. the ACP, CYL, SAI, SRI level of subgroups 2.0mm and 2.5mm in group B were lower than the others, and those of subgroup 2.5mm in group B were higher than those of subgroup 2.0mm of group B(PP>0.05, but the ACP and CYL level of subgroup 2.0mm and 2.5mm of group B were higher than those of the others(PP>0.05. CONCLUSION: Using eyebrow arched incision and appropriate distance to corneal limbus in the small incision cataract surgery can reduce the impact on corneal topography and benefit for control of postoperative astigmatism.

  10. Conjunctival sac bacterial flora isolated prior to cataract surgery

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    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

  11. 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; la Cour, Morten; Kjaerbo, Hadi

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    OpenAIRE

    Md Shafiqul Alam; Khaleda Nazneen Bari

    2014-01-01

    Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS) with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and ...

  14. 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.

  15. 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.

  16. Cataract - adult

    Science.gov (United States)

    ... home to avoid falls and injuries. The only treatment for a cataract is surgery to remove it. If a cataract ... Early diagnosis and treatment are key to preventing permanent ... a hypermature cataract) can begin to leak into other parts of ...

  17. Postage stamp multiple anterior capsulorhexisotomies in pediatric cataract surgery

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    Sharma Namrata

    2005-03-01

    Full Text Available Abstract Background Capsule related complications are common following pediatric cataract surgery. We report a new technique of multiple anterior capsulorhexisotomies after lens aspiration and intraocular lens (IOL implantation. Methods After performing automated lens aspiration, an IOL was implanted into the capsular bag. A bent 26 gauge needle was introduced through one side port and multiple small cuts were made in one half of the circumference of the anterior capsular rim by making a radial movement of the needle tip centripetally over the margin of the anterior capsular rim. The needle was again introduced through the other side port and multiple similar cuts were made in the other half thereby creating nearly 20 – 30 cuts at the margin of the anterior capsular rim. Results The mean size of the primary capsulorhexis was 4.33 ± 0.20 mm. A uniform enlargement of the capsulorhexis could be performed in all the eyes without peripheral extension in any of the eyes. There was no damage to the posterior capsule and no scratch mark on the IOL. In one eye, the primary capsulorhexis was slightly eccentric, though it was covering the IOL optic all around. The rhexisotomies in this eye were limited to the capsular rim that was overlapping more on the IOL optic (sectoral anterior capsulorhexisotomies. Conclusion The technique of postage stamp anterior capsulorhexisotomies is a feasible technique in pediatric cataracts.

  18. Orbital cellulits following cataract surgery under peribulbar anaesthesia

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    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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  1. 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.

  2. RELEVANCE OF HIV AND HBSAG SCREENING IN PATIENTS SELECTED FOR CATARACT SURGERIES

    Directory of Open Access Journals (Sweden)

    Hanumantharao

    2015-06-01

    Full Text Available AIM: To assess the relevance of HIV & HBS Ag screening in patients selected for cataract surgery. PATIENTS & METHODS: 1540 patients who were selected for cataract surgery in the eye camps during the period of September 2011 to September 2012 were included in the study. It was prospective randomized clinical study conducted at a tertiary hospital. RESULTS: Out of 1540 pati ents during the thirteen month period 5 were positive for HIV and 67 were positive for HBS Ag . CONCLUSION: It is very important to screen all the patients selected for cataract surgery for HIV & HBS Ag to prevent the risk of horizontal transmission among p atients and eye care providers.

  3. Correction of low corneal astigmatism in cataract surgery

    Directory of Open Access Journals (Sweden)

    Pia Leon

    2015-08-01

    Full Text Available AIM: To evaluate and compare aspheric toric intraocular lens (IOL implantation and aspheric monofocal IOL implantation with limbal relaxing incisions (LRI to manage low corneal astigmatism (1.0-2.0 D in cataract surgery.METHODS:A prospective randomized comparative clinical study was performed. There were randomly recruited 102 eyes (102 patients with cataracts associated with corneal astigmatism and divided into two groups. The first group received toric IOL implantation and the second one monofocal IOL implantation with peripheral corneal relaxing incisions. Outcomes considered were:visual acuity, postoperative residual astigmatism, endothelial cell count, the need for spectacles, and patient satisfaction. To determine the postoperative toric axis, all patients who underwent the toric IOL implantation were further evaluated using an OPD Scan III (Nidek Co, Japan. Follow-up lasted 6mo.RESULTS: The mean uncorrected distance visual acuity (UCVA and the best corrected visual acuity (BCVA demonstrated statistically significant improvement after surgery in both groups. At the end of the follow-up the UCVA was statistically better in the patients with toric IOL implants compared to those patients who underwent implantation of monofocal IOL plus LRI. The mean residual refractive astigmatism was of 0.4 D for the toric IOL group and 1.1 D for the LRI group (P<0.01. No difference was observed in the postoperative endothelial cell count between the two groups.CONCLUSION: The two surgical procedures demonstrated a significant decrease in refractive astigmatism. Toric IOL implantation was more effective and predictable compared to the limbal relaxing incision.

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

    Science.gov (United States)

    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 taken as the spherical equivalent of the refraction at 3 months after surgery. The prediction error was taken as the absolute difference between the estimated and actual postoperative refraction. The data were analysed to assess the effects of age at the time of surgery, keratometry, and axial length on the accuracy of calculation of IOL power.?RESULTS—For the overall group the mean and median prediction errors were 1.40 D and 0.84 D (SD 1.60). The mean and median prediction errors in eyes with axial lengths ?20 mm were 1.07 D and 0.71 D (SD 0.98) and in eyes children aged ?36 months were 1.06 D and 0.68 D (SD 1.02) and in children aged IOL power calculation is satisfactory. In eyes with axial lengths less than 20 mm and in children less than 36 months of age larger errors can arise. This study demonstrates the need for an IOL formula specifically designed for paediatric use.?? PMID:11466250

  5. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus phacoemulsification with posterior chamber intraocular lens for age-related cataract.

    OpenAIRE

    Riaz, Y; Silva, SR; Evans, JR

    2013-01-01

    BACKGROUND: Age-related cataract is a major cause of blindness and visual morbidity worldwide. It is therefore important to establish the optimal technique of lens removal in cataract surgery. OBJECTIVES: To compare manual small incision cataract surgery (MSICS) and phacoemulsification techniques. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 6), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Inde...

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

    OpenAIRE

    Minassian, D.; REIDY, A.; Desai, P.; Farrow, S.; Vafidis, G.; MINASSIAN, A

    2000-01-01

    BACKGROUND—The pool of old cases of cataract, the expected new cases, and the shortfall in cataract surgery and consequently the numbers dying with poor vision without the benefit of cataract surgery are regarded as escalating problems worldwide. Successive governments and the professional ophthalmic bodies have not had the wherewithal to estimate the magnitude or interaction of these elements in the population of the UK. This study has collected and applied the best available epidemiological...

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rahul Bhargava

    2015-10-01

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

  9. 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.

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

    Science.gov (United States)

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

    2005-04-01

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

  11. 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.

  12. Modelling lifetime cost consequences of ReSTOR® in cataract surgery in four European countries

    OpenAIRE

    Berdeaux Gilles; Lafuma Antoine

    2008-01-01

    Abstract Background To compare the lifetime costs of liberating patients from spectacles after cataract surgery by implanting the multifocal intraocular lens (IOL) 'ReSTOR®' versus monofocal IOLs in France, Italy, Germany and Spain. Methods A Markov model was created to follow patient cohorts from cataract surgery until death. Prevalence rates of patients not needing spectacles after cataract surgery were obtained from clinical trials. Resource utilisation included implant surgery, IOLs, spec...

  13. Are patient information leaflets contributing to informed consent for cataract surgery?

    OpenAIRE

    Brown, H; Ramchandani, M; Gillow, J; Tsaloumas, M.

    2004-01-01

    Aim: To assess, against a checklist of specific areas of required information and using standard published criteria, to what extent leaflets given before cataract surgery provided patients with enough information to give adequately informed consent.

  14. 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.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    UNLABELLED: We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly during surgery. Skin prick tests were also positive for methylcellulose. Based on symptoms and clinical signs of anaphylaxis following 2 separate cataract operations together with positive prick tests t...

  16. Topical diclofenac sodium for treatment of postoperative inflammation in cataract surgery

    OpenAIRE

    Reddy Manjoo; N.SUNEETHA; Thomas Reji; Battu R

    2000-01-01

    Purpose: To study the effect of a topical non-steroidal anti-inflammatory drug as an alternative to topical steroids for postoperative control of inflammation in cataract surgery. Methods: The effect of diclofenac sodium 0.1% following cataract surgery was studied and compared to routine corticosteroid, dexamethasone phosphate 1% in a prospective, double-blind randomized study. Both groups were similar in baseline parameters. Postoperative inflammatory response, intraocular pres...

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

    OpenAIRE

    Idalia Triana; Oaris de los Ángeles Socarrás; Nelsis Rondón

    2012-01-01

    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% re...

  18. 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.

  19. 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.

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

    International Nuclear Information System (INIS)

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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Kanthamani

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    more symmetrical visual acuity became after unilateral cataract surgery, the more pronounced was the grey matter increase in visual cortex. Conclusion:? The data suggest that cataract surgery triggered a use-dependent structural plasticity in V2 presumably through improved binocular integration of......Purpose:? The developing visual cortex has a strong potential to undergo plastic changes. Little is known about the potential of the ageing visual cortex to express plasticity. A pertinent question is whether therapeutic interventions can trigger plastic changes in the ageing visual cortex by...... restoring vision. Methods:? Twelve patients aged 50–85 years underwent structural high-resolution T1-weighted MRI of the whole brain 2 days and 6 weeks after unilateral cataract surgery. Voxel-based morphometry (VBM) based on T1-weighted magnetic resonance imaging (MRI) was employed to test whether cataract...

  4. The Success of Cataract Surgery and the Preoperative Measurement of Retinal Function by Electrophysiological Techniques

    Science.gov (United States)

    An, Jing; Zhang, Lei; Wang, Yusheng; Zhang, Zuoming

    2015-01-01

    Purpose. To study the effect of different electrophysiological methods to evaluate retinal function prior to cataract surgery. Methods. Cataract patients who had no significant other eye disease were chosen. VA, pattern visual evoked potential (PVEP), electroretinogram (ERG), and multifocal electroretinogram (mfERG) responses were measured from 150 cataract patients and 20 control subjects. Results. When the preoperative VA was more than 0.3 in cataract patients, the amplitude of PVEP was not significantly different between cataract and control subjects. The amplitude of central point mfERG was significantly lower in cataract patients compared with control group from HM to 0.8 of preoperative VA. The 95% confidence intervals (CIs) of the amplitudes of center point mfERG were calculated for a range of preoperative VA values. Most of the patients within 95% CI of the center point mfERG had a postoperative VA more than 0.5. Conclusions. The amplitude of central point mfERG in cataract patients was the most relevant parameter to the preoperative VA compared with PVEP and ERG. The 95% CI of the amplitude of central point mfERG for each level of VA could help to evaluate preoperative macular function which is used to predict the outcome of cataract surgery. PMID:26576292

  5. Cataract surgery at Aravind Eye Hospitals: 1988–2008

    OpenAIRE

    Natchiar, G; RD Thulasiraj; R Meenakshi Sundaram

    2008-01-01

    In the 1980s, cataract was the major cause of blindness in India and was responsible for 80% of all blindness. This prompted the Indian government to launch a national cataract control programme, which succeeded in lowering the prevalence of blindness from 1.49% to 1.1%. In addition, by 2000, this programme had reduced the proportion of people blind due to cataract from 80% to 62%.Aravind Eye Hospitals contributed to a third of all cataract operations in the state of Tamil Nadu during the las...

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

    Directory of Open Access Journals (Sweden)

    Rahul

    2015-08-01

    Full Text Available M anual small incision cataract surgery (MSICS is a very popular technique of cataract surgery in India. It’s a surgery which is done and in short time and in a country like India with a huge back - log of cataract blindness this surgery is very useful. OBJECTIVE: To evaluate the outcome of manual small incision cataract surgery (MSICS with AC mantainer under topical anesthesia with lignocaine 2% jelly and intracameral lignocaine . MATERIALS AND METHODS : This study was a prospectiv e interventional case series. One hundred patients of senile cataract were operated by MSICS under topical anesthesia using lignocaine 2% jelly and intracameral 1% lignocaine. The patients and the single operating surgeon were given a questionnaire to eval uate their experience in terms of pain, surgical experience and complications. RESULTS : The mean pain score was 0.82(SD±0.97. 63 patients (63% had a pain score of zero, that is, no pain. 37 patients (37 % had a score of 3 or less, that is, mild to none pain. 95 surgeries were free of complications while 5 had complications but they were not related to anaesthesia. Surgeon’s experience was favorable in terms of patient’s cooperation, anterior chamber stability, difficulty, and complications. CONCLUSIONS: MSICS can be comfortably performed under topical anesthesia with lignocaine jelly and intracameral lignocaine, which makes the surgery patient - friendly, without compromising the outcome.

