WorldWideScience
1

Cataract Surgery  

Medline Plus

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

2

Cataract Surgery  

Science.gov (United States)

... cataract removal before you meet the age or visual acuity eligibility requirements. Talk with your ophthalmologist if you are considering having early cataract surgery. If you don't have Medicare or private ...

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Small incision cataract surgery: Complications and mini-review  

Directory of Open Access Journals (Sweden)

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

Gogate Parikshit

2009-01-01

4

Small incision cataract surgery: Complications and mini-review.  

Science.gov (United States)

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. PMID:19075410

Gogate, Parikshit M

2009-01-01

5

Small incision cataract surgery: Complications and mini-review  

OpenAIRE

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...

Gogate Parikshit

2009-01-01

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Endophthalmitis following extracapsular cataract surgery: a review of 32 cases.  

OpenAIRE

Thirty two cases of endophthalmitis following extracapsular cataract surgery that had occurred within our department and had undergone intraocular diagnostic tap between May 1982 and May 1991 were reviewed. An infectious agent was identified in 20 cases (62.5%). The commonest organism was Staphylococcus epidermidis (11 cases) (55%). Proteus was the only gram negative organism identified (four cases) (20%). Both of these organisms were associated with a favourable visual outcome. In the cultur...

Heaven, C. J.; Mann, P. J.; Boase, D. L.

1992-01-01

7

Cataract Surgery in Uveitis  

Science.gov (United States)

Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors. PMID:22518338

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

2012-01-01

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Cataract Surgery  

Medline Plus

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

9

Cataract Surgery  

Medline Plus

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

10

Cataract Surgery in Uveitis  

OpenAIRE

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

Hazari Ajit; Sangwan Virender

2012-01-01

11

Cataract surgery and quality of life implications  

OpenAIRE

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...

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

2007-01-01

12

Cataract surgery in uveitis  

Directory of Open Access Journals (Sweden)

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

Hazari Ajit

2002-01-01

13

Viscoless microincision cataract surgery.  

Science.gov (United States)

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. PMID:19668421

Sallet, Guy

2008-12-01

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Viscoless microincision cataract surgery  

OpenAIRE

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. A...

Guy Sallet

2008-01-01

15

Pediatric Cataract Surgery  

Directory of Open Access Journals (Sweden)

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.

Farid Karimian

2008-12-01

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

Directory of Open Access Journals (Sweden)

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

Chatziralli Irini P

2012-06-01

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Changing indications for cataract surgery.  

OpenAIRE

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

Cairns, L.; Sommer, A.

1984-01-01

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Cataract surgery in ancient Egypt.  

Science.gov (United States)

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

Blomstedt, Patric

2014-03-01

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Heavier molecular weight ocular viscoelastic devices and timing of post-operative review following cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background To assess the safety of abandoning the next day post-operative review in preference for assessment only 2 hours post-surgery for both phacoemulsification and extracapsular surgery with heavier molecular weight ocular viscoelastic devices (OVD. Methods 475 patients who underwent uncomplicated cataract surgery using heavier molecular weight ocular viscoelastic device (Healon GV were studied. Of these 415 were phacoemulsification and 60 extracapsular and none received Intraocular pressure (IOP lowering prophylaxis at the end of surgery. All were examined at 2 hours post-surgery and on the following day. Results were tabulated and analysed assessing wound stability, corneal clarity, anterior chamber reaction and IOP. Results In the time between the two assessments 44 (10.6% patients developed a total of 53 new problems, with a majority being increases in IOP. Based on the lower threshold of IOP of 30 mmHg, the incidence of new problems at the next-day assessment was 9.8% (95% CI: 7.0 to 13.6 in the phacoemulsification group and 16.3% (7.3 to 29.7in the extracapsular surgery group. At the higher threshold of IOP of 35 mmHg the corresponding figures were 6.6% and 16.3%. Conclusion There is a higher incidence of new problems at the next-day assessment than previous studies with conventional OVD. Therefore results from previous studies using standard OVDs cannot be simply extrapolated to heavier molecular weight OVDs. When these agents are used, routine use of an ocular hypotensive agent may be necessary to increase the safety of abandoning the review on the first post-operative day for phacoemulsification patients. This is to be studied.

Brooker Lucenne

2007-02-01

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[Keratoplasty combined with cataract surgery].  

Science.gov (United States)

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

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

2012-09-01

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Cataract surgery after Descemet stripping endothelial keratoplasty  

OpenAIRE

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...

Chaurasia, Sunita; Ramappa, Muralidhar; Sangwan, Virender

2012-01-01

22

Patient satisfaction with cataract surgery  

Directory of Open Access Journals (Sweden)

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

Wasfi Ehab I

2008-10-01

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Diabetic retinopathy before and after cataract surgery.  

OpenAIRE

AIMS/BACKGROUND: Increased retinopathy progression has been reported after cataract surgery in patients with diabetes mellitus. To assess the influence of cataract surgery on visual acuity and retinopathy progression, all diabetic patients who were subjected to cataract surgery during 1991-3 have been followed up at the Department of Ophthalmology in Helsingborg. The average follow up time was 2 years. METHODS: One eye of each of 70 patients was included in the study, 35 monocularly and 35 bi...

Henricsson, M.; Heijl, A.; Janzon, L.

1996-01-01

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

Directory of Open Access Journals (Sweden)

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

Linertová R

2014-08-01

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Postoperative Endophthalmitis following Cataract Surgery in Asia  

OpenAIRE

Postoperative endophthalmitis is a rare clinical occurrence. However, it remains one of the most serious complications following cataract surgery because of its poor prognosis. We investigated the epidemiologic trends in postoperative endophthalmitis following cataract surgery, particularly in Asian populations. The incidence of postcataract endophthalmitis was generally consistent with epidemiologic data reported from Caucasian populations. The most frequently occurring causative organism wa...

Choi, Jin A.; Sung Kun Chung

2011-01-01

26

New technology update: femtosecond laser in cataract surgery  

OpenAIRE

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...

Zz, Nagy

2014-01-01

27

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

Directory of Open Access Journals (Sweden)

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

Grob SR

2014-07-01

28

Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery  

Directory of Open Access Journals (Sweden)

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

Fernando Facio

2010-10-01

29

Benign prostatic hyperplasia: clinical treatment can complicate cataract surgery  

Scientific Electronic Library Online (English)

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

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

2010-10-01

30

Cataract surgery after Descemet stripping endothelial keratoplasty  

Science.gov (United States)

Management of endothelial dysfunction in phakic patients is sometimes a dilemma for corneal surgeons. Phakic patients with visually significant cataract and endothelial dysfunction are preferably managed by performing combined cataract surgery with endothelial keratoplasty. However, combined surgery may be deferred in eyes with early incipient cataract, younger age and where anterior chamber is poorly visualized. As cataract formation may be accelerated after endothelial keratoplasty, these eyes may need cataract surgery subsequently. Surgical intervention in eyes with endothelial keratoplasty is of concern as this may affect the graft adversely and threaten graft survival. In this report, we describe the intraoperative surgical details and postoperative clinical course of a patient who underwent phacoemulsification with intraocular lens implantation after Descemet stripping automated endothelial keratoplasty (DSAEK). PMID:23202404

Chaurasia, Sunita; Ramappa, Muralidhar; Sangwan, Virender

2012-01-01

31

Intraocular adrenaline maintains mydriasis during cataract surgery.  

OpenAIRE

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...

Corbett, M. C.; Richards, A. B.

1994-01-01

32

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

OpenAIRE

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...

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

2014-01-01

33

Evaluation of povidone-iodine applications in cataract surgery  

Directory of Open Access Journals (Sweden)

Full Text Available As a routine measure to prevent intraocular inflammation, rinsing conjunctival sac with povidone-iodine(PVP-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.

Xi Zhang

2013-09-01

34

[Cataract surgery in patients with myopia].  