  7. MANUAL SMALL INCISION CATARACT SURGERY UNDER TOPICAL ANESTHESIA ALONE, IN PATIENTS WITH CARDIAC DISEASE

    Directory of Open Access Journals (Sweden)

    Suresh

    2015-03-01

    Full Text Available AIM: To evaluate the outcome of manual small incision cataract surgery (MSICS under topical anesthesia alone in patients at risk for local invasive anesthesia due to cardiac disease. MATERIALS AND METHOD S: A retrospective analysi s of all patients with underlying cardiac disease and operated for cataract under topical proparacaine, was done. Data was analyzed for demographic variants, operative experience, intra - and postoperative complications, need of conversion to peribulbar blo ck, visual outcome and effect of surgery on cardiac disease. RESULTS: A total of 78 eyes of 60 patients with existing cardiac disease underwent manual small incision cataract surgery under topical anesthesia were analyzed. All patients underwent surgery wi thout any major surgery related complications. No patient had complications related to IHD both intra - and early postoperative period. CONCLUSION: MSICS under topical anesthesia with proparacaine is safe and effective for high risk patients with coexisting cardiac disease without any compromise in visual outcome

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

    OpenAIRE

    Rajiv D. Sha; ?tefan ??l

    2011-01-01

    Modern cataract surgery is considered to be a successful procedure, with a low complication rate. During cataract surgery, a patient's cloudy natural lens is removed and replaced with an artificial intraocular lens implant to restore the lens's transparency. The goal of cataract surgery is to achieve improvement in visual acuity necessary to help the patient with activities of daily living and improve the quality of their life. Macular degeneration is a multifactorial syndrome with different ...

  9. 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.

  10. Photodynamic treatment of lens epithelial cells for cataract surgery

    Science.gov (United States)

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

    1991-06-01

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

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

    Scientific Electronic Library Online (English)

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

    2013-04-01

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

  12. 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.

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

    OpenAIRE

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

    2015-01-01

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

  14. Cataracts

    Science.gov (United States)

    ... cataract will appear gray, gray/white, or yellow/tan and, rarely, the lens will be pearly white ... or shades of color are difficult to discern. Self-Care Guidelines There are no proven ways to ...

  15. A Cross-Sectional Retrospective Analysis of the Racial and Geographic Variations in Cataract Surgery

    Science.gov (United States)

    Shahbazi, Sara; Studnicki, James; Warner-Hillard, Charles Wayne

    2015-01-01

    Background Cataract surgery is the most common surgery performed on beneficiaries of Medicare, accounting for more than $3.4 billion in annual expenditures. The purpose of this study is to examine racial and geographic variations in cataract surgery rates and determine the association between the racial composition of the community population and the racial disparity in the likelihood of receiving necessary cataract surgery. Methods Using the national prevalence rates from the National Institute of Eye Health and the 2010 Healthcare Cost and Utilization Project—Florida State Ambulatory Surgery Database, we determined the estimated cases of cataract and the actual number of cataract procedures performed, on four race/gender determined groups aged 65 and over in the state of Florida in 2010. The utilization rates and disparity ratios were also calculated for each Florida county. The counties were segmented into groups based on their racial composition. The association between racial composition and disparity ratios in receiving necessary cataract surgery was examined. The Geographic Information System was used to display county-level geospatial relationships. Results African-Americans have a lower gender-specific cataract prevalence (African-American male = 0.246, African-American female = 0.392, white male = 0.368, and white female = 0.457), but they are also less likely than whites to receive necessary cataract surgery (utilization rate: African-American male = 7.92%, African-American female = 6.17%, white male = 12.08%, and white female = 10.54%). The statistical results show no overall differences between the disparity ratios and the racial composition of the communities. However, our geospatial analyses revealed a concentration of high racial disparity/high white population counties largely along the West Coast and South Central portion of the state. Conclusions There are racial differences in the likelihood of receiving necessary cataract surgery. However, there is no significant statewide association between the racial composition of the community population and the racial disparity in the likelihood of receiving necessary cataract surgery. Geospatial techniques did, however, identify subpopulations of interest which were not otherwise identifiable with typical statistical approaches, nor consistent with their conclusions. PMID:26540168

  16. Cataract surgery: interim results and complications of a randomised controlled trial. Oxford Cataract Treatment and Evaluation Team (OCTET).

    OpenAIRE

    1986-01-01

    A randomised controlled trial in progress for more than five years, with no loss to follow-up (except death), assessed 333 eyes treated by three methods of cataract surgery. They were (A) intracapsular extraction and contact lens usage, (B) intracapsular extraction and implantation of an iris supported lens (Federov I), and (C) extracapsular extraction and implantation of an iridocapsular lens (Binkhorst 2-loop). The purpose of the paper is to report interim visual results, complications, and...

  17. 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.

  18. Changes of vision-related quality of life in retinal detachment patients after cataract surgery.

    Science.gov (United States)

    Zhu, Mingming; Huang, Jiannan; Zhu, Bijun; Sun, Qian; Xu, Xian; Miao, Yuyu; Zou, Haidong

    2015-01-01

    Rhegmatenous retinal detachment (RRD) is one of the most serious complications after phacoemulsification combined with intraocular lens implantation surgery. It has been reported that vision-related quality of life (VRQoL), as well as visual acuity rapidly decreased when RRD developed. However, little is known of the VRQoL in those RRD patients after anatomical retinal re-attachment, especially whether or not the VRQoL is higher than that before cataract surgery. In this prospective case series study, we use the Chinese-version low vision quality of life questionnaire (CLVQOL) to assess the changes of VRQoL in age-related cataract patients who suffered from RRD after phacoemulsification with intraocular lens (phaco-IOL) implantation. All participants were asked to complete questionnaires in face- to-face interviews one day before and two weeks after cataract surgery, as well as one day before and three months after RRD surgery. A total of 10,127 consecutive age-related cataract patients were followed up to one year after phaco-IOL implantation; among these patients, 17 were diagnosed as RRD. The total CLVQOL scores and subscale scores except "Mobility" decreased significantly when RRD developed. After retinal surgery, only the score of "General vision and lighting" in the CLVQOL questionnaires improved when compared to the scores two weeks after cataract surgery, although the best corrected visual acuity of all patients significantly raised up. However, the mean CLVQOL scores and subscale scores were still considerably higher than the level prior to cataract surgery. Our study suggests that cataract patients at high risk of postoperative RRD should not deny the opportunity to undergo phaco-IOL implantation, even though potential VRQoL impairment induced by RRD exists. PMID:25764367

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

    Directory of Open Access Journals (Sweden)

    Gadekar

    2013-10-01

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

  20. 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.

  1. Outcomes of 360° suture trabeculotomy with deep sclerectomy combined with cataract surgery for primary open angle glaucoma and coexisting cataract

    Directory of Open Access Journals (Sweden)

    Sato T

    2014-07-01

    Full Text Available Tomoki Sato,1 Akira Hirata,2 Takanori Mizoguchi3 1Sato Eye Clinic, Kumamoto, 2Hayashi Eye Hospital, Fukuoka, 3Mizoguchi Eye Clinic, Nagasaki, Japan Background: The purpose of this study was to investigate treatment outcomes in 360° suture trabeculotomy with deep sclerectomy combined with phacoemulsification and aspiration and intraocular lens implantation (360P-LOT + DSMethods: Thirty-two eyes in 32 consecutive patients treated by 360P-LOT + DS for primary open angle glaucoma with coexisting cataracts at Sato Eye Clinic from March 2011 to April 2013 were retrospectively compared with 23 eyes in 23 consecutive patients treated by cataract surgery and 120° trabeculotomy with deep sclerectomy (120P-LOT + DS at the same clinic from January 2010 to February 2011. The parameters investigated during the 15 months after surgery were the course of intraocular pressure, number of antiglaucoma medications, best-corrected visual acuity, and complications.Results: Both groups showed a significant decrease in intraocular pressure starting at one month after surgery when compared with values before surgery. At 3, 6, 9, and 15 months after surgery, the intraocular pressure was significantly lower and the survival rate was significantly higher in the 360P-LOT + DS group compared with the 120P-LOT + DS group. The number of antiglaucoma medications, best-corrected visual acuity value, and complications did not differ significantly between the groups.Conclusion: Although the complications are similar to those seen in 120P-LOT + DS, treatment of primary open angle glaucoma and coexisting cataracts using 360P-LOT + DS may yield better outcomes. Keywords: nonpenetrating surgery, trabeculectomy, IOP spike

  2. Cataract blindness and barriers to uptake of cataract surgery in a rural community of northern Nigeria

    OpenAIRE

    Rabiu, M.

    2001-01-01

    AIMS—A population based cross sectional survey was conducted to determine the magnitude of cataract blindness and the barriers to uptake of cataract services in a rural community of northern Nigeria.?METHODS—1461 people out of 1924 registered eligible people were examined. The study population was chosen by two stage cluster random sampling. In the first sampling stage 15 villages were randomly chosen while in the final stage 170 people who were 40 years and over were selected in each village...

  3. Long term clinical outcome of a randomised controlled trial of anterior chamber lenses after high volume intracapsular cataract surgery

    OpenAIRE

    Hennig, A.; Johnson, G.; Evans, J.; Lagnado, R.; Poulson, A.; D. Pradhan; Foster, A; Wormald, R.

    2001-01-01

    BACKGROUND—Age related cataract remains the major cause of blindness throughout the world. In many countries, the majority of cataract surgery continues to be done by the intracapsular cataract extraction (ICCE) method. The results of a large randomised controlled trial of multiflex open loop anterior chamber intraocular lenses (ACIOL) were reported from a busy eye hospital in Nepal.?METHODS—There was a randomised controlled trial of 2000 people with bilateral cataract reducing vision to less...

  4. Impact of Cataract Surgery on Sleep in Patients Receiving Either Ultraviolet-Blocking or Blue-Filtering Intraocular Lens Implants

    OpenAIRE

    Alexander, I; Cuthbertson, FM; Ratnarajan, G; Safa, R; Mellington, FE; Foster, RG; Downes, SM; Wulff, K

    2014-01-01

    PURPOSE: Although visual impairment is a well-recognized consequence of cataract development, little is known about the ability of the melanopsin-based photosensitive retinal ganglion cells (pRGCs) to regulate sleep-wake timing in the presence of cataract. In this study, we replaced a cataractous natural crystalline lens with two different types of artificial intraocular lenses, a UV-blocking lens or a blue-filtering lens. We investigated the level of sleep disturbance before cataract surgery...

  5. 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.

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

    Science.gov (United States)

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

    2007-12-01

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

  7. Cataracts

    Science.gov (United States)

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

  8. 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.

  9. Recognizing Cataracts

    Science.gov (United States)

    ... link, please review our exit disclaimer . Subscribe Recognizing Cataracts Watch for Vision Changes as You Age As ... cause of impaired eyesight later in life is cataracts. A cataract is a clouding of the lens ...

  10. 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...

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

    OpenAIRE

    Yuan Rongdi; Zhang Yao; Chen Chunlin; Chen Xiaofan; Ye, Jian

    2011-01-01

    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 rece...

  12. Cataract surgery in the management of the late complications of lepromatous leprosy in South Korea.

    OpenAIRE

    ffytche, T. J.

    1981-01-01

    Clinical examination of 113 patients in South Korea with lepromatous leprosy and severe visual impairment showed that the main cause of visual loss was the combined effect of corneal and lens opacities associated with small nonreacting pupils and iris atrophy. Cataract surgery with broad iridectomy and inferior sphincterotomy offers these patients with chronic lepromatous complications the best chance of preserving vision. Eighty-one cataract operations were performed under local anaesthesia,...

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

    Directory of Open Access Journals (Sweden)

    Takatoshi Tano

    2010-11-01

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

  14. Cataract surgery at Aravind Eye Hospitals: 1988–2008

    Directory of Open Access Journals (Sweden)

    G Natchiar

    2008-09-01

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

  15. Cataracts

    International Nuclear Information System (INIS)

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

  16. Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery

    OpenAIRE

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

    2013-01-01

    This study was done to compare the results of posterior continuous curvilinear capsulorhexis created using forceps with those created using vitrector in eyes suffering from congenital cataract. Vitrectorhexis term was first used by Wilson et al in 1999.[1] Fifty eyes with congenital and developmental cataract were included in this study. The posterior capsulorhexis was created using utrata forceps in 17 eyes or through a vitrector in 33 eyes. Forceps capsulorhexis was performed before IOL imp...

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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.

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

    Science.gov (United States)

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

    2014-07-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Akçay B?

    2012-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Armando Rafael Milanés Armengol

    2012-11-01

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

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

    Science.gov (United States)

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

  6. 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.

  7. Cataract surgery and postoperative complications in diabetic patients.

    Science.gov (United States)

    Ivanci?, Dorotea; Mandi?, Zdravko; Bara?, Josip; Kopi?, Mirta

    2005-01-01

    Diabetes mellitus influences the function and morphology of the eye lens. The cataract is the second most common complication of diabetes mellitus on the eye. A hundred patients with cataract were examined in the prospective study. The patients were divided into two groups. The first group consisted of 50 patients with cataract who had not suffered from a system or local disease. The second group consisted of 50 patients with cataract and diabetes mellitus that had lasted for at least five years. In both groups the patients underwent identical cataract extra capsular extraction with intraocular PMMA (polymethylmethacrylate) lens implantation in camera posterior. The objective of this study was to compare the two groups of patients in order to find out the most common intraoperative or postoperative complications in diabetics. The most common postoperative complications in patients suffering from diabetes were inflammatory reactions and bleeding: postoperative keratopathy, uveitis anterior serous and uveitis anterior fibrinous with posterior sinechia and opacity of the posterior lens capsule as results. Postoperative visual acuity was worse in the patients in group II on the seventh day and six months after operation. It was diabetic retinopathy and its progression that caused deterioration of visual acuity. Diabetic retinopathy and its progression, as well as maculopathy were found only in patients who were not treated with photocoagulation before the operation. PMID:16193678

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

    Directory of Open Access Journals (Sweden)

    Twyana Shankha N

    2011-01-01

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

  9. [Two cases of Parkinson's disease in which visual hallucinations disappeared after cataract surgery].