Science.gov (United States)

Cataract surgery in myopic eyes can be difficult. We present a retrospective study of 97 myopic eyes, with axial length of at least 26 mm. All eyes, extracapsular extraction with or without intraocular posterior chamber lens. Mean follow up is 14 months, and 54% of cases have a 1 year follow up. In only one case did a retinal break without retinal detachment appear after surgery, that was successfully treated with argon laser photocoagulation. A longer follow up of our cases will be necessary to estimate long term complications of cataract extraction in myopic eyes. PMID:8282954

Lamrani, M; Korobelnik, J F; Renard, G; Pouliquen, Y

1993-01-01

35

New technology update: femtosecond laser in cataract surgery  

Directory of Open Access Journals (Sweden)

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

Nagy ZZ

2014-06-01

36

An Evaluation Of Short Cataract Surgery In Rural Haryana  

OpenAIRE

Research question: Whether short post operative stay after cataract surgery affects the visual acuity & complications as compared to routine post operative stay? Objective: To study the outcome of short post operative stay after cataract surgery with that of routine cataract surgery. Study design: Cross-sectional Setting: Ophthalmology deptt. Pt. B.D. Sharma PGIMS, Rohtak Participants: 180 patients of senile cataract from rural area. Statistical Analysis: Chi-square test Results: During 6...

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

1998-01-01

37

Cost-utility of routine cataract surgery  

Directory of Open Access Journals (Sweden)

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

Ryynänen Olli-Pekka

2006-09-01

38

Small incision cataract surgery: tips for avoiding surgical complications  

OpenAIRE

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

Reeta Gurung; Albrecht Hennig

2008-01-01

39

Cataract surgery following KAMRA presbyopic implant  

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

Tan TE

2013-09-01

40

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)

41

Microphakonit: 700 micron cataract surgery  

OpenAIRE

We describe the smallest incision cataract removal technique, Microphakonit, in which bimanual phacoemulsification can be performed with a 0.7 mm phaco tip and 0.7 mm irrigating chopper. Cortical removal is done using 22 gauge or 0.7 mm irrigation/aspiration instruments. The technique was used for 25 adult human eyes with grade 2 nuclear sclerosis and 5 adult human eyes with grade 3 nuclear sclerosis. None of these patients were noted to have intraoperative complications. One eye with grade 3...

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

2007-01-01

42

[From cataract eyeglasses to the artificial lens--changes in cataract surgery].  

Science.gov (United States)

After a brief retrospective on the millennia-old technique of luxation of an opaque lens, the radical changes happening in the past 10 to 20 years to cataract surgery are outlined as follows: Microsurgical extracapsular cataract extraction and artificial intracular lens implantation. Some of the consequences for patient and physician are shown, particularly the criteria for undergoing surgery: cataract surgery should be performed whenever the cristalline lens opacities cause marked visual impairment to the patient. PMID:2191464

Bischoff, P

1990-04-01

43

High-fidelity cataract surgery simulation and third world blindness.  

Science.gov (United States)

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

Singh, Ajay; Strauss, Glenn H

2015-04-01

44

South Africa's cataract surgery rates: why are we not meeting our targets?  

Science.gov (United States)

Cataract is the leading cause of blindness in South Africa, responsible for about 50% of the prevalence of blindness and identified as a national health priority. The cataract surgery rate (CSR) should be at least 2 000 per million population per year for elimination of cataract blindness. The national CSR target was planned to increase from 1 000 in 2005 to 2 000 in 2010, but since CSRs have failed to reach targets each year, the national target for 2010 was reduced from 2 000 to 1 500. We reviewed data from a situational analysis in 2007 of cataract surgery services to ascertain the obstacles to achieving CSR targets. PMID:21920119

Lecuona, Karin; Cook, Colin

2011-08-01

45

Epithelial iris cyst after cataract surgery.  

Science.gov (United States)

We report a case of an epithelial inclusion cyst of the iris following cataract surgery that was successfully treated with en bloc excision, after an unsuccessful attempt with Neodymium-doped Yttrium Aluminium Garnet (Nd YAG) Laser. A 60-year-old man had undergone cataract surgery two years back. One year later, he developed a pigmented epithelial inclusion cyst of the iris which progressively increased in size. His vision reduced to finger counting close to face as the cyst grew over the pupil. We performed Nd YAG laser cystotomy of the cyst wall initially, but the treated lesion recurred. So we performed an en bloc iris excision of the cyst with sector iridectomy. There was no recurrence as determined by slit lamp examination at six months after treatment. Hence, we conclude that en bloc excision can be used to effectively treat epithelial inclusion cyst of the iris. PMID:22344022

Chaudhry, M; Grover, S; Sood, N; Gupta, R

2012-01-01

46

Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients  

OpenAIRE

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...

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

2007-01-01

47

Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results  

Directory of Open Access Journals (Sweden)

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

Chang JS

2013-04-01

48

Management of ocular inflammation and pain following cataract surgery: focus on bromfenac ophthalmic solution  

OpenAIRE

Recently, several new ophthalmic NSAID products have been introduced for commercial use in the United States. The purpose of this review is to briefly overview the ophthalmic NSAIDs currently in use and to discuss the management of postoperative ocular inflammation and pain following cataract surgery with a particular focus on bromfenac ophthalmic solution 0.09%. Bromfenac ophthalmic solution 0.09% is indicated for the reduction of ocular pain and inflammation following cataract surgery. Stud...

Cho, Hyung; Wolf, Kenneth J.; Wolf, Eric J.

2009-01-01

49

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

OpenAIRE

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...

Rs, Joshi

2013-01-01

50

Visual Rehabilitation Following Manual Small Incision Cataract Surgery  

OpenAIRE

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

Imtiyaz Ahmad, Abdul Wahab

2005-01-01

51

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

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

Bunce Catey

2007-09-01

52

Outcome of cataract surgery in patients with retinitis pigmentosa  

OpenAIRE

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 ...

Jackson, H.; Garway-heath, D.; Rosen, P.; Bird, A.; Tuft, S.

2001-01-01

53

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

OpenAIRE

AIM: To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China. METHODS:Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis. RESULTS:A total of 117 eyes of 117 patients (96 boys and 21 girls) with unilateral injuries (66 right and 51 left eyes) were included i...

Yu-Sen Huang; Li-Xin Xie; Ying-Nan Xu

2013-01-01

54

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

OpenAIRE

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 ...

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

2012-01-01

55

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

Science.gov (United States)

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

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

2011-01-01

56

Audit of cost and clinical outcome of cataract surgery.  

Science.gov (United States)

An audit of routine cataract surgery in our hospital was carried out by examining records of 340 adult patients who underwent such surgery during October 1990. The category of intended accommodation (day case or inpatient), operative details, post-operative course and management were recorded, along with the outcome measures of visual acuity (unaided and corrected) and refractive error (spherical equivalent and cylinder). The costs of treatment, including post-operative management, were calculated for each patient. The results indicate that day case surgery under local anaesthesia was the most cost-effective method of cataract surgery, with no detrimental effect on clinical outcome. PMID:10171839

Aylward, G; Larkin, D; Cooling, R

57

Central corneal thickness changes following manual small incision cataract surgery  

Science.gov (United States)

Aim To determine changes in post-cataract surgery central corneal thickness (CCT) at Lagos University Teaching Hospital by assessing the time it takes for the cornea to return to its preoperative thickness value. Methods This study is a prospective, hospital-based open within-patient controlled study with the unoperated eye controlling for the operated one. Results Two hundred patients with 400 eyes were analyzed, with bilateral mature cataract in 47.0%. All the patients had manual small incision cataract surgery with posterior chamber intraocular lens implant. There is an increase in mean baseline CCT from 520.6±20.3 ?m by 76.9 ?m (597.9±30.4 ?m) 24 hours after cataract surgery followed by relative reduction in the mean CCT to 555.2±24.7 ?m and 525.1±19.7 ?m at 2 weeks and 12 weeks, respectively. Increase in mean CCT in the unoperated and contralateral eyes were recorded in this study. Conclusion There was a transient increase in corneal thickness following cataract surgery with subsequent decrease to preoperative thickness by 12th and fourth week in the operated and unoperated eyes, respectively. Corneal manipulations during cataract surgery must be minimal to reduce visual rehabilitation time to barest minimum. Postoperative refraction will be better at eighth week to 12th week considering the time it takes for the CCT to return to its stable preoperative values. PMID:25653497

Aribaba, Olufisayo Temitayo; Adenekan, Olusesan Adetunji; Onakoya, Adeola Olukorede; Rotimi-Samuel, Adekunle; Olatosi, John Olutola; Musa, Kareem Olatunbosun; Oyefeso, Akinyele Oyedele; Akinsola, Folashade Bolanle

2015-01-01

58

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

Science.gov (United States)

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% (P<0.05). A majority of the surgeons (80%) had a lower complication rate while using FLACS. CONCLUSION FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients. PMID:25709932

Chen, Ming; Swinney, Christian; Chen, Mindy

2015-01-01

59

Change in vision, visual disability, and health after cataract surgery.  