    Science.gov (United States)

    Matsui, Hideaki; Udaka, Fukashi; Oda, Masaya; Kubori, Tamotsu; Nishinaka, Kazuto; Kameyama, Masakuni

    2004-04-01

    We report two cases of Parkinson's disease in which visual hallucinations disappeared after cataract surgery. Patient 1 was a 72-year-old woman with Parkinson's disease, visual hallucinations and musical hallucinations. Patient 2 was a 77-year-old woman with Parkinson's disease and visual hallucinations. Both patients had severe bilateral cataracts. Though it was difficult to control their visual hallucinations with medication only, cataract surgery made them disappeared quickly. The visual hallucinations of Parkinson's disease are similar to those of Charles Bonnet syndrome. For example, both hallucinations often happen in dim light, at night and when patients are awake with eyes open. Though there have been many reports describing visual hallucinations in Parkinson's disease, there have been few reports discussing the relation between these hallucinations and impaired visual acuity. Similar to the hallucinations of Charles Bonnet syndrome, impaired visual acuity should be related to the visual hallucinations of Parkinson's disease. When Parkinson's disease, visual hallucinations and severe cataract coexist, visual hallucinations may disappear after cataract surgery. PMID:15237728

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

    Directory of Open Access Journals (Sweden)

    Karthigeyan

    2013-11-01

    Full Text Available ABSTRACT: PURPOSE: To describe the use of anterior capsule staining in all phacoemulsification cataract surgery using a 0.025% trypan blue solution . METHODS: Thirty eyes of 30 patients with cataracts were submitted to phacoemulsification using a direct injection of 0.2 to 0.5 ml of 0.025% trypan blue in the anterior chamber through the side port before injecting viscoelastic injection. All patients h ad preop ophthalmologic examination prior to surgery. RESULTS: In all cases the capsule became stained with a faint blue color that enabled an adequate visibility of the flap while doing anterior capsulorhexis through the side port using a 26G needle. Ther e were no intra - operative or postoperative complications. The endothelial cell loss varie d between 1.37% and 6.67% (mean 3.90%. CONCLUSION: Staining the anterior capsule with 0.025% trypan blue solution allows a good visibility of the capsular flap and fa cilitates the confection of capsulorhexis in cataracts without red reflex. KEYWORDS: Cataract; Cataract extraction; Lens capsule; Crystalline/surgery; Trypan blue/therapeutic use; Dyes

  11. 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.

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

    Science.gov (United States)

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

    2016-03-01

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

  13. Surgical approaches to posterior polar cataract: a review.

    Science.gov (United States)

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

    2012-06-01

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

  14. 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)

  15. Cataract surgery in Knobloch syndrome: a case report

    OpenAIRE

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

    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...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bernal-Delgado Enrique

    2007-04-01

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

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    Umesh

    2014-03-01

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

  20. Phacoemulsification with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    OpenAIRE

    Silva, SR; Riaz, Y; Evans, JR

    2014-01-01

    BACKGROUND: Age-related cataract is one of the leading causes of blindness worldwide. Therefore, it is important to establish the most effective surgical technique for cataract surgery. OBJECTIVES: The aim of this review is to examine the effects of two types of cataract surgery for age-related cataract: phacoemulsification and extracapsular cataract extraction (ECCE). SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library...

  1. Cataract prevalence and prevention in Europe: a literature review

    OpenAIRE

    Prokofyeva, Elena; Wegener, Alfred; Zrenner, Eberhart; Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany

    2012-01-01

    This literature review is aimed at the evaluation of the potential for cataract prevention in Europe. It was performed using Pub-MED with Mesh and free text terms. Studies included were: a) performed on a population of Caucasian origin at an age range of 40-95 years, b) cataract was clinically verified, c) drug record of prescriptions, their indication, a record of every diagnosis, dosage, and quantity of prescribed medicine were available, d) sample size >300, e) published between 1990 and 2...

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

    OpenAIRE

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

    2011-01-01

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

  3. Capsular Block Syndrome Following Combined Cataract and Vitrectomy Surgery in a Patient With Intraocular Gas.

    Science.gov (United States)

    Goodwin, Diamond M; Casey, Richard; Tsui, Irena

    2015-10-01

    The aim of this report is to describe the diagnosis, treatment, and prevention of the rare complication of capsular block syndrome following combined cataract and vitrectomy surgery in a patient with intraocular gas. [Ophthalmic Surg Lasers Imaging Retina. 2015;46:980-982.]. PMID:26469241

  4. Experimental studies on the usage possibilities of the holmium laser in cataract surgery

    Science.gov (United States)

    Kecik, Tadeusz; Kecik, Dariusz; Kasprzak, Jan; Pratnicki, Antoni; Jankiewicz, Zdzislaw; Zajac, Andrzej

    1996-03-01

    The authors present initial investigations of used holmium laser during experimental cataract surgery. The investigations were performed 'in vitro' and 'in vivo.' The presented results of the experiments show that structure of the lens can be emulsified with the use of the holmium laser.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: To compare the risk of surgical complications after primary surgical intervention for postoperative endophthalmitis after cataract surgery (PE) in cases that underwent a pars plana vitrectomy (PPV) or a vitreous tap (VT) in Denmark in the calendar period 1 January 2000 to 30 June 2011...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  7. 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.

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

    OpenAIRE

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

    1994-01-01

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

  9. Changes of Vision-Related Quality of Life in Retinal Detachment Patients after Cataract Surgery

    OpenAIRE

    Zhu, Mingming; Huang, Jiannan; Zhu, Bijun; SUN, QIAN; XU, XIAN; Miao, Yuyu; Zou, Haidong

    2015-01-01

    Rhegmatenous retinal detachment (RRD) is one of the most serious complications after phacoemulsification combined with intraocular lens implantation surgery. It has been reported that vision-related quality of life (VRQoL), as well as visual acuity rapidly decreased when RRD developed. However, little is known of the VRQoL in those RRD patients after anatomical retinal re-attachment, especially whether or not the VRQoL is higher than that before cataract surgery. In this prospective case seri...

  10. Use of vision tests in clinical decision making about cataract surgery: results of a national survey

    OpenAIRE

    Frost, N; Sparrow, J

    2000-01-01

    AIM—To provide information on the use of vision tests in clinical decision making about cataract surgery in the UK.?METHOD—A questionnaire survey was mailed to 703 consultant ophthalmologists.?RESULTS—A response rate of 70% was obtained. Monocular distance visual acuity was the only visual function that was tested routinely by all surgeons. Supplementary use of contrast sensitivity and glare testing was low. Many surgeons (35%) were willing to consider surgery at acuity levels better than 6/9...

  11. 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...

  12. Congenital Cataract: Prevalence and Surgery Age at Zhongshan Ophthalmic Center (ZOC)

    OpenAIRE

    Lin, Haotian; Yang, Ye; Chen, Jingjing; Zhong, Xiaojian; Liu, Zhaochuan; Lin, Zhuoling; chen, Wan; Luo, Lixia; Qu, Bo; Zhang, Xinyu; Zheng, Danying; Zhan, Jiao; Wu, Hanfu; WANG, ZHIRONG; Geng, Yu

    2014-01-01

    Congenital cataract (CC) is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Residence, gender, age at surgery, hospital...

  13. Effect of 1% brinzolamide and 0.5% timolol fixed combination on intraocular pressure after cataract surgery with phacoemulsification

    OpenAIRE

    Kemal Örnek; Nesrin Büyüktortop; Nurgül Örnek; Reyhan O?urel; ?nci Elif Erbahçeci; Zafer Onaran

    2013-01-01

    AIM: To evaluate the effect of brinzolamide-timolol fixed combination on intraocular pressure (IOP) after cataract surgery.METHODS:The study included 92 eyes of 87 patients who underwent cataract surgery and intraocular lens implantation. Patients scheduled for phacoemulsification were assigned to 1 of 2 groups. The treatment group received 1 drop of brinzolamide-timolol fixed combination immediately after surgery, and the control group received no treatment. The IOP was measured preoperative...

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Shaheen P Shah

    2011-10-01

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

  16. A prospective study on postoperative pain after cataract surgery

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2013-01-01

    Jonathan S Chang, Harry W Flynn Jr, Darlene Miller, William E Smiddy Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Background: Stenotrophomonas maltophilia is a Gram-negative organism known to cause opportunistic infections. It is a rare source of endophthalmitis, often in the setting of trauma, but has been reported following cataract extraction. The purpose of this study was to evaluate antimicrobial sensitivities, c...

  18. Cataract surgery: expectations of patients assisted during a community project in São Paulo, state of São Paulo, Brazil

    OpenAIRE

    Kara-Júnior Newton; Temporini Edméa Rita; Kara-José Newton

    2001-01-01

    OBJECTIVE: To identify social characteristics and expectations of individuals seen during a community project for the treatment of senile cataracts. Expected results from their eye surgery and its consequences to their quality of life were studied as well. METHODOLOGY: Cataract patients (visual acuity equal to or lower than 0.2 in the more superior eye) aged 50 years or over, were surveyed by means of interviews held during their visit at the Cataract Project in São Paulo city, State of São P...

  19. Etiopathogenesis of cataract: An appraisal

    OpenAIRE

    Gupta, Varun B; Rajagopala, Manjusha; Ravishankar, Basavaiah

    2014-01-01

    Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise...

  20. EVALUATION OF VISUAL OUTCOME AFTER CATARACT EVALUATION OF VISUAL OUTCOME AFTER CATARACT SURGERY IN CAMP PATIENTS - A STUDY FROM CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Madhu

    2014-02-01

    Full Text Available BACKGROUND : Cataract is the leading cause of avoidable blindness in India. Around 4 million people become blind each year because of cataract. AIM : To assess the visual outcome and complications associated with cataract surgery in camp patients operated at a Medical College tertiary hospital. MATERIALS AND METHODS : It was a retrospective study where 412 camp patients underwent posterior chamber intrao cular lens implantation surgery over a period of one year. Data was compiled based on demographic characteristics , and post - operative complications. It was graded as per Oxford Cataract Treatment and Evaluation Team (OCTET definitions on first post - operat ive day. After one month post - operative complications , best corrected visual acuity and refractive errors were also analyzed. RESULTS : 412 eyes underwent cataract surgery with posterior chamber intraocular lens implantation . The maximum patients were in th e age group of 60 - 69 years , 180 (43.6% patients. , Among these patients 240 were males (58.2 % and 172 were females (41.7 %. Small incision cataract surgery (SICS with intraocular lens implant was the commonest surgical method (80% used. 792 eyes of 41 2 patients had cataract , of which 596 had the cortical type (75.3 % and 196 had the nuclear type (24.7 %. Of the cortical type , 428 were immature and 168 were mature cataracts Based on OCTET grading , the most common first post - operative day complication was mild iridocyclitis (26.2% followed by transient corneal edema in 86 patients. The major post - operative complications after 4 weeks of cataract surgery were pigments on PCIOL in 18 (4.36% cases and capsular flap in 12 cases. After 4 weeks post - operati ve best corrected visual acuity of eye 6/18 in 89.8% cases. The commonest refractive error was Myopia with against the rule astigmatism seen in 172 out of 300 patients. CONCLUSION : Acceptable results can be obtained from eye camp surgery patients with expe rienced ophthalmologists in the base hospitals and these camps help in reducing huge burden of cataract patients. Our aim remains to reach more blind and needy patient and to provide an improved standard of visual rehabilitation

  1. 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.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    UNLABELLED: We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly...... during surgery. Skin prick tests were also positive for methylcellulose. Based on symptoms and clinical signs of anaphylaxis following 2 separate cataract operations together with positive prick tests to HPMC, HPMC is the most plausible cause of the reactions. The patient has since had uneventful surgery...... 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....

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

    DEFF Research Database (Denmark)

    Munk, Sofie J; Heegaard, Steffen

    2013-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Roberta Ferrari Marback

    2012-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Eva I Mönestam

    2008-03-01

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

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

    OpenAIRE

    Soo Jung Lee; Wan-Soo Kim

    2014-01-01

    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 patie...

  7. Axial Elongation following Cataract Surgery during the First Year of Life in the Infant Aphakia Treatment Study

    OpenAIRE

    Lambert, Scott R; LYNN, MICHAEL J.; DuBois, Lindreth G.; Cotsonis, George A; Hartmann, E. Eugenie; Wilson, M. Edward

    2012-01-01

    We compared ocular axial elongation in infants after unilateral cataract surgery corrected with a contact lens or intraocular lens implantation. Aphakic eyes were on average 0.6 mm shorter than pseudophakic eyes at age 12 months.