OpenAIRE

PURPOSE: Cataract surgery improves vision and visual functioning; the effect on general health is not established. We investigated if vision, visual functioning, and general health follow the same trajectory of change the year after cataract surgery and if changes in vision explain changes in visual disability and general health. METHODS: One-hundred forty-eight persons, with a mean (SD) age of 78.9 (5.0) years (70% bilateral surgery), were assessed before and 6 weeks and 12 months after surg...

Helbostad, Jl; Oedegaard, M.; Lamb, Se; Delbaere, K.; Lord, Sr; Sletvold, O.

2013-01-01

60

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

Directory of Open Access Journals (Sweden)

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

Aasuri Murali

1999-01-01

61

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)

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.

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

2013-12-01

62

Maximal mydriasis evaluation in cataract surgery  

OpenAIRE

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...

Ho Tony; Fan Richard; Hong Wong; Khian Khoo

1992-01-01

63

Monitoring visual outcome of cataract surgery in India.  

OpenAIRE

Two simple methods of assessing visual outcome following cataract surgery were evaluated in India. The first used data obtained from standardized patient records of cataract surgery. The second used data from population-based rapid epidemiological assessments. Analysis of 4168 hospital and eye camp records showed that, with the available standard correction, a good outcome (visual acuity > or = 6/18) was achieved in 37.8%, a borderline outcome (visual acuity 6/246-6/60) in 45.6% and a poor ou...

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

1999-01-01

64

The effects of diazepam on blood pressure levels in cataract surgery  

OpenAIRE

Objectives: To evaluate the effects of oral diazepam on blood pressure (BP) alterations in patients that underwent cataract surgery under topical anesthesia. Methods: A total of 147 patients that underwent phacoemulsification surgery under topical anesthesia, were reviewed retrospectively. The study took place in the Department of Ophthalmology, Adnan Menderes University Medical Faculty, Aydin, Turkey, between January 2011 and July 2013. Patients were divided into 2 groups: Group 1: received ...

Harun Çakmak; Tolga Kocatürk; Du?ndar, Sema O.; Nil Kaan; Mehmet Özba?çivan; Erol Erkan

2014-01-01

65

Long-term outcome after cataract surgery : a longitudinal study  

OpenAIRE

Background Cataract surgery is the most common surgical procedure carried out in the developed world and surgery volumes have increased considerably during the last decades. Various aspects of the surgical procedure, including surgical incision size and intraocular lens materials, have changed substantially, improving the safety and the quality of the outcome. Previous research has primarily focused on the visual function results with a short follow-up time. Long-term population-based studies...

Lundqvist, Britta

2009-01-01

66

Conjunctival inclusion cysts following small incision cataract surgery  

Directory of Open Access Journals (Sweden)

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

Narayanappa Shylaja

2010-01-01

67

Cataract surgery: ensuring equal access for boys and girls  

Directory of Open Access Journals (Sweden)

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

Sylvia Shirima

2009-06-01

68

Focussing both eyes on health outcomes: revisiting cataract surgery  

Directory of Open Access Journals (Sweden)

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.

Davis Jennifer C

2012-09-01

69

Maximal mydriasis evaluation in cataract surgery  

Directory of Open Access Journals (Sweden)

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

Ho Tony

1992-01-01

70

Cataract surgery in Fuchs' heterochromic iridocyclitis.  

OpenAIRE

Eighteen eyes in 17 patients with Fuchs' heterochromic iridocyclitis underwent cataract extraction with or without intraocular lens implantation (17 extracapsular and one intracapsular). Intraoperative complications included hyphaema, poor pupillary dilatations, and localised zonule dehiscence with vitreous loss. Only four eyes developed a marked anterior uveitus (two pseudophakic and two aphakic) which resolved within 2 weeks with topical steroids. Three eyes developed a rise in intraocular ...

Sherwood, D. R.; Rosenthal, A. R.

1992-01-01

71

DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY  

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

Ibrahim SAHBAZ

2014-04-01

72

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

OpenAIRE

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

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

2012-01-01

73

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

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

Yu-Sen Huang

2013-04-01

74

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

OpenAIRE

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

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

2007-01-01

75

Pediatric Cataract Surgery in National Eye Centre Kaduna, Nigeria: Outcome and Challenges  

Science.gov (United States)

Purpose: To assess the outcomes of congenital/developmental cataract from a tertiary eye care hospital in Northwest Nigeria. Materials and Methods: A retrospective chart review was performed of all patients diagnosed with congenital or developmental cataract who underwent surgery from January 2008 to December 2009. Data were collected on patient demographics, preoperative characteristics, intraoperative complications, and postoperative outcomes as well as complications. Results: A total of 181 eyes of 102 patients underwent surgery. There were 95 (52.5%) right eyes. There were 64 (62.7%) males. The mean age of the patients was 6.88 ± 7.97 years. Fifty-four (51.3%) patients were below 3 years old. Most (62%) patients had congenital cataract with a history of onset within the first year of life [39 (62.9%) patients]. Amblyopia, nystagmus, and strabismus were the most frequent ocular comorbidities accounting for 50.3%, 36.5%, and 35.4% of eyes respectively. The majority (84.3%) of the patients had surgery within 6 months of presentation. All patients underwent manual small incision cataract surgery (MSICS). Seventy-nine (77.5%) patients underwent simultaneous bilateral surgery. Intraocular lens implantation was performed in 83.4% eyes. The most common early and late postoperative complication was, posterior capsular opacity which occurred in 65 eyes of 43 children. In these cases, moderate visual acuity was predominant visual outcome. Conclusion: Treatment of pediatric cataract in our setting is complicated by demographic factors which results in late presentation and consequently, late treatment of children. Short-term visual outcome is fair. Data on long term postoperative outcomes could not be acquired due to poor follow-up. PMID:25624681

Umar, Murtala M.; Abubakar, Ahmed; Achi, Ibrahim; Alhassan, Mahmoud B.; Hassan, Amina

2015-01-01

76

Nucleus management in manual small incision cataract surgery by phacosection  

OpenAIRE

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 ...

Ravindra M

2009-01-01

77

Safety and efficacy of intracameral mydriatics in cataract surgery  

OpenAIRE

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

Lundberg, Bjo?rn

2008-01-01

78

Peritopic anesthesia: a new alternative in cataract surgery  

OpenAIRE

José A Abreu,1 Rodrigo Abreu,2 Luis M Cordovés,1 José J Aguilar11Ophthalmology Department, University Hospital of the Canary Islands, Tenerife, Canary Islands, Spain; 2Ophthalmology Department, University Hospital of La Candelaria, Tenerife, Canary Islands, Spain We read with interest the recently published article "Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training prog...

Ja, Abreu; Abreu R; Lm, Cordov Amp Eacute S.; Jj, Aguilar

2013-01-01

79

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

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Postage stamp multiple anterior capsulorhexisotomies in pediatric cataract surgery  

OpenAIRE

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...

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

2005-01-01

81

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

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

Qing-Cheng Shi

2013-05-01

82

Iris retractors: the saviours in cataract surgery for cataract in lens coloboma.  

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A 67-year-old woman presented with features of bilateral cataract and lens coloboma. The lens coloboma was from 1 to 8 o'clock and from 5 to 9 o'clock positions in right and left eye, respectively. With some modifications, phacoemulsification was performed in both eyes at an interval of 1 month. A smaller (4.5 mm) anterior capsulorrhexis was made due to poor peripheral lenticular support. Three iris retractors were used to stabilise anterior capsulorrhexis margin to the limbus. Phacoemulsification was performed by direct chop technique under low phacodynamics. A capsular tension ring was placed in a bag followed by tangential cortical clean up and implantation of a foldable intraocular lens (IOL). One month following surgery, both eyes had a visual acuity of 20/20 with a stable IOL. This case report highlights the rarest malformation of the lens with cataract and its successful management by phacoemulsification using iris retractors as capsule supporting device. PMID:24347454

Sati, Alok; Shankar, Sandeep; Gurunadh, V S; Sangwan, Virender S

2013-01-01

83

Bilateral photic maculopathy after extracapsular cataract surgery: a case report  

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

Chalfin, Steven

1997-05-01

84

Cirurgia da catarata infantil unilateral / Unilateral pediatric cataract surgery  

Scientific Electronic Library Online (English)

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.

Adriana Maria Drummond, Brandão; Márcia Beatriz, Tartarella.

2008-04-01

85

Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery  

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

Adriana Maria Drummond Brandão

2008-04-01

86

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

Science.gov (United States)

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 postoperative endophthalmitis (PE). The thesis consists of four retrospective studies. In the first study (paper I), we used data from the NPR in the calendar period 2000-2010 to investigate the risk of pseudophakic retinal detachment (PRD) using the fellow non-operated eyes of the patients as reference. The study showed that over a 10-year study period, the risk of PRD was increased by a factor of 4.2 irrespective of sex and age. The risk of PRD was highest in the first part of the postoperative period and then gradually decreased but remained statistically significantly higher than the risk of RD in non-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 study period 2002-2010. The overall risk of PE among the seven public eye departments was 0.36 per 1000 registered cataract operations, and the PE risk among the departments was homogeneous. The overall risk of PE among the 28 private hospitals/clinics was 0.73 per 1000 registered cataract operations, and the risk among the private hospitals/clinics was heterogeneous. Most private hospitals/clinics had a risk of PE that was lower than or similar to the risk of PE after registered cataract surgery in public eye departments, but six private hospitals/clinics had a statistically significantly higher risk of PE compared to the public eye departments. We used PE as a proxy measure of the registration of cataract surgery and found that 98% of the cataract operations performed in public eye departments were registered in the NPR while only 38% of the cataract operations performed in private hospitals/clinics were registered in the NPR. In general, the coding of the PE cases was not uniform and the lack of registration by the private hospitals/clinics meant that the NPR could not be used to monitor the true risk of PE. NPR data were also used in the third study (paper III) to examine whether patients who had surgical intervention for PE following cataract surgery with either a pars plana vitrectomy (PPV) or a vitreous tap (VT) had a higher risk of subsequent surgical complications. There was no statistically significant difference in the overall risk of complications among the two groups, but the risk of surgery for vitreous opacities was statistically significantly higher for patients who underwent a VT. A surgical complication occurred in 27.3% of the patients and 9.9% of the patients developed more than one surgical complication. Ninety-seven per cent of the primary surgical complications occurred within the first 5 months. The risk of surgical complications in this study was similar to or higher than the risk of complications in the landmark Endophthalmitis Vitrectomy Study from the early 1990s. In the fourth study (paper IV), we used data from all three Danish cataract registries to describe the epidemiology of cataract operations performed in public hospitals and private hospitals/clinics in the study period 2004-2012. Again, PE was used as a proxy measure of the registration of cataract surgery. There were several noticeable differences in the epidemiology of the cataract operations performed in public hospitals and private hospitals/clinics. Patients who had cataract surgery in public hospitals had a statistically significantl

Bjerrum, Søren Solborg

2015-03-01

87

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

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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.

Cannon Paul S

2005-06-01

88

Iris recognition as a biometric method after cataract surgery  

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

Roizenblatt Jaime

2004-01-01

89

Management of intraoperative miosis during pediatric cataract surgery using healon 5  

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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.

Jhanji Vishal

2011-01-01

90

Selective suture cutting for control of astigmatism following cataract surgery  

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

Bansal R

1992-01-01

91

Floppy iris behaviour during cataract surgery: associations and variations  

Science.gov (United States)

Aim To assess the association of floppy iris behaviour during cataract surgery with use of ??1?antagonists and diabetes mellitus. Methods 1842 eyes of 1786 patients undergoing phacohoemulsification surgery were prospectively enrolled. The use of commonly prescribed ??1?antagonists and the presence or absence of diabetes mellitus were noted. The occurrence of any of the features of the intraoperative floppy iris syndrome (IFIS) was noted by surgeons blinded to the patient's history. Results 57% of patients receiving tamsulosin showed features of IFIS compared with 1% of the non?tamsulosin group (psyndrome in an incomplete form. Only 1 of the 51 patients receiving other ??1?antagonists had IFIS. Diabetes was also not associated with IFIS (p?=?1). Conclusions Tamsulosin is significantly associated with floppy iris behaviour during cataract surgery. But not all of these patients will necessarily show all or any features of IFIS. The floppy iris syndrome is likely to represent a continuum of severity. Various undefined factors, diabetes not being one of them, may have a contributory role. Non?selective ??1?antagonists are unlikely to be associated with IFIS. PMID:16943229

Chadha, V; Borooah, S; Tey, A; Styles, C; Singh, J

2007-01-01

92

Cost of cataract surgery after implantation of three intraocular lenses  

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

Catherine Boureau

2009-03-01

93

Is ultrasonography essential before surgery in eyes with advanced cataracts?  

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

Salman Amjad

2006-01-01

94

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)

95

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

Science.gov (United States)

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

Utman, Saqib Ali Khan

2013-09-01

96

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

Directory of Open Access Journals (Sweden)

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

Gunvant P

2011-09-01

97

Conjunctival sac bacterial flora isolated prior to cataract surgery  

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

Suto C

2012-01-01

98

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

OpenAIRE

Background. To compare the efficacy and safety of a new ocular insert versus conventional mydriasis in cataract surgery. Methods. We selected 70 patients undergoing cataract surgery. Thirty five patients (Group 1) received instillation of mydriatic drops (tropicamide 1%, phenylephrine 10%, and cyclopentolate 1%) prior to surgery, and 35 patients (Group 2) had a Mydriasert insert (Théa Pharma) (0.28?mg of tropicamide and 5.4?mg of phenylephrine hydrochloride) placed in the inferior fornix...

C. Torrón; Calvo, P.; Ruiz-moreno, O.; Leci Amp Xf Ena, J.; Amp Xe Rez-i Amp Xf Igo, A. P.

2013-01-01

99

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

OpenAIRE

A patient with retinitis pigmentosa showed visual disturbances following successful cataract surgery. He had a dense asteroid hyalosis in the eye before cataract surgery. After the surgery he noticed that his vision became worse. The visual disturbance was explained as being caused by the progression of retinal degeneration. Although the electroretinogram was non-recordable, the degeneration of macular area appeared relatively small. We considered that dense asteroid hyalosis was responsible ...

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

2011-01-01

100

Orbital cellulits following cataract surgery under peribulbar anaesthesia  

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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.

Mukherjee, Chandoshi

2015-01-01

101

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

Science.gov (United States)

Background Cataract day surgery has rapidly gained worldwide acceptance, because the new surgical techniques and costs are generally lower than those involved in ordinary hospitalization. Cataract surgery serves as a proxy indicator of the trend towards day surgery hospitalization in Italy and, therefore, of regional variability in health-care delivery and cost. The aim of this study was to update the diffusion of cataract day surgery through various surgical ophthalmological centers in central and southern Italy during 2005. Methods A two-stage stratified cluster sampling method was used to draw a sample of Cataract Surgery Unit from Ophthalmic Units of central and southern Italy. A questionnaire was sent to 25 cataract surgery centers in nine health districts that represented the range of establishments (public, private, accredited or otherwise) in which cataract surgery is performed. Data were collected on numbers of procedures performed in 2005, hospital admission type, time from the onset of cataract day surgery, surgical procedure, and presence of other surgical centers. Results The response rate was 42% (10 surveys), resulting in at least one completed questionnaire for each of these 9 districts. There is a positive trend towards day surgery hospitalization in all surgical centers. The percentage of patients treated as outpatients during 2005 varied from 50–60% (Avellino, Naples, Campobasso), to 80–90% (Rome, Bari), up to 90–100% (Catania, Palermo, Siracusa and Trapani), with an increasing trend in all the centers studied. Few differences were found in surgical procedures, and these were statistically insignificant. Conclusion Our results confirm a positive trend towards day surgery in place of hospital inpatient admission for cataract surgery. This trend is expected to close the existing regional gap in Italy. Increased efficiency is an overriding need for the National Health Service in order to improve the rationalization of resources. PMID:17270040

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

2007-01-01

102

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

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

Cillino Giovanni

2007-02-01

103

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

OpenAIRE

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...