  8. Intraoperative usefulness and postoperative results of the endoilluminator for performing primary posterior capsulectomy and anterior vitrectomy during pediatric cataract surgery

    Science.gov (United States)

    Matalia, J; Anaspure, H; Shetty, B K; Matalia, H

    2014-01-01

    Purpose To analyze the intraoperative usefulness and postoperative results of endoilluminator use during pediatric cataract surgery. Methods Medical records of children lens aspiration with primary posterior capsulectomy (PPC) and anterior vitrectomy (AV) with or without intraocular lens implantation (IOL) were studied. An endoilluminator was used intraoperatively as an external light source in all cases to ensure the completeness of PPC and adequacy of AV. All children were divided into three groups depending upon the age at surgery and presence of IOL. We included only the first operated eye in bilateral cases. We studied the intraoperative performance for all and postoperative complications for those with >6 months follow-up. Results The charts of 79 eyes of 46 children (26 boys, 20 girls: 33 bilateral, 13 unilateral) were reviewed, of which we analyzed 46 eyes of 46 children for intraoperative performance and 42 eyes of 42 children for postoperative complications. The intraoperatively adequate size of PPC was obtained in all cases with no vitreous in the anterior chamber. Two cases in the first group developed peaking of the pupil, and one case developed visual axis contraction requiring membranectomy. None of the cases in the other groups developed any complication. Conclusion An endoilluminator is a simple, safe, and powerful tool for better visualization of the posterior capsule and anterior vitreous during pediatric cataract surgery. It helps in confirming a good vitrectomy, ensuring its completeness and thereby reducing the chances of any complication due to inadequate AV. PMID:24946844

  9. Clinical observation of bromfenac sodium 0.1% eye drops on cataract surgery

    Directory of Open Access Journals (Sweden)

    Jie Chen

    2015-12-01

    Full Text Available AIM:To investigate the effects of combined with bromfena sodium 0.1% eye drops and steroids eye drops on cataract surgery, then further study its safety and effectiveness on phaeoemulsfieation.METHODS:A prospective, randomized, controlled study including 100 patients(120 eyes, enrolled for cataract surgery. The patients were randomized to topical treatment with Tobramycin and Dexamethasone combined with bromfenac sodium 0.1%(trial group, 60 eyesor Tobramycin and Dexamethasone(control group, 60 eyes. Scleral tunnel incision phacoemulsification cataract extraction and intraocular lens implantation was used. The sign, symptom, intraocular pressure(IOPand optical coherence tomography(OCTwere determined postoperative 1, 7, 14d.RESULTS:There were significant differences in symptoms and signs between two groups at postoperative 7 and 14d(PP>0.05. The value of the trial group was lower than that of the control group. Preoperative IOP was 14.657±2.605mmHg in trial group and 14.415±2.761mmHg in control group, the difference was not statistically significant(P>0.05. IOP in trial group were lower than that of control group at postoperative 1, 7, 14d, the difference was statistically significant(PPCONCLUSION:Application of 0.1% bromfenac sodium eye drop and Tobramycin and Dexamethasone eye drops for cataract extraction and intraocular lens implantation in the treatment of postoperative inflammation has better treatment effect. It is safe and effective, and less prone to ocular hypertension and other serious complications; At the same time it can significantly reduce the incidence of postoperative macular edema, prevention of macular edema after cataract surgery, with security and reliability, worthy of clinical application.

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

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    Zhong-Yu Xu

    2013-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Heloisa Neumann Nogueira

    2015-04-01

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

  12. Cirurgia de catarata: o porquê dos excluídos / Reasons for not having cataract surgery

    Scientific Electronic Library Online (English)

    Newton, Kara-José; Edméa Rita, Temporini.

    1999-10-01

    Full Text Available A catarata é a principal causa de cegueira no mundo, embora seja passível de recuperação por intervenção cirúrgica relativamente simples e de baixo custo. O presente estudo, realizado em 1997 e 1998 em cinco municípios do Estado de São Paulo, Brasil, teve o propósito de identificar as razões para a [...] falta de acesso ao tratamento cirúrgico por parte dos deficientes visuais por catarata senil. Foram entrevistados pacientes atendidos em um projeto comunitário de reabilitação da cegueira por catarata, o Projeto Zona Livre de Catarata. Obteve-se uma amostra prontamente acessível, composta por 776 sujeitos que procuraram a assistência do projeto e que apresentavam acuidade visual menor do que 0,2 no olho melhor (média de idade = 70 anos). Foi aplicado um questionário por entrevista. Dentre os pacientes, 683 haviam procurado atendimento oftalmológico antes do Projeto Catarata; o tipo mais comum de atendimento procurado foi o serviço público de saúde (27%). Dificuldades financeiras (69%) e ainda enxergar bem (69%) foram as razões predominantes alegadas pelos pacientes para não terem se submetido à cirurgia de catarata. Dentre os que manifestaram receio da cirurgia, a principal alegação foi medo de ficar cego. Todos os pacientes que receberam indicação cirúrgica no período do estudo concordaram em se submeter à cirurgia. Aparentemente, existe uma lacuna entre a busca de serviços oftalmológicos e a resolução cirúrgica da catarata. Os fatores predominantes para a não realização da cirurgia foram econômicos e logísticos. É necessário facilitar o acesso da população à cirurgia de catarata por meio de modelos assistenciais descentralizados e de projetos e campanhas comunitárias de prevenção da cegueira por catarata. Abstract in english Cataracts are the main cause of blindness in the world, although they can be treated with relatively simple and inexpensive surgery. This study was carried out in 1997 and 1998 in five cities in the state of São Paulo, Brazil, to identify the reasons for persons not having cataract surgery. The popu [...] lation studied were patients seen at a community project for the rehabilitation of cataract-caused blindness, Projeto Zona Livre de Catarata (the Cataract-free-Zone Project). A questionnaire was used to interview 776 individuals with cataracts who sought assistance at the project and who had a visual acuity of 20/100 or less in the better eye. Six hundred and eighty-three patients had previously sought ophthalmic care, most frequently (27%) at public health services. The main reasons for subjects not having had cataract surgery were financial (69% of respondents) and the feeling of "still having good eyesight" (69% of respondents). Among patients who said they were afraid of surgery, the main reason was concern about being left blind. All the subjects whom the project deemed suitable for surgery agreed to undergo the procedure. Apparently, there is a gap between searching for ophthalmic services and the surgical resolution of cataracts. The predominant reasons for not having surgery were financial and logistical. There is a need to facilitate access to cataract surgery by decentralizing social services and by developing community projects to prevent cataract-caused blindness.

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

    OpenAIRE

    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, histochemica...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Corrective Techniques and Future Directions for Treatment of Residual Refractive Error Following Cataract Surgery

    OpenAIRE

    Moshirfar, Majid; McCaughey, Michael V; Santiago-Caban, Luis

    2014-01-01

    Postoperative residual refractive error following cataract surgery is not an uncommon occurrence for a large proportion of modern-day patients. Residual refractive errors can be broadly classified into 3 main categories: myopic, hyperopic, and astigmatic. The degree to which a residual refractive error adversely affects a patient is dependent on the magnitude of the error, as well as the specific type of intraocular lens the patient possesses. There are a variety of strategies for resolving r...

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

    OpenAIRE

    Gunvant P; Ablamowicz A; Gollamudi S

    2011-01-01

    Pinakin Gunvant1,2, Anna Ablamowicz2, Subba Gollamudi31Western University of Health Sciences, College of Optometry, Pomona, CA, 2Southern College of Optometry, Memphis, TN, 3Eye Specialty Group, Memphis, TN, USAPurpose: To investigate if the parameters measured routinely prior to cataract surgery with multifocal intraocular lens (IOL) implantation can predict the necessity of additional laser in situ keratomileusis (LASIK) to improve visual outcome.Methods: Records of patients undergoing cata...

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

    OpenAIRE

    Tarabishy, Ahmad B.; Steinemann, Thomas L

    2010-01-01

    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 ant...

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

    OpenAIRE

    Ansari Imran A; Onyema Ernest

    2008-01-01

    Abstract Introduction Systemic hypersensitivity reactions to topical ophthalmic treatment occur rarely, but when they do they can be severe as highlighted by this case. Case presentation A post-operative cataract surgery patient developed a severe and generalised hypersensitivity reaction following topical treatment with Maxitrol (Dexamethasone and Neomycin) eye drops. The patient reported a previous allergic reaction to Neomycin. Conclusion This case report emphasises the importance of a tho...

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

    OpenAIRE

    Eva I Mönestam; Lundqvist, Britta M; Åsa C Jonsson

    2008-01-01

    Eva I Mönestam, Britta M Lundqvist, Åsa C JonssonDepartment of Clinical Sciences/Ophthalmology, Umeå University, Umeå, SwedenBackground/aims: To assess longitudinal 5-year results of cataract surgery on low vision patients.Methods: In this prospective, long-time, observational case-series, we report the outcome regarding the subjective visual function (n = 35) assessed by a visual function questionnaire (VF-14) and the visual acuity (n = 30) of surviving...

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

    OpenAIRE

    Saedon H

    2013-01-01

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

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

    OpenAIRE

    Saedon, Habiba

    2013-01-01

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

  3. The need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern

    OpenAIRE

    McCarty, C.; Keeffe, J.; Taylor, H

    1999-01-01

    AIM—To assess the projected needs for cataract surgery by lens opacity, visual acuity, and patient concern.?METHODS—Data were collected as part of the Melbourne Visual Impairment Project, a population based study of age related eye disease in a representative sample of Melbourne residents aged 40 and over. Participants were recruited by a household census and invited to attend a local screening centre. At the study sites, the following data were collected: presenting and best corrected visual...

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

    DEFF Research Database (Denmark)

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

    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 morphomet...

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

    OpenAIRE

    Yelda B Özkurt; Arzu Taskiran; Nadire Erdogan; Baran Kandemir; et. al.

    2009-01-01

    Yelda B Özkurt, Arzu Taskiran, Nadire Erdogan, Baran Kandemir, Ömer K Dog?anDepartment of Ophthalmology, Kartal Training and Research Hospital, Istanbul, TurkeyPurpose: To evaluate the influence of irrigation of the anterior chamber with heparin sodium on postoperative inflammation after pediatric cataract surgery. Setting: Kartal Training and Research Hospital, First Eye Clinic, Istanbul, Turkey.Design: Randomized prospective double-blind study.Methods: Fourteen consecutive...

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

    OpenAIRE

    H. Zahedi

    2004-01-01

    Background: Postoperative shivering is a common event of unknown etiology with an incidence of 5-65%. This study intended to compare the efficacy of tramadol with that of pethidine in controlling postanesthetic shivering. Methods: This double-blind clinical trial was performed on 300 consecutive patients underwent general anesthesia for elective cataract surgery. Intravenous tramadol 1 mg/kg or pethidine 0.5 mg/kg was administered for alternate subjects who developed postanesthetic shivering....

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

    Directory of Open Access Journals (Sweden)

    Dong-Mei Cai

    2013-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Diane TW Chang

    2009-05-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  10. [Surgical management of coexisting glaucoma and cataract].

    Science.gov (United States)

    Zhong, Hua; Yuan, Yuan-sheng

    2012-06-01

    Coexisting glaucoma and cataract is a common eye disorder in elderly population. Recent advances in the management of patients with coexisting cataract and glaucoma offer a promising alternative in patients with uncontrolled glaucoma and a cataract and provide an individualized treatment depending upon patient's characteristics and intraocular pressure (IOP). Based on many significant studies that have been conducted in the combining cataract extraction with a glaucoma surgery in recent years, present article reviews the different surgical options on the control of their postoperative IOP level in the different stages of glaucoma and the surgical strategies for patients with combined cataract and glaucoma. PMID:22943814

  11. Effects of Cataract Surgery on Intraocular Pressure in Patients with and without Glaucoma

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    Tülin ?smi

    2013-06-01

    Full Text Available Pur po se: To evaluate the effects of phacoemulsification surgery with primary intraocular lens (IOL implantation on intraocular pressure (IOP in various types of glaucoma patients with visually significant cataract and to compare these results with cataract patients without glaucoma. Ma te ri al and Met hod: This retrospective study included consecutive cases of 21 primary open-angle glaucoma patients, 13 primary angle-closure glaucoma (PACG patients, 11 pseudoexfoliation glaucoma patients, and 21 control eyes without any type of glaucoma; all patients had co-existing cataract. Visual acuities, IOP, number of glaucoma medications used, anterior chamber depth (ACD, and gonioscopic evaluations were noted both pre- and postoperatively. Phacoemulsification and IOL implantations were performed via clear corneal incisions in the whole study group. Study group was followed-up for six months. Re sults: Postoperative visits at the 1st, 3rd, and 6th months were noted. After surgery, visual acuities improved significantly (p=0.001 in all groups. Intraocular pressures decreased in all groups postoperatively, but the change was statistically significant in the PACG group (p=0.013. Increase in ACD was significant in PACG group (p=0.001. Widening of iridocorneal angle and decrease in the number of antiglaucoma drugs were observed in all groups, but these were significant in the PACG group (p=0.001 and p<0.05, respectively. Dis cus si on: In glaucoma patients with co-existing cataract, phacoemulsification surgery allows both the visual rehabilitation and IOP control. This IOP lowering effect is seen most markedly in the PACG group. (Turk J Ophthalmol 2013; 43: 167-72

  12. 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.

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

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    Agresta Blaise

    2012-08-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  15. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2015-01-01

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

  17. 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.

  18. Observation of corneal endothelial cells in small incision phacoemulsification and phacoemulsification surgery in elderly hardcore cataract

    Directory of Open Access Journals (Sweden)

    Li Wang

    2015-09-01

    Full Text Available AIM:To observe and compare the changes of corneal endothelial cells with after phacoemulsification and small incision non- phacoemulsification in elderly hard nuclear cataract.METHODS:In this retrospective analysis, the patients received small incision non-phacoemulsification cataract extraction combined with intraocular lens implantation were as group A, 36 cases(40 eyesand those underwent ultrasonic phacoemulsification combined with intraocular lens implantation were for group B, 38 cases(46 eyes. Operation time, preoperative, postoperative 1and 6mo, uncorrected visual acuity, corneal endothelial changes were compared.RESULTS: The operation time of the two groups had no significant difference. UCVA of postoperative 1mo was ? 0.5 after surgery, the difference between the two groups had statistical significance(?2=5.174, P=0.023. One month and 6mo after operation, the corneal endothelial cell counts of two groups were compared, with statistical significance(t=2.565, P=0.038; t=2.774, P=0.041and the difference of corneal endothelial cell loss rate between two groups had statistical significance(Pt=2.225, P=0.045; t=2.153, P=0.039. The coefficient variation of two groups had statistically significant difference(PCONCLUSION: Small incision non-phacoemulsification operation is a more safe and effective surgery method for treating elderly hardcore cataract patients.