Riaz, Y.; Silva, Sr; Evans, Jr

2013-01-01

104

Nucleus management in manual small incision cataract surgery by phacosection  

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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.

Ravindra M

2009-01-01

105

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

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

Henderson BA

2014-08-01

106

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

LENUS (Irish Health Repository)

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

Saeed, Ayman

2012-02-01

107

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

108

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

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Full Text Available Manual small incision cataract surgery (MSICS involves the manual removal of nucleus through a scleral tunnel. To achieve 100% success every time, one has to do a good capsulotomy and should master the technique to prolapse the nucleus into anterior chamber. During conversion from extracapsular cataract surgery to MSICS, one can perform a can-opener capsulotomy and prolapse the nucleus. However, it is safer and better to perform a capsulorrhexis and hydroprolapse the nucleus, as it makes the rest of the steps of MSICS comfortable. Use of trypan blue in white and brown cataracts makes the capsulorrhexis and prolapse simple and safe. Extra caution should be taken in cases with hypermature cataracts with weak zonules and subluxated cataracts.

Venkatesh Rengaraj

2009-01-01

109

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

OpenAIRE

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

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

2007-01-01

110

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

OpenAIRE

AIM:To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty (PKP).METHODS:In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin 0.5% ophthalmic solution (0.5 mg/0.1 mL). The main outcome measures were anterior chamber reaction, best corrected visual acuity (BCVA), corneal endothelial cell count (ECC), and central corneal t...

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

2014-01-01

111

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

OpenAIRE

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% ...

Idalia Triana; Oaris de los Ángeles Socarrás; Nelsis Rondón

2012-01-01

112

Cytological factors relating to posterior capsule opacification following cataract surgery.  

OpenAIRE

Simulated extracapsular cataract extractions on cadaver eyes were performed which demonstrated that the cells of the anterior capsule remain largely intact and that only a small amount of cortical lens matter remains postoperatively. Human lens epithelial cells from normal and cataractous lenses were grown in culture. There was no appreciable difference in growth rate between cells from normal and those from cataractous lenses or between equatorial and central capsule cells. The cells grew fr...

Jacob, T. J.; Humphry, R. C.; Davies, E. G.; Thompson, G. M.

1987-01-01

113

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

OpenAIRE

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 ...

Sha, Rajiv D.; ?tefan ??l

2011-01-01

114

Management of ocular inflammation and pain following cataract surgery: focus on bromfenac ophthalmic solution.  

Science.gov (United States)

Recently, several new ophthalmic NSAID products have been introduced for commercial use in the United States. The purpose of this review is to briefly overview the ophthalmic NSAIDs currently in use and to discuss the management of postoperative ocular inflammation and pain following cataract surgery with a particular focus on bromfenac ophthalmic solution 0.09%. Bromfenac ophthalmic solution 0.09% is indicated for the reduction of ocular pain and inflammation following cataract surgery. Studies have shown that bromfenac ophthalmic solution 0.09% has equivalent efficacy to the other topical NSAIDs in reducing postsurgical inflammation and controlling pain. The unique chemical structure of bromfenac makes it both a potent inhibitor of the COX-2 enzyme and a highly lipophilic molecule that rapidly penetrates to produce early and sustained drug levels in all ocular tissues. Clinically, these pharmacokinetic features are manifested in a rapid reduction of postsurgical inflammation and pain with bid dosing. Bromfenac ophthalmic solution 0.09% is a versatile agent and is effective when used as either monotherapy or as an adjunct therapy to steroids. PMID:19668566

Cho, Hyung; Wolf, Kenneth J; Wolf, Eric J

2009-01-01

115

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

OpenAIRE

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...

1986-01-01

116

Endophthalmitis: controlling infection before and after cataract surgery  

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

Nuwan Niyadurupola

2008-03-01

117

Photodynamic treatment of lens epithelial cells for cataract surgery  

Science.gov (United States)

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.

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

1991-06-01

118

Histopathologic correlation of Aspergillus endophthalmitis following uncomplicated cataract surgery  

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

Haddock LJ

2012-09-01

119

A review of current technologies to visualise cataract  

OpenAIRE

Cataract is one of the major causes for visual impairment and blindness across the world. The current technologies involved in cataract grading are subjective and involve manual efforts. A more objective grading technology which does not require manual handling of images and can perform instant in vivo analysis of the lens is needed. In order to be able to develop such a novel technology, the existing technologies and their pitfalls to be evaluated. The aim of this project was to review the a...

Gaurav, Tyagi

2011-01-01

120

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

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

Yuan Rongdi

2011-03-01

121

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

Science.gov (United States)

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

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

2015-01-01

122

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

Directory of Open Access Journals (Sweden)

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

Morkin MI

2014-08-01

123

National cataract surgery survey 1997-8: a report of the results of the clinical outcomes  

OpenAIRE

AIMS—A national survey of over 100 hospitals in the UK was carried out to collect routine clinical information on the outcomes of cataract surgery. The clinical outcomes of interest were: visual acuity at time of discharge from postoperative hospital follow up, visual acuity at time of final refraction; complications related to surgery occurring during the operation, within 48 hours of surgery, and within 3 months of surgery. In addition, information on age and comorbidity was obtained. ...

Desai, P.; Minassian, D.; Reidy, A.

1999-01-01

124

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

LENUS (Irish Health Repository)

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.

Barry, Peter

2014-01-01

125

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

Directory of Open Access Journals (Sweden)

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.

Soo Jung Lee

2014-06-01

126

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

OpenAIRE

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

Aj, Kanellopoulos

2013-01-01

127

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

Directory of Open Access Journals (Sweden)

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.

Takatoshi Tano

2010-11-01

128

Cataract surgery at Aravind Eye Hospitals: 1988–2008  

Directory of Open Access Journals (Sweden)

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

G Natchiar

2008-09-01

129

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

OpenAIRE

Background: Corticocapsular adhesions (CCA) are frequently seen between lens capsule and adjacent cortical layer. During cataract surgery, in the presence of CCA, excessive efforts to rotate the nucleus can result in zonular damage. To reduce morbidity, identification of associations with CCA can be helpful in appropriately modifying the surgical procedure. Aim: To investigate probable associations with CCA in patients undergoing cataract surgery. Setting and Design: Iladevi Cataract and...

Vasavada Abhay; Raj Shetal; Praveen M; Vasavada Viraj; Vasavada Vaishali

2008-01-01

130

Non steroidal anti-inflammatory drugs in the prevention of cystoid macular edema after uneventful cataract surgery  

Science.gov (United States)

Background Cystoid macular edema (CME) remains an important complication after cataract surgery. There is no consensus about how to prevent this frequent complication. The purpose of this study was to conceive an effective anti-inflammatory strategy using nonsteroidal anti-inflammatory drugs (NSAIDs) together with regular treatment with corticosteroids to prevent CME and improve visual acuity after cataract surgery in patients without risk factors. Materials and methods We searched the PubMed, Cochrane, and Google Scholar databases focused on prospective, controlled, randomized, double-blind clinical trials published in the last 10 years, with a minimum follow-up of 4 weeks. Results A total of nine clinical trials, one systematic review, and two reviews satisfied our search criteria. Most studies highlighted that NSAIDs are as powerful as corticosteroids to diminish postoperative inflammation, and demonstrated an additional benefit when used in combination with standard corticosteroid postsurgical therapy. In addition, the use of NSAIDs in the perioperative period seems to significantly improve the outcome after surgery and helps prevent CME in low-risk patients. Conclusion The prophylactic use of NSAIDs in combination with the standard postoperative steroid scheme appears to be a positive course of action for preventing CME after cataract surgery. We suggest a therapeutic scheme based on the administration of one drop four times a day, beginning the day before surgery and for 4 weeks after the procedure. It is also advisable to administer one drop every 15 minutes in the hour prior to surgery in order to obtain better anti-inflammatory efficacy. PMID:25028534

Quintana, Nicolás E; Allocco, Alejandro R; Ponce, Julia A; Magurno, Mauricio GB

2014-01-01

131

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

Science.gov (United States)

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. PMID:22869248

Triana, Idalia; Socarrás, Oaris Angeles de Los; Rondón, Nelsis

2012-07-01

132

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

Scientific Electronic Library Online (English)

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.