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

    Directory of Open Access Journals (Sweden)

    Morkin MI

    2014-08-01

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

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

    Science.gov (United States)

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

    2015-01-01

    Purpose: A systematic review and meta-analysis comparing the safety, efficacy, and expenses related to phacoemulsification versus manual small incision cataract surgery (SICS). Methods: PubMed, Cochrane, and Scopus databases were searched with key words manual SICS 6/18 and 6/60; astigmatism and endothelial cell loss postoperatively, intra- and post-operative complications, phacoemulsification, and comparison of SICS and phacoemulsification. Non-English language manuscripts and manuscripts not indexed in the three databases were also search for comparison of SICS with phacoemulsification. Data were compared between techniques for postoperative uncorrected and corrected distance visual acuity (UCVA and best corrected visual acuity [BCVA], respectively) better than 6/9, surgical cost and duration of surgery. The Oxford cataract treatment and evaluation team scores were used for grading intraoperative and postoperative complications, uncorrected near vision. Result: This review analyzed, 11 comparative studies documenting 76,838 eyes that had undergone cataract surgery considered for analysis. UCVA of 6/18 UCVA and 6/18 BCVA were comparable between techniques (P = 0.373 and P = 0.567, respectively). BCVA of 6/9 was comparable between techniques (P = 0.685). UCVA of 6/60 and 6/60 BCVA aided and unaided vision were comparable (P = 0.126 and P = 0.317, respectively). There was no statistical difference in: Endothelial cell loss during surgery (P = 0.298), intraoperative (P = 0.964) complications, and postoperative complications (P = 0.362). The phacoemulsification group had statistically significantly less astigmatism (P = 0.005) and more eyes with UCVA of 6/9 (P = 0.040). UCVA at near was statistically significantly better with SICS due to astigmatism and safer during the learning phase (P = 0.003). The average time for SICS was lower than phacoemulsification and cost <½ of phacoemulsification. Conclusion: The outcome of this meta-analysis indicated there is no difference between phacoemulsification and SICS for BCVA and UCVA of 6/18 and 6/60. Endothelial cell loss and intraoperative and postoperative complications were similar between procedures. SICS resulted in statistically greater astigmatism and UCVA of 6/9 or worse, however, near UCVA was better. PMID:26180478

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Real-time task recognition in cataract surgery videos using adaptive spatiotemporal polynomials.

    Science.gov (United States)

    Quellec, Gwénolé; Lamard, Mathieu; Cochener, Béatrice; Cazuguel, Guy

    2015-04-01

    This paper introduces a new algorithm for recognizing surgical tasks in real-time in a video stream. The goal is to communicate information to the surgeon in due time during a video-monitored surgery. The proposed algorithm is applied to cataract surgery, which is the most common eye surgery. To compensate for eye motion and zoom level variations, cataract surgery videos are first normalized. Then, the motion content of short video subsequences is characterized with spatiotemporal polynomials: a multiscale motion characterization based on adaptive spatiotemporal polynomials is presented. The proposed solution is particularly suited to characterize deformable moving objects with fuzzy borders, which are typically found in surgical videos. Given a target surgical task, the system is trained to identify which spatiotemporal polynomials are usually extracted from videos when and only when this task is being performed. These key spatiotemporal polynomials are then searched in new videos to recognize the target surgical task. For improved performances, the system jointly adapts the spatiotemporal polynomial basis and identifies the key spatiotemporal polynomials using the multiple-instance learning paradigm. The proposed system runs in real-time and outperforms the previous solution from our group, both for surgical task recognition ( Az = 0.851 on average, as opposed to Az = 0.794 previously) and for the joint segmentation and recognition of surgical tasks ( Az = 0.856 on average, as opposed to Az = 0.832 previously). PMID:25373078

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

    Directory of Open Access Journals (Sweden)

    H SOLTANI NEZHAD

    2003-03-01

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

  4. Transient leopard spot corneal endothelial staining with trypan blue during cataract surgery in a child with congenital rubella syndrome.

    Science.gov (United States)

    Baldwin, Andrew; Risma, Justin; Longmuir, Susannah

    2013-12-01

    We report the complication of corneal endothelial staining with trypan blue that limited the surgical view during cataract extraction in a 10-month-old boy. The boy had presented with a pigmentary retinopathy, microphthalmia, and a dense, white, unilateral congenital cataract. He was suspected of having, and was later diagnosed with, congenital rubella syndrome. We hypothesize that the corneal staining may have resulted from virally induced corneal endothelial damage. To our knowledge, this is the first reported case of trypan blue adversely affecting congenital cataract surgery. PMID:24210344

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

    Directory of Open Access Journals (Sweden)

    Glisic Selimir

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

    Khumbo Kalua; Francis Masiye; Vincent Jumbe; John Barrows; Victoria Sheffield

    2013-01-01

    Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making withi...

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

    Directory of Open Access Journals (Sweden)

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

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    Xue-Jiao Xu

    2015-12-01

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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Manuela Bezerril Cipião Fernandes

    2013-12-01

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

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

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    Jatin

    2015-05-01

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

  13. 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.

  14. 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)

  15. Research on refractive status characteristics and anterior chamber depth after cataract surgery

    Directory of Open Access Journals (Sweden)

    Xiao-Cheng Feng

    2015-07-01

    Full Text Available AIM:To study the refractive status characteristics aftser cataract surgery and the correlation between preoperative anterior chamber depth(ACDand refractive status.METHODS: Ninety-six cases of patients with cataract were randomly divided into two groups. The patients in phacoemulsification group were treated with phacoemulsification combined intraocular lens(IOLimplantation while the patients in small incision group were treated by small incision extracapsular cataract extraction combined with IOL implantation. Changes in ACD and postoperative refractive status and refractive fully corrected value were counted and the correlation of them were analyzed.RESULTS: ACD of the phacoemulsification group s deepened 0.74mm while that of the small incision group deepened 0.78mm after treatment and there was no significant difference(P>0.05. After operation, the ACD of two groups significantly deepened(PPP>0.05. CONCLUSION: ACD is significant deepened after operation. Surgeon needs full consideration of changes to improve the refractive IOL calculation accuracy.

  16. Effects of regulated competition on key outcomes of care: cataract surgeries in the Netherlands.

    Science.gov (United States)

    Heijink, Richard; Mosca, Ilaria; Westert, Gert

    2013-11-01

    Similar to several other countries, the Netherlands implemented market-oriented health care reforms in recent years. Previous studies raised questions on the effects of these reforms on key outcomes such as quality, costs, and prices. The empirical evidence is up to now mixed. This study looked at the variation in prices, volume, and quality of cataract surgeries since the introduction of price competition in 2006. We found no price convergence over time and constant price differences between hospitals. Quality indicators generally showed positive results in cataract care, though the quality and scope of the indicators was suboptimal at this stage. Furthermore, we found limited between-hospital variation in quality and there was no clear-cut relation between prices and quality. Volume of cataract care strongly increased in the period studied. These findings indicate that health insurers may not have been able to drive prices down, make trade-offs between price and quality, and selectively contract health care without usable quality information. Positive results coming out from the 2006 reform should not be taken for granted. Looking forward, future research on similar topics and with newer data should clarify the extent to which these findings can be generalized. PMID:23827262

  17. 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.

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

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    Juan Carlos Sánchez Caballero

    2013-04-01

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

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

    Science.gov (United States)

    Hjelmstad, David P.; Sayegh, Samir I.

    2013-03-01

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

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

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    Yelda B Özkurt

    2009-06-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    ABSTRACT. Purpose: To estimate the long-term cumulative incidence of cataract surgery and associated risk factors in a 25-year follow-up of a population-based cohort of patients with type 1 diabetes. Methods: Based on insulin prescriptions, a population-based cohort of 727 patients with type 1 diabetes was identified in 1973. In 1981-1982 diabetic retinopathy was graded and other markers of diabetes were measured in 573 patients who participated in a clinical baseline examination. Based on data ...

  2. Restoring sight: how cataract surgery improves the lives of older adults

    OpenAIRE

    Sarah Polack

    2008-01-01

    The fundamental aim of most ophthalmic interventions in later life is to improve the quality of patients' lives, whether through sight-restoring cataract surgery or the provision of visual aids. Amidst the pressures of targets, outputs, and backlogs, this may be all too easily forgotten. It is therefore important to step back and remember just how important good vision is in the lives of older adults.Vision loss has a major negative impact on the quality of older people's lives. Sight remains...

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

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    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.

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

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    Matsuura K

    2014-09-01

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

  5. Use of a grading system in the evaluation of complications in a randomised controlled trial on cataract surgery. Oxford Cataract Treatment and Evaluation Team (OCTET).

    OpenAIRE

    1986-01-01

    A randomised controlled trial in progress for more than five years assessed 333 eyes by three methods of cataract surgery. These were (A) intracapsular extraction and contact lens usage; (B) intracapsular extraction and implantation of an iris supported lens (Federov I); and (C) extracapsular extraction and implantation of an iridocapsular lens (Binkhorst 2-loop). This paper reports the use of a weighting scale for rank scoring complications which are dissimilar or are mutually exclusive (for...

  6. 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.

  7. Continuous Curvilinear Capsulorhexis in Cataract Surgery Using a Modified 3-Bend Cystotome

    Science.gov (United States)

    Zeng, Yuan; Gao, Jian-hua

    2015-01-01

    We modified a 2-bend cystotome for continuous curvilinear capsulorhexis (CCC) in manual or phacoemulsification cataract surgery to improve the safety and ease of performance. A 26G needle was converted into a cystotome with 3 bends. In this retrospective study, the performance of modified 3-bend cystotome was compared with conventional 2-bend cystotome. During cataract surgery, in the 3-bend cystotome group, mean completion time of CCC was shorter, mean times of viscoelastic agent supplement were less, and CCC success rate was higher than that in 2-bend group. Complication incidence, such as postoperative transient corneal edema and irreparable V-shaped tear, was also lower in 3-bend group. No posterior capsular rupture or no other complication was observed in either group. A polymethyl methacrylate intraocular lens or a hydrogel intraocular lens was implanted in the capsular bag in all eyes. We conclude that it is safe and efficient to accomplish a CCC using the 3-bend cystotome due to its ability to sustain the anterior chamber depth (ACD) and keep the posterior lip intact. Using the 3-bend cystotome also allowed for an adequate view into the anterior chamber from lack of wound deformation. PMID:26509078

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. Real-time segmentation and recognition of surgical tasks in cataract surgery videos.

    Science.gov (United States)

    Quellec, Gwénolé; Lamard, Mathieu; Cochener, Béatrice; Cazuguel, Guy

    2014-12-01

    In ophthalmology, it is now common practice to record every surgical procedure and to archive the resulting videos for documentation purposes. In this paper, we present a solution to automatically segment and categorize surgical tasks in real-time during the surgery, using the video recording. The goal would be to communicate information to the surgeon in due time, such as recommendations to the less experienced surgeons. The proposed solution relies on the content-based video retrieval paradigm: it reuses previously archived videos to automatically analyze the current surgery, by analogy reasoning. Each video is segmented, in real-time, into an alternating sequence of idle phases, during which no clinically-relevant motions are visible, and action phases. As soon as an idle phase is detected, the previous action phase is categorized and the next action phase is predicted. A conditional random field is used for categorization and prediction. The proposed system was applied to the automatic segmentation and categorization of cataract surgery tasks. A dataset of 186 surgeries, performed by ten different surgeons, was manually annotated: ten possibly overlapping surgical tasks were delimited in each surgery. Using the content of action phases and the duration of idle phases as sources of evidence, an average recognition performance of Az = 0.832 ± 0.070 was achieved. PMID:25055383

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Background.?Premature aging has been suggested a risk factor for early death in patients infected with human immunodeficiency virus (HIV). Therefore, the risk of age-related diseases, such as cataracts, should be increased in this population. In a nationwide, population-based cohort study we...... assessed the risk of cataract surgery in HIV-infected individuals compared with the general population.Methods.?We identified 5315 HIV-infected individuals from a Danish national cohort of HIV-infected individuals and a population-based age- and sex-matched comparison cohort of 53?150 individuals. Data on...... cataract surgery were obtained from the Danish National Hospital registry. Cumulative incidence curves were constructed. Incidence rate ratios (IRRs) and impact of immunodeficiency, highly active antiretroviral therapy (HAART), and treatment with abacavir, tenofovir, protease inhibitors, and nonnucleoside...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Background. Premature aging has been suggested a risk factor for early death in patients infected with human immunodeficiency virus (HIV). Therefore, the risk of age-related diseases, such as cataracts, should be increased in this population. In a nationwide, population-based cohort study we...... assessed the risk of cataract surgery in HIV-infected individuals compared with the general population. Methods. We identified 5315 HIV-infected individuals from a Danish national cohort of HIV-infected individuals and a population-based age- and sex-matched comparison cohort of 53¿150 individuals. Data on...... cataract surgery were obtained from the Danish National Hospital registry. Cumulative incidence curves were constructed. Incidence rate ratios (IRRs) and impact of immunodeficiency, highly active antiretroviral therapy (HAART), and treatment with abacavir, tenofovir, protease inhibitors, and nonnucleoside...

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

    Scientific Electronic Library Online (English)

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

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

  14. Visual outcome of uveitic cataract in Ibadan.

    Science.gov (United States)

    Fasina, O; Bekibele, C O

    2010-12-01

    The aim of this study is to evaluate the factors responsible for poor visual outcome in patients who had surgery for cataract due to uveitis in our subpopulation. A nonrandomized retrospective chart review of 28 patients (28 eyes) diagnosed with uveitic cataract that had cataract surgery between June 2001 and May 2007 at the University College Hospital, Ibadan, Nigeria was carried out. All had extracapsular cataract extraction with or without IOL implantation. The outcome measure was post-operative best corrected visual acuity. Over 60% of our patients achieved final best corrected visual acuity (BCVA) of 6/18 or better. The major causes of poor vision were posterior capsule opacity (PCO) in 6 patients, cystoid macular oedema (CMO) in 2 patients and pre-existing chorioretinal scar in 1 patient. We conclude that post uveitic cataract surgery results in good visual outcome with few complications in Ibadan. PMID:21735999

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

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    Mei-Na Huang

    2015-10-01

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

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

    Scientific Electronic Library Online (English)

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

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

  17. The Impact of Successful Cataract Surgery on Quality of Life, Household Income and Social Status in South India

    Science.gov (United States)

    Fenwick, Eva; Balasubramaniam, Bharath; Ramani, Ramanathan V.; Holz, Frank G.; Gilbert, Clare E.

    2012-01-01

    Background To explore the hypothesis that sight restoring cataract surgery provided to impoverished rural communities will improve not only visual acuity and vision-related quality of life (VRQoL) but also poverty and social status. Methods Participants were recruited at outreach camps in Tamil Nadu, South India, and underwent free routine manual small incision cataract surgery (SICS) with intra-ocular lens (IOL) implantation, and were followed up one year later. Poverty was measured as monthly household income, being engaged in income generating activities and number of working household members. Social status was measured as rates of re-marriage amongst widowed participants. VRQoL was measured using the IND-VFQ-33. Associations were explored using logistic regression (SPSS 19). Results Of the 294 participants, mean age ± standard deviation (SD) 60±8 years, 54% men, only 11% remained vision impaired at follow up (67% at baseline; pcataract surgery were less likely to remain in the lower categories of monthly household income (OR 0.05–0.22; psurgery (OR 3.28; p?=?0.006). Participants widowed at baseline who had successful cataract surgery were less likely to remain widowed at one year (OR 0.02; p?=?0.008). Conclusion These findings indicate the broad positive impact of sight restoring cataract surgery on the recipients’ as well as their families’ lives. Providing free high quality cataract surgery to marginalized rural communities will not only alleviate avoidable blindness but also - to some extent - poverty in the long run. PMID:22952945

  18. 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

    OpenAIRE

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

    2011-01-01

    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 o...

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hamid Fesharaki

    2012-01-01

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

  1. Visual performance of Acrysof ReSTOR compared with a monofocal intraocular lens following implantation in cataract surgery

    OpenAIRE

    Ji, Jing; HUANG, XIAOLIN; Fan, Xianqun; Luo, Min

    2012-01-01

    The aim of this study was to compare the visual performance of Acrysof ReSTOR and Acrysof Natural intraocular lenses (IOLs) following cataract surgery. A randomized prospective study was performed in which 64 eyes (51 patients) were divided randomly into two groups. Monofocal IOLs (Acrysof Natural) were implanted into 34 eyes (27 patients) and multifocal IOLs (Acrysof ReSTOR) were implanted into 30 eyes (24 patients) using phacoemulsification surgery. The corrected distance visual acuity, nea...

  2. 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 analys...

  3. Congenital cataract. Report 2. Current strategies of congenital cataract management in children: a review

    Directory of Open Access Journals (Sweden)

    N. Ya. Senchenko

    2014-07-01

    Full Text Available Different approaches to surgical and pleoptic treatment of congenital cataract and amblyopia of obscure origin in children are represented. Main tendencies that determine the indications to surgical procedures and their terms are described. Current techniques of aphakia correction, their advantages and disadvantages as well as pleoptic methods of visual system stimulation are discussed

  4. 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.

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

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    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.

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

    Science.gov (United States)

    Tassignon, Marie-José; Dhubhghaill, Sorcha Ní

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Zare

    2011-01-01

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

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

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    Frederico F. Marques

    2011-08-01

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

  9. [Ten most progression of cataract research in China].

    Science.gov (United States)

    2015-04-01

    Ten researches that may represent the most advanced cataract related studies in China were reviewed, which were recommended and voted by specialists from Chinese Cataract and Intraocular Lens Society. These researches focused on the following fields: the clinical study of the refractive cataract surgery, the clinical study on the premium intraocular lens, location and function study of the disease-associated genes of congenital cataract, the mechanism and prevention of age-related cataract, the mechanism and prevention of oxidative damage of crystalline lens and so on. These studies represented the level of crystalline lens related disease field in China. PMID:26081235

  10. Secondary membrane formation after cataract surgery with primary intraocular lens implantation in children.

    Science.gov (United States)

    Bar-Sela, Shai M; Har-Noy, Nurit Birman; Spierer, Abraham

    2014-08-01

    To evaluate the risk factors for secondary membrane (SM) formation after congenital cataract surgery with intraocular lens (IOL) implantation. A retrospective non-interventional comparative study. Thirty-nine patients (63 eyes) aged 1-135 months. The study included patients who underwent cataract extraction and primary IOL implantation between 1994 and 2001 at the University Hospital. The postoperative follow-up was 6-24 months. Thirty-three eyes received a poly(methyl methacrylate) (PMMA) IOL without square edges, 29 eyes received a hydrophobic acrylic IOL with truncated square edges (AcrySof), and there was no data for IOL type in one eye. Thirty-nine eyes had primary posterior capsulotomy (PPC) and anterior vitrectomy (AV) and in 24 eyes the posterior capsule was left intact. Cox proportional hazard regression analysis was performed to identify significant risk factors for SM formation, and Wilcoxon test to evaluate the difference in time from surgery to SM formation. SM developed in 24 eyes (38 %)--58 % of eyes with an intact posterior capsule and 26 % of eyes having PPC and AV, 42 % of eyes with a PMMA IOL, and 34 % of eyes with an AcrySof lens. In multivariate Cox regression analysis intraoperative PPC and AV (P = 0.02) and AcrySof lens implantation (P = 0.097) were associated with decreased postoperative incidence of SM formation. Median time until SM development was 2.9 months with PMMA IOLs (range 1-17 months) and 6 months with AcrySof lenses (range 1-21.8 months) (P = 0.037). Posterior capsule management as well as IOL design and material influence the incidence and the timing of SM formation after primary IOL implantation in children. PMID:24166705

  11. 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.

  12. 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

  13. 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.

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

    Science.gov (United States)

    Wenzel, M; Schulze Schwering, M

    2016-03-01

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

  15. Effect of 1% brinzolamide and 0.5% timolol fixed combination on intraocular pressure after cataract surgery with phacoemulsification

    Directory of Open Access Journals (Sweden)

    Kemal Örnek

    2013-12-01

    Full Text Available AIM: To evaluate the effect of brinzolamide-timolol fixed combination on intraocular pressure (IOP after cataract surgery.METHODS:The study included 92 eyes of 87 patients who underwent cataract surgery and intraocular lens implantation. Patients scheduled for phacoemulsification were assigned to 1 of 2 groups. The treatment group received 1 drop of brinzolamide-timolol fixed combination immediately after surgery, and the control group received no treatment. The IOP was measured preoperatively and at 2h and 24h postoperatively.RESULTS: The mean IOP change was lower in the treatment group than in the control group at 2h postoperatively. The difference between the mean IOP values of the two groups at 2h postoperatively was found to be statistically significant. Twenty-four hours after the surgery, the mean IOP change was still higher in the control group when compared to the treatment group.CONCLUSION: The fixed combination brinzolamide-timolol can effectively reduce IOP after cataract surgery.

  16. Imaging and investigating the effects of incision angle of clear corneal cataract surgery with optical coherence tomography

    Science.gov (United States)

    Rao, Bin; Zhang, Jun; Taban, Mehran; McDonnell, Peter J.; Chen, Zhongping

    2003-12-01

    Effects of incision angle in construction of clear corneal cataract incision are studied with optical coherence tomography (OCT). A stable incision angle range is found to be existent for single-planed, clear corneal cataract incisions. When well pressurized, incision angles within this stable range result in well-apposed incision edges that resist gapping while incision angles falling outside this range have a larger tendency for wound leakage. It is also shown that a two-planed incision can effectively expand the stable range. For incision angles outside the stable range, the farther the incision angle is away from stable range, the larger the gap between incision wound edges when well pressurized. These findings emphasize the significance of incision construction to the self-sealing property of clear corneal cataract incisions. Finally, we demonstrate that OCT could be an effective modality for imaging and monitoring corneal surgery.

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  19. 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.

  20. Cataract surgery: factors influencing decision to treat and implications for training (south-east Scotland 2008–2014

    Directory of Open Access Journals (Sweden)

    Sniatecki JJ

    2015-09-01

    Full Text Available Jan J Sniatecki, Caroline Styles, Natalie Boyle, Roshini Sanders Cataract Unit, Queen Margaret Hospital, Dunfermline, Fife, UK Purpose: To describe the population referred for cataract surgery, identify factors that influenced decision to treat, and patients suitable for ophthalmic training. Patients and methods: A total of 2,693 consecutive referrals over 6 years were interrogated using Business Objects software on cataract electronic patient records. Results: A total of 2,693 patients were referred for cataract surgery (group A. Of these patients 2,132 (79% had surgery (group B and 561 (21% did not (group C. Age for group B vs group C: 672 (32% vs 115 (20% ?69 years, P<0.001; 803 (38% vs 225 (40% 70–79 years, P=0.48; 586 (27% vs 203 (36% 80–89 years, P<0.05; 71 (3% vs 18 (3% ?90 years, P=1.0. Visual acuity, group B vs group C: 556 (26% vs 664 (59% 6/12 or better; 1,275 (60% vs 367 (33% 6/18–6/60; 266 (12% vs 64 (6% counting fingers or worse, P<0.05. Medical history for group B vs C: cognitive impairment: 55 (2.6% vs 29 (5.2%, P<0.05; cardiovascular accident: 158 (7.4% vs 60 (10.7%, P<0.05; diabetes: 372 (17.4% vs 96 (17.1%, P=0.87; COPD/asthma: 382 (17.9% vs 93 (16.6%, P=0.53; heart disease: 535 (25.1% vs 155 (27.6%, P=0.35; hypertension: 971 (45.5% vs 263 (46.9%, P=0.73. Ocular history for group B vs C was significant (P<0.05 for age-related macular degeneration 255 (12.0% vs 93 (16.6%, other macular pathology 38 (1.8% vs 25 (4.5%, corneal pathology 92 (4.3% vs 36 (6.4%, amblyopia 37 (1.7% vs 22 (3.9%. Detailed data on presenting complaint, ophthalmic history, and social status is discussed. Conclusion: We observed that surgery at a younger age with good levels of visual acuity was a factor in deferring cataract surgery. Cognitive impairment, cardiovascular accident, amblyopia, corneal and macular pathology significantly affected decision not to operate. We estimate that 80% of patients would be suitable for ophthalmic training. Keywords: audit, electronic patient record, cataract surgery, co-morbidity, guarded visual prognosis, ophthalmic training

  1. Effect of Ultrasound Time on Macular Thickness and Visual Acuity in Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Zeynep Gürsel Özkurt

    2011-10-01

    Full Text Available Pur po se: The aim of this study was to investigate the effect of ultrasound time on macular thickness and the influence of macular thickness on visual acuity after uneventful phacoemulsification surgery. Ma te ri al and Met hod: In this study, 42 eyes of 30 cataract patients who underwent uncomplicated phacoemulsification surgery were evaluated. The phacoemulsification was performed using 20% “pulse mode” ultrasound energy. The ultrasound time of each case was noted. Visual acuity (logMAR and macular thickness were measured pre- and postoperatively. Macular thickness was measured by “spectraldomain” optical coherence tomography using “macular map 6” (MM6 programme. Re sults: All patients who underwent uncomplicated phacoemulsification surgery showed a statistically significant improvement in bestcorrected visual acuity in postoperative first and third months (p=0.001. When minimum central macular, mean central zone, mean parafoveal and mean perifoveal macular thicknesses in the postoperative first week, first month and third month were compared with the preoperative values, a statistically significant increase in all zones was detected (p=0.001. The mean ultrasound time applied was 128 sec. ±11 SD: 70.17. No statistically significant correlation was found between ultrasound time and increase in macular thickness in the postoperative first week, first month and third month. There was no significant correlation between best-corrected visual acuity and minimum central macular/central zone macular thickness. Dis cus si on: This study shows that in patients who underwent uneventful phacoemulsification surgery, there is an increase in macular thickness independent of ultrasound time. We also found no correlation between macular thickness and visual acuity. (Turk J Ophthalmol 2011; 41: 286-90

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

    Science.gov (United States)

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

    2016-01-01

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

  3. 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.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Zhan-Jiang Liu

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Puri S

    2015-09-01

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

  7. The risk of a new retinal break or detachment following cataract surgery in eyes that had undergone repair of phakic break or detachment: a hypothesis of a causal relationship to cataract surgery.

    OpenAIRE

    Grand, M Gilbert

    2003-01-01

    PURPOSE: To determine the risk of new retinal tear or detachment following cataract surgery in eyes that had undergone successful repair of phakic retinal tear or detachment. METHODS: A computerized search of records of patients evaluated at the Barnes Retina Institute from 1990 to 2000 for a diagnosis of phakic retinal tear or detachment was accomplished. The records of successfully treated patients were analyzed by type of tear or detachment, method of treatment, and development of sequenti...

  8. 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.