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

2012-07-01

133

Rigid gas-permeable contact lens-assisted cataract surgery in patients with severe keratoconus.  

Science.gov (United States)

We describe rigid gas-permeable (RGP) contact lens-assisted cataract surgery in patients with severe keratoconus. During cataract surgery in cases with severe keratoconus, the intraocular images are distorted and visual perspective is lost because of irregular corneal astigmatism. Poor visibility can lead to complications, including posterior capsule rupture and corneal endothelial cell damage. To overcome these problems, an RGP contact lens was placed on the cornea in 2 cases. The image distortion decreased markedly, and the visual perspective improved. Intraocular manipulations such as irrigation/aspiration were performed safely. Improvement in transillumination led to good visualization of the anterior and posterior capsules. No intraoperative or postoperative complications developed in either case. This technique provided excellent visualization during cataract surgery in patients with severe keratoconus. PMID:24491385

Oie, Yoshinori; Kamei, Motohiro; Matsumura, Nagakazu; Fujimoto, Hisataka; Soma, Takeshi; Koh, Shizuka; Tsujikawa, Motokazu; Maeda, Naoyuki; Nishida, Kohji

2014-03-01

134

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery  

Directory of Open Access Journals (Sweden)

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

Akçay B?

2012-09-01

135

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

Science.gov (United States)

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

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

2015-03-01

136

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

OpenAIRE

The purpose of this article is to report a case of nonarteritic anterior ischemic optic neuropathy (NAION) after uneventful cataract surgery. A 53-year-old Filipina underwent cataract surgery. She had a small optic disc with cup-to-disc ratio of 0.2 in the left eye and 0.3 in the right eye. On the first postoperative day, the uncorrected visual acuity (UCVA) was 20/20, with an intraocular pressure (IOP) of 20 mmHg in the left eye. At one week after operation, the UCVA was 20/20 and the IOP wa...

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

2010-01-01

137

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

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

Li-Quan Zhao

2014-02-01

138

Optical quality of toric intraocular lens implantation in cataract surgery  

Science.gov (United States)

AIM To analyze the optical quality after implantation of toric intraocular lens with optical quality analysis system. METHODS Fifty-two eyes of forty-four patients with regular corneal astigmatism of at least 1.00 D underwent implantation of AcrySof toric intraocular lens, including T3 group 19 eyes, T4 group 18 eyes, T5 group 10 eyes, T6 group 5 eyes. Main outcomes evaluated at 3mo of follow-up, included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), residual refractive cylinder and intraocular lens (IOL) axis rotation. Objective optical quality were measured using optical quality analysis system (OQAS II®, Visiometrics, Spain), included the cutoff frequency of modulation transfer function (MTFcutoff), objective scattering index (OSI), Strehl ratio, optical quality analysis system value (OV) 100%, OV 20% and OV 9% [the optical quality analysis system (OQAS) values at contrasts of 100%, 20%, and 9%]. RESULTS At 3mo postoperative, the mean UDVA and CDVA was 0.18±0.11 and 0.07±0.08 logMAR; the mean residual refractive cylinder was 0.50±0.29 D; the mean toric IOL axis rotation was 3.62±1.76 degrees, the mean MTFcutoff, OSI, Strehl ratio, OV 100%, OV 20% and OV 9% were 22.862±5.584, 1.80±0.84, 0.155±0.038, 0.76±0.18, 0.77±0.19 and 0.78±0.21. The values of UDVA, CDVA, IOL axis rotation, MTFcutoff, OSI, Strehl ratio, OV100%, OV20% and OV9% depending on the power of the cylinder of the implantation were not significantly different (P>0.05), except the residual refractive cylinder (P<0.05). CONCLUSION The optical quality analysis system was useful for characterizing the optical quality of AcrySof toric IOL implantation. Implantation of an AcrySof toric IOL is an effective and safe method to correct corneal astigmatism during cataract surgery. PMID:25709910

Xiao, Xian-Wen; Hao, Jing; Zhang, Hong; Tian, Fang

2015-01-01

139

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)

140

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

DEFF Research Database (Denmark)

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

Lou, Astrid R.; Madsen, Kristoffer Hougaard

2013-01-01

141

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

OpenAIRE

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

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

2011-01-01

142

Nuclear management in manual small incision cataract surgery by snare technique  

Directory of Open Access Journals (Sweden)

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.

Bhattacharya Debasish

2009-01-01

143

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

OpenAIRE

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

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

2000-01-01

144

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

OpenAIRE

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

Qinxiang Zheng; Ronghan Wu; Wensheng Li

2011-01-01

145

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

OpenAIRE

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...

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

2001-01-01

146

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

OpenAIRE

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...

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

147

Profile of patients presenting for cataract surgery in the UK: national data collection  

OpenAIRE

AIMS/METHODS—A national data collection exercise was carried out in more than 100 hospital eye service units within the UK to provide clinical and administrative information on patients undergoing cataract surgery. This included patient clinical data such as visual acuity at the time of wait listing and at the time of admission for surgery, presence of other eye disorders, other serious medical disorders, and data on waiting time and type of admission.?RESULTS—The profiles of the 18 4...

Desai, P.; Reidy, A.; Minassian, D.

1999-01-01

148

Outcome of cataract surgery in central India: a longitudinal follow-up study.  

OpenAIRE

An epidemiological follow-up study of patients who had intracapsular cataract extraction in a voluntary hospital and its associated eye camps in Central India has for the first time evaluated the outcome one year after surgery in terms of visual acuity, use of spectacles, and improvement in income and mobility. The findings indicate that under these fairly typical conditions, 92% of the cases have adequate vision of 6/18 or better one year after surgery. Information on high usage of spectacle...

Reidy, A.; Mehra, V.; Minassian, D.; Mahashabde, S.

1991-01-01

149

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

OpenAIRE

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...

Soo Jung Lee; Wan-Soo Kim

2014-01-01

150

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

Science.gov (United States)

Cataract surgery is aimed at restoring sight to near normal vision. This study, conducted at the Department of Ophthalmology, Government Medical College, Srinagar, is an attempt to determine the causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir. One hundred patients who underwent cataract surgery with an unaided visual acuity of <6/9 at 16 weeks postoperatively were included in the study. Postoperative follow-up examinations were conducted until the 16th week. Intraoperative and postoperative complications were recorded to determine the cause of subnormal vision. Of 100 patients, 40 underwent extracapsular cataract extraction (ECCE), 30 underwent small incision cataract surgery (SICS) and 30 underwent phacoemulsification. Seventy-five percent of the patients who underwent ECCE had postoperative astigmatism with a mean astigmatism of 2.2 ± 0.81 diopters at 16 weeks, with the majority having with-the-rule astigmatism. In the SICS group, 17 (56.6 %) patients had a mean postoperative astigmatism of 0.75 ± 0.40 diopters, with the majority (82.3 %) having against-the-rule (ATR) astigmatism. In the phacoemulsification group, 13 (43.3 %) of the patients had a mean postoperative astigmatism of 0.48 ± 0.23 diopters with the majority having ATR astigmatism. Other causes of subnormal vision were pseudophakic ametropia, posterior capsular opacity and intraoperative complications like posterior capsular rent and vitreous loss. Postoperative astigmatism was the major cause of subnormal vision with greater astigmatism seen in the ECCE group. Therefore, procedures like smaller incision sutureless surgery and careful biometry are advocated to improve visual outcome and patient satisfaction. PMID:24522881

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

2014-10-01

151

Sequential Intrastromal Corneal Ring Implantation and Cataract Surgery in a Severe Keratoconus Patient with Cataract  

OpenAIRE

A 49-year-old man with an uncorrected visual acuity (UCVA) of 20 / 1000, a best spectacle-corrected visual acuity (BSCVA) of 20 / 400, keratometric readings of K1 = 59.88 × 82° / K2 = 45.88 × 172°, and an inferior steepening that was consistent with keratoconus in his left eye was treated with clear-cornea phacoemulsification and an intraocular lens (IOL) implantation after insertion of keraring intrastromal corneal ring segments for severe keratoconus and cataract. An asymmetrical pair o...