  9. 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. Etiopathogenesis of cataract: An appraisal

    Directory of Open Access Journals (Sweden)

    Varun B Gupta

    2014-01-01

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

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

    Science.gov (United States)

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

    2013-02-22

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

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

    Science.gov (United States)

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

    2012-04-01

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

  4. Effect of a resutured iridotomy on glare disability in glaucoma patients having cataract surgery.

    Science.gov (United States)

    Cahane, M; Glovinsky, Y; Blumenthal, M

    1991-01-01

    Twenty-two glaucoma patients with fixed miotic pupils prior to cataract surgery were retrospectively divided into two groups: Group A in which the sector iridotomy was resutured after intraocular lens insertion; Group B in which the sector iridotomy was not resutured. The two groups were matched for average age, sex, average disease duration, glaucoma type, operation type, mean follow-up, and average intraocular pressure and cup/disc ratio. Glare disability was measured with the Miller-Nadler tester. A similar reduction in visual acuity under glare was found in the two groups: 0.55 + 1.2 and 0.45 + 0.9 Snellen lines for Groups A and B, respectively. These findings are explained by two additional observations: Reduction in visual acuity under glare was positively correlated to the degree of posterior capsule opacity (r=0.4) and not to the functional pupillary area (r=0.13). Functional pupillary area (upper lid in normal position) was 42% larger in the nonresutured group compared to 85% difference in the total pupillary area. PMID:2005559

  5. Pediatric cataract: challenges and future directions.

    Science.gov (United States)

    Medsinge, Anagha; Nischal, Ken K

    2015-01-01

    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. PMID:25609909

  6. Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery

    Science.gov (United States)

    Bucci, Frank A; Evans, Ruth E; Amico, Loretta M; Morris, Timothy W; Fluet, Angel T; Sanfilippo, Christine M; DeCory, Heleen H; Comstock, Timothy L

    2015-01-01

    Background The purpose of this study was to investigate the ocular bacterial flora in patients scheduled to undergo cataract surgery and compare the antibacterial effects of besifloxacin ophthalmic suspension 0.6% and moxifloxacin ophthalmic solution 0.5% in these patients. Methods This was a prospective, randomized, laboratory-masked clinical trial. Patients received besifloxacin or moxifloxacin “quater in die” or QID (four times a day) for 3 days before cataract surgery in the surgical eye and 1 hour before surgery in the nonsurgical fellow eye. Conjunctival and eyelid swabs were obtained from both eyes at baseline and after treatment, on the day of surgery (Visit 2). Swabs were processed for bacterial colony counts (in terms of colony-forming units) and species identification. In vitro antibiotic susceptibilities of isolates were determined using Clinical and Laboratory Standards Institute breakpoints. Results Fifty-nine patients (n=28 besifloxacin, n=31 moxifloxacin) completed the study. The majority (73%) of conjunctival samples were culture negative at baseline. The most frequent isolates were coagulase-negative staphylococci (CoNS, 89%), specifically Staphylococcus epidermidis (72%). Both fluoroquinolones reduced the lid CFU values when administered QID for 3 days (P?0.019), but only besifloxacin reduced the lid CFU estimate 1 hour following instillation of a single drop (P=0.039). Fewer besifloxacin-treated eyes had lids that were culture positive for CoNS at Visit 2 compared with moxifloxacin-treated eyes regardless of dosing regimen (P?0.03). The minimum inhibitory concentration (MIC90) of besifloxacin against methicillin-resistant S. epidermidis (MRSE) was eightfold lower than that of moxifloxacin. Conclusion Besifloxacin appeared more effective in reducing bacterial counts on eyelids of patients undergoing cataract surgery, with significant reductions as early as 1 hour postdose, compared with moxifloxacin. Besifloxacin was more active in vitro against MRSE. PMID:25999691

  7. Caracterización de la cirugía de catarata en pacientes con retinopatía diabética Cataract surgery in patients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Yamirka Rodríguez Alonso

    2012-06-01

    Full Text Available Objetivo: Caracterizar la extracción extracapsular del cristalino con implante de lente intraocular en pacientes con retinopatía diabética en los hospitales "Saturnino Lora" y "Juan Bruno Zayas" de Santiago de Cuba de enero a septiembre de 2007. Métodos: Se realizó un estudio observacional, descriptivo y longitudinal prospectivo en 72 pacientes. Se analizaron las variables: edad, sexo, indicación de cirugía de catarata, agudeza visual antes de la cirugía y después de esta, y complicaciones. Se utilizó el porcentaje como medida de resumen y se aplicaron las pruebas de chi cuadrado y de hipótesis de comparación de proporciones. Resultados: Predominó el sexo femenino, la edad de 70 años o más y la indicación óptica de la cirugía de catarata. La agudeza visual posquirúrgica fue superior a 20/40 en 47,2 % de los pacientes. La opacificación de la cápsula posterior fue la complicación más frecuente. Conclusiones: La indicación más frecuente de la cirugía de catarata, en pacientes con retinopatía diabética, es con fin óptico. La evaluación de la agudeza visual antes de la cirugía y después de esta, en el paciente con retinopatía diabética y catarata con criterio de cirugía, es un parámetro de valor diagnóstico y pronóstico. La opacidad de cápsula posterior constituyó la complicación más frecuente.Objective: To identify existing complications in patients suffering diabetic retinopathy during or after extracapsular lens extraction with intraocular lens implantation surgery performed at "Saturnino Lora" and "Juan Bruno Zayas” hospitals in Santiago de Cuba, from January to September 2007. Methods: A prospective, longitudinal, observational and descriptive, study was conducted in 72 patients. The analyzed variables were age, sex, indication for cataract surgery, visual acuity before and after surgery, and complications. The percentage as a summary measure and the chi-square tests and comparison of proportions hypotheses were used, according to each table. Results: Predominance of females, 70 years or older age and visual indication of cataract surgery. Postoperative visual acuity was above 20/40 in 47.2% of patients and posterior capsule opacification was the most common complication. Conclusion: The optical indication is the most common for cataract surgery in patients with diabetic retinopathy as well as the assessment of visual acuity before and after surgery in these patients with cataract surgery criterion is a diagnostic and prognostic parameter. Posterior capsule opacity was the most frequent complication.

  8. Caracterización de la cirugía de catarata en pacientes con retinopatía diabética / Cataract surgery in patients with diabetic retinopathy

    Scientific Electronic Library Online (English)

    Yamirka, Rodríguez Alonso; Yudania, Fouces Gutiérrez; Magdevis, Ruiz Miranda; César A, Irarragorri Dorado; Taimí, Cárdenas Díaz; Iraisi, Hormigó Puertas.

    2012-06-01

    Full Text Available Objetivo: Caracterizar la extracción extracapsular del cristalino con implante de lente intraocular en pacientes con retinopatía diabética en los hospitales "Saturnino Lora" y "Juan Bruno Zayas" de Santiago de Cuba de enero a septiembre de 2007. Métodos: Se realizó un estudio observacional, descript [...] ivo y longitudinal prospectivo en 72 pacientes. Se analizaron las variables: edad, sexo, indicación de cirugía de catarata, agudeza visual antes de la cirugía y después de esta, y complicaciones. Se utilizó el porcentaje como medida de resumen y se aplicaron las pruebas de chi cuadrado y de hipótesis de comparación de proporciones. Resultados: Predominó el sexo femenino, la edad de 70 años o más y la indicación óptica de la cirugía de catarata. La agudeza visual posquirúrgica fue superior a 20/40 en 47,2 % de los pacientes. La opacificación de la cápsula posterior fue la complicación más frecuente. Conclusiones: La indicación más frecuente de la cirugía de catarata, en pacientes con retinopatía diabética, es con fin óptico. La evaluación de la agudeza visual antes de la cirugía y después de esta, en el paciente con retinopatía diabética y catarata con criterio de cirugía, es un parámetro de valor diagnóstico y pronóstico. La opacidad de cápsula posterior constituyó la complicación más frecuente. Abstract in english Objective: To identify existing complications in patients suffering diabetic retinopathy during or after extracapsular lens extraction with intraocular lens implantation surgery performed at "Saturnino Lora" and "Juan Bruno Zayas” hospitals in Santiago de Cuba, from January to September 2007. Method [...] s: A prospective, longitudinal, observational and descriptive, study was conducted in 72 patients. The analyzed variables were age, sex, indication for cataract surgery, visual acuity before and after surgery, and complications. The percentage as a summary measure and the chi-square tests and comparison of proportions hypotheses were used, according to each table. Results: Predominance of females, 70 years or older age and visual indication of cataract surgery. Postoperative visual acuity was above 20/40 in 47.2% of patients and posterior capsule opacification was the most common complication. Conclusion: The optical indication is the most common for cataract surgery in patients with diabetic retinopathy as well as the assessment of visual acuity before and after surgery in these patients with cataract surgery criterion is a diagnostic and prognostic parameter. Posterior capsule opacity was the most frequent complication.

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

    OpenAIRE

    Li-Quan Zhao; Liang-Mao Li; Huang Zhu; The Epidemiological Evidence-Based Eye Disease Study Research Group

    2014-01-01

    Antioxidant vitamins supplements have been suggested as a strategy to decrease the risk of age-related cataract development. However, the results from observational studies and interventional trials of associations between antioxidant vitamins A, C, and E and cataract development have been inconsistent. We aim to evaluate the effectiveness of multivitamin/mineral supplements for decreasing the risk of age-related cataracts by conducting a systematic review and meta-analysis. In September 2013...

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

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    Md Shafiqul Alam

    2014-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  12. Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery

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    Bucci FA Jr

    2015-05-01

    Full Text Available Frank A Bucci Jr,1 Ruth E Evans,1 Loretta M Amico,1 Timothy W Morris,2 Angel T Fluet,1 Christine M Sanfilippo,3 Heleen H DeCory,3 Timothy L Comstock3 1Bucci Laser Vision Institute, Wilkes-Barre, PA, USA; 2Microbiology and Sterilization Sciences, Bausch and Lomb, Rochester, NY, USA; 3Medical Affairs, Bausch and Lomb, Rochester, NY, USA Background: The purpose of this study was to investigate the ocular bacterial flora in patients scheduled to undergo cataract surgery and compare the antibacterial effects of besifloxacin ophthalmic suspension 0.6% and moxifloxacin ophthalmic solution 0.5% in these patients. Methods: This was a prospective, randomized, laboratory-masked clinical trial. Patients received besifloxacin or moxifloxacin “quater in die” or QID (four times a day for 3 days before cataract surgery in the surgical eye and 1 hour before surgery in the nonsurgical fellow eye. Conjunctival and eyelid swabs were obtained from both eyes at baseline and after treatment, on the day of surgery (Visit 2. Swabs were processed for bacterial colony counts (in terms of colony-forming units and species identification. In vitro antibiotic susceptibilities of isolates were determined using Clinical and Laboratory Standards Institute breakpoints. Results: Fifty-nine patients (n=28 besifloxacin, n=31 moxifloxacin completed the study. The majority (73% of conjunctival samples were culture negative at baseline. The most frequent isolates were coagulase-negative staphylococci (CoNS, 89%, specifically Staphylococcus epidermidis (72%. Both fluoroquinolones reduced the lid CFU values when administered QID for 3 days (P?0.019, but only besifloxacin reduced the lid CFU estimate 1 hour following instillation of a single drop (P=0.039. Fewer besifloxacin-treated eyes had lids that were culture positive for CoNS at Visit 2 compared with moxifloxacin-treated eyes regardless of dosing regimen (P?0.03. The minimum inhibitory concentration (MIC90 of besifloxacin against methicillin-resistant S. epidermidis (MRSE was eightfold lower than that of moxifloxacin. Conclusion: Besifloxacin appeared more effective in reducing bacterial counts on eyelids of patients undergoing cataract surgery, with significant reductions as early as 1 hour postdose, compared with moxifloxacin. Besifloxacin was more active in vitro against MRSE. Keywords: besifloxacin, moxifloxacin, prophylaxis, cataract patients, coagulase-negative staphylococci

  13. 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.

  14. 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.

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

    Scientific Electronic Library Online (English)

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

    2010-12-01

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

  16. Training a Cataract Surgeon

    OpenAIRE

    M Babar Qureshi; M Daud Khan

    2002-01-01

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

  17. Warfarin and cataract extraction.

    OpenAIRE

    Robinson, G. A.; Nylander, A

    1989-01-01

    Ten cataract extractions were performed on eight patients for whom warfarin was not discontinued prior to surgery. Three were complicated by hyphaema. No retrobulbar haemorrhages occurred in the four cases given a local anaesthetic. Cataract surgery can be performed successfully without discontinuing warfarin.

  18. Training a cataract surgeon

    Directory of Open Access Journals (Sweden)

    M Babar Qureshi

    2014-07-01

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

  19. Intracameral tissue plasminogen activator to prevent severe fibrinous effusion after congenital cataract surgery

    OpenAIRE

    Siatiri, H; Beheshtnezhad, A H; Asghari, H.; Siatirit, N; S. Moghimi; Piri, N

    2005-01-01

    Background/aims: To evaluate the efficacy of intracameral recombinant tissue plasminogen activator (r-TPA) in prevention of fibrinous effusion after lensectomy, anterior vitrectomy, and posterior chamber intraocular lens (PCIOL) implantation in patients with congenital cataract.

  20. 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.

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

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    Leshan Tan

    2006-12-01

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

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

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    V. N. Trubilin

    2014-07-01

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

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

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    MR Safavi

    2007-11-01

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

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

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    Joao Crispim

    2015-10-01

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

  5. Surgical approaches to posterior polar cataract: a review

    OpenAIRE

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

    2012-01-01

    The aim of this study is to provide a comprehensive overview of surgical methods used in the emulsification of posterior polar cataracts (PPCs) that have been devised to minimize the risk of posterior capsule rupture (PCR) and its consequences. A Pubmed and Medline search of relevant literature on PPC was done. Only articles relevant to the treatment of PPC were included. The posterior capsule in eyes with PPC are known to have an abnormal adhesion to the polar opacity or a pre-existing weakn...

  6. 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)

  7. High order aberration and straylight evaluation after cataract surgery with implantation of an aspheric, aberration correcting monofocal intraocular lens

    Directory of Open Access Journals (Sweden)

    Florian T A Kretz

    2015-08-01

    Full Text Available AIM:To evaluate the quality of vision in respect to high order aberrations and straylight perception after implantation of an aspheric, aberration correcting, monofocal intraocular lens (IOL.METHODS:Twenty-one patients (34 eyes aged 50 to 83y underwent cataract surgery with implantation of an aspheric, aberration correcting IOL (Tecnis ZCB00, Abbott Medical Optics. Three months after surgery they were examined for uncorrected (UDVA and corrected distance visual acuity (CDVA, contrast sensitivity (CS under photopic and mesopic conditions with and without glare source, ocular high order aberrations (HOA, Zywave II and retinal straylight (C-Quant.RESULTS:Postoperatively, patients achieved a postoperative CDVA of 0.0 logMAR or better in 97.1% of eyes. Mean values of high order abberations were +0.02±0.27 (primary coma components and -0.04±0.16 (spherical aberration term. Straylight values of the C-Quant were 1.35±0.44 log which is within normal range of age matched phakic patients. The CS measurements under mesopic and photopic conditions in combination with and without glare did not show any statistical significance in the patient group observed (P?0.28.CONCLUSION:The implantation of an aspherical aberration correcting monofocal IOL after cataract surgery resulted in very low residual higher order aberration (HOA and normal straylight.

  8. EFFICACY OF BETAXOLOL TO RECOVER UNEXPLAINED VISUAL LOSS AFTER UNEVENTFUL SMALL INCISION CATARACT SURGERY IN HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    Lakshmikanta

    2014-03-01

    Full Text Available AIM: To test the efficacy of topical betaxolol to recover unexplained visual loss after uneventful cataract surgery in hypertensive patients. Study design: Randomized clinical trial. MATERIALS AND METHODS: One hundred patients of decreased visual acuity (20\\40 to 20/50 after best correction after 6 weeks of uncomplicated small incision surgery in hypertensive patients were enrolled. Fifty eyes received topical betaxolol twice daily and fifty eyes received placebo eye drops as a randomized comparison group and followed up for more than six months. Change in best-corrected visual acuity was considered as change of five letters (0.1 log MAR or more. Statistical analysis: Significance of difference of results between study and control groups is determined by Mann-Whitney U test and Fisher Exact test. RESULTS: 14 (28 % patients demonstrated three lines and 31 (62 % patients showed two line improvement in best-corrected visual acuity under treatment group. Whereas one (0.3 to 0.0 and 11 (0.4 to 0.2 eyes of the placebo group demonstrated same amount visual improvement. CONCLUSION: Topical betaxolol significantly improves visual acuity in unexplained visual loss after uneventful small incision cataract surgery in hypertensive patients.

  9. Congenital cataract

    Science.gov (United States)

    Cataract - congenital ... Unlike most cataracts, which occur with aging, congenital cataracts are present at birth. Congenital cataracts are rare. In most patients, no cause can be found. Congenital cataracts often occur as part of ...

  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

    Directory of Open Access Journals (Sweden)

    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. Pediatric cataract: challenges and future directions

    Directory of Open Access Journals (Sweden)

    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

  12. A retrospective study on the outcomes of cataract surgery in an Eastern Regional Health Authority hospital of Trinidad and Tobago.

    Science.gov (United States)

    Sonron, Ebiakpo-Aboere; Tripathi, Vrijesh; Bridgemohan, Petra; Sharma, Subash

    2015-01-01

    Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA) hospital in Trinidad and Tobago. Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral) at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA). The outcome variable of interest was Snellen's post-operative (presenting) VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses. Results. Good outcome (presenting VA 6/18 or better) was seen in 350 (67%) eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346-3.380]), hypertension (OR = 0.520; 95% CI [0.381-0.928]), surgical procedure (OR = 1.56; 95% CI [1.004-2.425]), good preoperative VA (OR = 0.388, 95% CI [0.211-0.714]), borderline preoperative VA (OR = 0.485; 95% CI = [0.278-0.843]) and year of first visit to clinic (OR = 2.243; 95% CI [1.215-4.141]). Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced. PMID:26357596

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

    Scientific Electronic Library Online (English)

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

    2009-12-01

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

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

    OpenAIRE

    Leshan Tan

    2006-01-01

    Cataract: the situation in ChinaEighteen per cent of the world’s blind people live in China. The country is home to one of the world’s largest populations of blind people, an estimated 6.6 million. Cataract is the number one cause of blindness in China, accounting for nearly 50 per cent of all cases. China is also estimated to have the world’s most rapidly ageing population. By 2020, the country’s elderly population is expected to increase by 90 per cent and reach 240 million people. In 2005,...

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

    Science.gov (United States)

    Holló, Gábor; Naghizadeh, Farzaneh; Hsu, Sofia; Filkorn, Tamás; Bausz, Mária

    2015-12-01

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

  16. 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.

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

    Science.gov (United States)

    Goswami, Devalina; Seetharamaiah, Shwetha; Kedia, Sraban Kumar; Nayak, Bhagabat Kumar; Akshat, Shiv

    2015-06-01

    In a patient with tetralogy of Fallot (TOF) and pulmonary atresia, treating the cardiac problem or the associated congenital illness is always a challenge. We describe the challenges and successful initial management of bilateral cataract to prevent visual loss in an infant with TOF with pulmonary atresia. PMID:26265652

  18. Comparison of preoperative nepafenac (0.1%) and flurbiprofen (0.03%) eye drops in maintaining mydriasis during small incision cataract surgery in patients with senile cataract: A randomized, double-blind study

    Science.gov (United States)

    Sarkar, Saumya; Mondal, Kanchan Kumar; Roy, Sukalyan Saha; Gayen, Sharmistha; Ghosh, Abhishek; De, Radha Raman

    2015-01-01

    Aims: This study compared the effectiveness of prophylactic administration of topical flurbiprofen 0.03% and nepafenac 0.1% in maintaining mydriasis during small incision cataract surgery (SICS). Materials and Methods: This study was a prospective, randomized, double-blind comparative study in adult cataract patients given topical flurbiprofen or nepafenac prior to SICS and capsular bag intraocular lens (IOL) implantation at a tertiary care hospital. Horizontal and vertical diameters of pupil were measured at the beginning and end of surgery, and the mean values were compared across the two groups. Unpaired t-test and Fisher's exact test were used to analyse the results. Results: A total of 70 eyes of cataract surgery patients, 33 males and 37 females, with a mean age of 58.5 ± 11.24 years, were included in the study. The mean horizontal and vertical diameters of the two groups were similar at the start of surgery. Significant differences were seen after IOL implantation, with the nepafenac group having the larger mean diameters in both horizontal (P = 0.03) and vertical (P = 0.04) pupillary measurements. Conclusions: Topical nepafenac has been shown to be a more effective inhibitor of meiosis during SICS and provides a more stable mydriatic effect compared to topical flurbiprofen.

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Fidel Saúl Ricardo Suárez

    2010-08-01

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

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

    Czech Academy of Sciences Publication Activity Database

    Š?astná, Miroslava; Behrens, A.; McDonell, P.J.; Van Eyk, J.E.

    2011-01-01

    Ro?. 9, ?. 8 (2011), s. 1-15. ISSN 1477-5956 Institutional research plan: CEZ:AV0Z40310501 Keywords : proteomics * tandem mass spectrometry * cataract surgery Subject RIV: CB - Analytical Chemistry, Separation Impact factor: 2.328, year: 2011 http://www.proteomesci.com/content/9/1/8

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

    Scientific Electronic Library Online (English)

    Fidel Saúl, Ricardo Suárez.

    2010-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Xue-Lian Gu

    2015-10-01

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

  5. 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.

  6. 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.

  7. Cataract (image)

    Science.gov (United States)

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

  8. [Ophthalmology in the ancient river cultures. Was cataract surgery performed during the time of King Hammurabi?].

    Science.gov (United States)

    Bieganowski, Lech

    2003-01-01

    The article presents the state of ophthalmological knowledge in the Ancient River Cultures. Medical and ophthalmological information included in King Hammurabi Code is discussed. The author presents a critical analysis of the views related to the hypothesis of possible performance of cataract operation in Babylon during the Hammurabi period. Terminological and medical matters related to this issue are discussed. The original opinion about surgical treatment of symblepharon or pannus trachomatosus is presented. PMID:14552195

  9. Modulation of amblyopia therapy following early surgery for unilateral congenital cataracts.

    OpenAIRE

    Lloyd, I. C.; Dowler, J G; KRISS, A; Speedwell, L; Thompson, D A; Russell-Eggitt, I; Taylor, D.

    1995-01-01

    BACKGROUND--Stimulus deprivation amblyopia is the principal cause of visual impairment in infants with unilateral congenital cataract. Even if lensectomy is undertaken at an early age, intensive postoperative occlusion of the phakic eye is essential for the development of useful vision in the aphakic eye. Despite this, the optimum method of regulating occlusion therapy is uncertain. METHODS--Interocular acuity differences identified using clinical preferential looking techniques (Keeler cards...

  10. inVestIgating the pSychologIcal and ecONomic impAct of cataRact surgerY in Vietnam: The VISIONARY observational study protocol

    Directory of Open Access Journals (Sweden)

    Phuc Huynh

    2011-09-01

    Full Text Available Abstract Background Visual impairment caused by cataracts not only affects an individual's quality of life but can also have a profound impact on other important psychological factors and on the economic circumstances of individuals and their households. Cataract surgery is an effective intervention to restore vision and is also associated with other positive consequences including improvements in quality of life, economic and psychological outcomes. While there has been an increase in the number and quality of cataract surgeries performed in Vietnam, the programs currently in place are still unable to meet the existing demand and need for surgery. Data on both the cost-effectiveness of cataract surgery and the economic and psychological impact of untreated cataract in this setting is lacking. Methods/Design This study, investigating the psychological and economic impact of cataract surgery in Vietnam (VISIONARY, will recruit and interview a sample of adults (18 years or over who are referred for cataract surgery by one of the following sites and their outreach programs: Hue Eye Hospital; Thai Binh Eye Hospital; Binh Dinh Department of Health Eye Hospital and the Vinh Long Department of Health Social Disease Centre. All participants (those who have cataract surgery and those who do not have surgery will be followed up at six and 12 months. Discussion This study is designed to examine the impact of low vision on household economic circumstances and psychological outcomes as well as to investigate the effectiveness and cost-effectiveness of cataract surgery in Vietnam. It will help to inform international and national non-government organisations working in the country and local policy-makers on priorities for further investment in eye-health services in this setting and their relevance to broader economic development goals.

  11. Monitoring Cataract Surgical Outcomes: 'Hand Written' Registration Method

    OpenAIRE

    Colin Cook

    2002-01-01

    The purpose of this hand written method of monitoring cataract surgery outcomes is to provide a practical method, assisting cataract surgeons and programme managers to monitor qualitatively the results of their cataract surgery. Such monitoring is the key to improving the quality and results of our cataract surgery.The hand registered method is quick, simple, and friendly to use!

  12. Molecular Genetics of Cataract.

    Science.gov (United States)

    Shiels, Alan; Hejtmancik, J Fielding

    2015-01-01

    Lens opacities or cataract(s) represent a universally important cause of visual impairment and blindness. Typically, cataract is acquired with aging as a complex disorder involving environmental and genetic risk factors. Cataract may also be inherited with an early onset either in association with other ocular and/or systemic abnormalities or as an isolated lens phenotype. Here we briefly review recent advances in gene discovery for inherited and age-related forms of cataract that are providing new insights into lens development and aging. PMID:26310156

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Gudlavalleti VS Murthy

    2012-01-01

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

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

    Science.gov (United States)

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

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

  16. Genetics Home Reference: Hyperferritinemia-cataract syndrome

    Science.gov (United States)

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

  17. Genetics Home Reference: Hypomyelination and congenital cataract

    Science.gov (United States)

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

  18. Down's syndrome and early cataract

    Science.gov (United States)

    Haargaard, B; Fledelius, H C

    2006-01-01

    Aims To estimate the occurrence of early cataract among patients with Down's syndrome and to evaluate the clinical characteristics of the cases. Methods Cases with Down's syndrome were ascertained from a cohort of all Danish children between 0 and 17?years of age, who were diagnosed with cataract during the period 1977–2001 (n?=?1027). Information on the patients was obtained from the medical records. Results Of the total of 1027 cases with non?traumatic, non?acquired cataract there were 29 cases (13 males, 16 females) with Down's syndrome (2.8%). This corresponds to an occurrence of early cataract among patients with Down's syndrome of 1.4%; 27 had bilateral cataract and two had unilateral cataract. Half of the patients (n?=?14) underwent cataract surgery, of whom two had bilateral primary lens implantation. 10 patients had bilateral cataract observed soon after birth, and five of these underwent cataract surgery within the first 6?months of life. Conclusion The frequency of early cataract among children with Down's syndrome is estimated to be 1.4%, with cataracts requiring surgery during childhood being even rarer. In one third of the 29 cases, bilateral cataract was detected in the neonatal period. PMID:16672328

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

    OpenAIRE

    Ang RE; Martinez GA; Cruz EM; Tiongson AA; Dela Cruz AG

    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...

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

    Directory of Open Access Journals (Sweden)

    Vikas

    2015-01-01

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