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

2012-01-01

152

Application of hands chopping cataract surgery in patients with microcoria  

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

Bing-Jie Zhang

2014-06-01

153

Stenotrophomonas maltophilia endophthalmitis following cataract surgery: clinical and microbiological results  

OpenAIRE

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...

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

2013-01-01

154

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

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

Abdulmoghni Al-Barrag

2009-06-01

155

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

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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.

Yi Zhang

2014-09-01

156

Cost of Intraocular Lens vs Contact Lens Treatment after Unilateral Congenital Cataract Surgery: Retrospective Analysis at Age 1 Year  

Science.gov (United States)

Purpose To describe the differences in treatment costs for infants randomized to contact lens correction versus primary intraocular lens (IOL) implantation after unilateral cataract surgery in The Infant Aphakia Treatment Study. Design Retrospective cost analysis of a prospective, randomized clinical trial based on Georgia Medicaid data and the actual costs of supplies used. Participants The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter (n=12) clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with unilateral congenital cataract. Intervention Infants underwent cataract surgery with or without placement of an IOL. Main Outcome Measures The mean cost of cataract surgery, and all additional surgeries, examinations, and supplies used up to 12 months of age. Results The mean cost of treatment for a unilateral congenital cataract with primary IOL implantation was $14,752 versus $10,726 with contact lens correction. The initial cataract surgery accounted for approximately 50% of the treatment costs for both groups. Contact lens costs accounted for 15% ($1,600/patient) in the aphakic group whereas glasses costs only represented 4% ($535/patient) in the IOL group. The increased costs in the IOL group were primarily due to the higher cost of cataract surgery in this group ($7,302 vs. $5,357) and the cost of additional operations. Conclusions For IATS patients up to 12 months of age, cataract surgery coupled with IOL implantation and spectacle correction was 37.5% (about $4000) more expensive than cataract surgery coupled with contact lens correction. PMID:23047003

Carrigan, Anna K; DuBois, Lindreth G; Becker, Edmund R; Lambert, Scott R

2012-01-01

157

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

DEFF Research Database (Denmark)

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

Munk, Sofie J; Heegaard, Steffen

2013-01-01

158

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

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

Dada Tanuj

2010-01-01

159

Rapid bilateral anterior capsule contraction following high myopic cataract surgeries: a case report  

OpenAIRE

We describe a rapid anterior capsule contraction following phacoemulsifiction and intraocular lens(IOL) implantation in an old woman with high myopia. The patient with high myopia complicated with cataract received phacoemulcification and IOL implantation bilaterally .The best-corrected visual acuity (BCVA) improved from 0.1 to 0.4 in the right eye and 0.5 in the left eye 1 week after surgeries.5 weeks after surgery of the right eye and 4 weeks after surgery of the left eye, the patient compl...

Xiao, Wei; Zhao, Dai-xin; Xue, Long-quan

2011-01-01

160

Agreement between optical coherence tomography and fundus fluorescein angiography in post-cataract surgery cystoid macular edema  

OpenAIRE

PURPOSE: To evaluate the agreement between optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) regarding the detection of cystoid macular edema (CME) following cataract surgery. METHODS: Retrospective comparative observational series of 25 eyes with suspected CME. Patients with low visual acuity and alterations in fundus biomicroscopy after cataract surgery underwent OCT scanning followed by FFA on the same visit. The diagnosis of CME was established considering fluore...

Mitne Somaia; Paranhos Júnior Augusto; Rodrigues Ana Paula Silvério; Guia Tércio; Bordon Arnaldo; Moraes Nilva Simeren Bueno de; Farah Michel Eid; Bonomo Pedro Paulo

2003-01-01

161

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

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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.

Dan Yu

2014-04-01

162

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

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

Shan-Jun Wu

2013-12-01

163

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

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

Ahmad B Tarabishy

2010-03-01

164

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

OpenAIRE

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...

Tarabishy, Ahmad B.; Steinemann, Thomas L.

2010-01-01

165

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

OpenAIRE

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)...

Cannon Paul S; Habib Maged S; Hw, Steel David

2005-01-01

166

The fixed dilated pupil after cataract surgery--is it related to intraocular use of hypromellose?  

OpenAIRE

Hypromellose can be used as a viscoelastic substance during cataract surgery. Two groups of patients, one group operated on using hypromellose, the other using sodium hyaluronate as a viscoelastic substance were followed up 2-6 months postoperatively. A total of 16.7% of the eyes operated on using hypromellose developed a non-reactive semidilated pupil whereas none of the eyes from the control group developed this phenomenon. It was concluded that there is a probable link between the intraocu...

Tan, A. K.; Humphry, R. C.

1993-01-01

167

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

OpenAIRE

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

Abdulmoghni Al-Barrag; Motaher Al-Shaer; Nabil Al-Matary; Mahfoud Bamashmous

2009-01-01

168

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

OpenAIRE

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...

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

1999-01-01

169

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

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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.

Agresta Blaise

2012-08-01

170

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

Scientific Electronic Library Online (English)

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.

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

2012-06-01

171

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

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

Osman Sevki Arslan

2014-10-01

172

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

OpenAIRE

OBJECTIVE: To identify daily life difficulties perceived by patients suffering from senile cataract before and after second eye cataract surgery. METHODS: Longitudinal prospective study with 84 patients consecutively seen within the framework of the Cataract Project, with visual acuity equal to or higher than 20/30 in the pseudophakic eye, and equal to or lower than 20/40 with the best possible optical correction in the cataractous eye. A questionnaire was applied during an interview. RESULTS...

Amaryllis Avakian; Edmea Rita Temporini; Newton Kara-José

2005-01-01

173

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

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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

Wang BZ

2013-03-01

174

What effects has the cataract surgery on the development and progression of Age-Related Macular Degeneration (AMD)?  

OpenAIRE

Background: The cataract (Cataracta senilis) is the most frequent eye disease of elderly people worldwide. In Germany, the cataract operation - with currently 450,000 interventions each year the most frequent operation in ophthalmology – can be seen as routine surgery. The age related macular degeneration (AMD) is a further one of the most common, age-related eye diseases and the most frequent cause of blindness of elderly people in industrial nations. Due to demographic changes an increasi...

Willich, Stefan N.; Roll, Stephanie; Rasch, Andrej; Bockelbrink, Angelina; Greiner, Wolfgang

2006-01-01

175

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

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

Juan Raúl Hernández Silva

2008-12-01

176

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

Scientific Electronic Library Online (English)

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

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

2008-12-01

177

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

Scientific Electronic Library Online (English)

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

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

2012-03-01

178

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)

179

Cataract surgery with a mid-infrared endo-laser system  

Science.gov (United States)

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

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

1992-08-01

180

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

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

Yelda B Özkurt

2009-06-01

181

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

Science.gov (United States)

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

Srinivasan, Sathish; Hanumanthu, Saileela; Varikkara, Mohan

2013-03-01

182

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

OpenAIRE

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, 8T...

Singh R; Alpern L; Gj, Jaffe; Rp, Lehmann; Lim J; Hj, Reiser; Sall K; Walters T; Sager D

2012-01-01

183

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

Science.gov (United States)

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

Hjelmstad, David P.; Sayegh, Samir I.

2013-03-01

184

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

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

Soliman Mahdy MAE

2012-03-01

185

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

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

Juan C. Medina Perdomo

2010-12-01

186

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

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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.

Chang-Jian Yang

2013-08-01

187

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

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

Micheli Patrícia de Fátima Magri

2012-10-01

188

Cataract Surgery  

Medline Plus

Full Text Available ... the age of 65 as part of the aging process, but as in Paul's case, certain medications ... table inside. How do you feel now? Paul Wood: OK. I feel fine. Announcer: It's amazing. Paul ...

189

Cataract Surgery  

Medline Plus

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

190

Cataract Surgery  

Medline Plus

Full Text Available ... And how was it affecting you? Was it -- did it make a difference to your driving? Paul ... next day you say, "What kind of night did you have?" "Fine, no problems at all." "How ...

191

Cataract Surgery  

Medline Plus

Full Text Available ... just rotate the implant. There we go -- that looks wonderful. Then we check to make sure the eye pressure is normal, which it is. And that's the end of the operation. All done. Announcer: So it's only about three minutes since you were on the table inside. How do you feel now? Paul Wood: ...

192

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

OpenAIRE

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...

Ji, Jing; Huang, Xiaolin; Fan, Xianqun; Luo, Min

2012-01-01

193

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

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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.

Nidhi Jauhari

2014-12-01

194

Aspergillus terreus Infection in a Sutureless Self-sealing Incision Made During Cataract Surgery.  

Science.gov (United States)

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

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

2015-02-01

195

A longitudinal cohort study of the impact of first- and both-eye cataract surgery on falls and other injuries in Vietnam  

Science.gov (United States)

Aim Little information exists on the impact of cataract surgery on falls and other injuries in Vietnam. The aim of this study was to determine the impact of first and both eye cataract surgery on the number of falls and other injuries among bilateral cataract patients in Ho Chi Minh City, Vietnam. Materials and methods A longitudinal cohort study was conducted involving 413 bilateral cataract patients aged 50+ years. Participants were assessed at three time points: 1 week before, 1–3 months after, and 1 year after first-eye cataract surgery. Visual measures (visual acuity, contrast sensitivity and stereopsis) were taken, and self-reported falls and injury data were collected. A multilevel longitudinal Poisson regression model was used to investigate change in the number of falls after surgery. Results The risk of falls decreased by 78% (incidence-rate ratio [IRR] 0.22, 95% confidence interval [CI] 0.06–0.77; P=0.018) in the year after cataract surgery for participants who had first-eye surgery only and 83% (IRR 0.17, 95% CI 0.04–0.69; P=0.012) for participants who had the second eye operated on compared to before surgery. The risk of falls was three times higher for females than males (IRR 3.13, 95% CI 1.53–6.40; P=0.002). Improved binocular contrast sensitivity was also associated with a decrease in falls (IRR 0.40, 95% CI 0.17–0.97; P=0.042). The prevalence of other injuries also decreased after cataract surgery. Conclusion Cataract surgery reduced the number of falls and other injuries in Vietnam. Contrast sensitivity may be important for ophthalmologists to consider when prioritizing patients for surgery and assessing their fall risk. PMID:24812501

To, Kien Gia; Meuleners, Lynn; Bulsara, Max; Fraser, Michelle L; Duong, Dat Van; Do, Dung Van; Huynh, Van-Anh Ngoc; Phi, Tien Duy; Tran, Hoang Huy; Nguyen, Nguyen Do

2014-01-01

196

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

DEFF Research Database (Denmark)

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

Rasmussen, Line D; Kessel, Line

2011-01-01

197

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

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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.

Kemal Örnek

2013-12-01

198

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

Science.gov (United States)

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

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

2006-01-01

199

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

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

P Gómez-Faíña

2005-05-01

200

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

Scientific Electronic Library Online (English)

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

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

2005-05-01

201

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

Science.gov (United States)

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.

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

2013-03-01

202

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

Directory of Open Access Journals (Sweden)

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

Juan R Hernández Silva

2005-06-01

203

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

Scientific Electronic Library Online (English)

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

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

2005-06-01

204

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

LENUS (Irish Health Repository)

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

Goto, Y

2012-02-03

205

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

Science.gov (United States)

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

Tran, V Tao

2015-04-01

206

Lens and cataract research of the 20th century: a review of results, errors and misunderstandings.  

Science.gov (United States)

Lens and cataract research from a clinical, biophysical, biological and mainly biochemical point of view has a long tradition. Already since the beginning of the 20th century research relating to the chemical composition and metabolism of the lens was conducted. With these analyses an attempt was made to understand the existence and maintenance of lens transparency and the mechanisms leading to lens opacities. Around the middle of the century the stationary analyses measuring the content of certain substances in the lens were more and more replaced by the search for dynamic metabolic processes responsible for lens growth, maintenance of transparency and possibly active participation in lens function (such as accommodation). Also the disturbances as a result of ageing or the formation of lens opacities have been investigated and resulted partially in the elucidation of reaction chains, leading from a trigger to the formation of a cataract. Lens biochemistry is no longer a closed book to us, but there are still many question marks. Why were we not able to solve more problems around lens and cataract? The research effort with a remarkable financial input and a great number of scientists worldwide during the second half of the century does not correspond to the results obtained. There must be something wrong with our strategy, our interpretation of the results or even both. We would like to stress some points which might be regarded as errors or misunderstandings in the lens research community, thus preventing a better outcome of the enormous investment of work and money. A great disadvantage is the missing cooperation between clinicians and epidemiologists on one hand and basic lens researchers on the other. Especially the ignorance of basic researchers regarding the clinical problems of the lens and of cataracts might be to blame for several 'errors and misunderstandings'. It is not even so long ago since the slitlamp microscope examination of animals belonged to the essential standard methods of a lens research team. Another disadvantage still is the use of the general diagnosis 'cataract' by the clinicians without further classification of the topography of the opacification, which supports the concept that all cataracts have the same trigger mechanism. But most regrettable is the fact that many clinicians have never been really interested in basic research of the lens, in cataract pathogenesis and epidemiology of risk factors or in testing the efficacy of cataract-preventing medication. Their main goal was cataract surgery. On the basis of the success of the cataract surgery at the present time clinicians have even developed the opinion that lens and cataract research is no longer necessary to overcome cataract blindness. But as we all know this refers only to highly industrialized countries; millions of cataract-blind people are still without such help and a change of this condition is not in sight. In our opinion lens and cataract research is still necessary and it will be more successful if we bear in mind the mostly unintentional errors of the 20th century but keep them out of our daily practice. PMID:12061266

Hockwin, Otto; Kojima, Masami; Müller-Breitenkamp, Ursula; Wegener, Alfred

2002-01-01

207

Pediatric cataract: challenges and future directions.  

Science.gov (United States)

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

Medsinge, Anagha; Nischal, Ken K

2015-01-01

208

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

OpenAIRE

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

Dl, Demill; Hsu M; Moshirfar M

2011-01-01

209

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

Science.gov (United States)

Background: Correcting the pre-existing astigmatism is an optimal goal in cataract surgery. The aim of this study is to compare the astigmatic correcting effect of a single regular 3.2 mm clear corneal incision (CCI) with paired opposite CCI in cataract patients and effect of these incisions on optical aberrations using the wavefront quantitative analysis. Materials and Methods: This was a randomized controlled trial study undertaken in an ophthalmology referral center on 50 patients planned for cataract surgery who were randomized to either single 3.2 mm CCI or paired opposite CCI group. Post-operative evaluation was performed at 12 weeks and included refraction, keratometery, corneal topography and wavefront analysis. Corneal astigmatism and post-operative values were compared in two groups. Results: The mean pre-operative corneal astigmatism was 2.58 ± 1.03 D in the single incision group and 2.70 ± 0.94 D in the paired opposite incisions group. After 12 weeks of surgery, the corneal astigmatism was reached to 2.15 ± 0.82 D in single incision group and 1.63 ± 1.21 in the paired opposite incisions group. There was a statistically significant difference in two arms of treatment regarding to surgically induced astigmatism after 3 months. The mean post-operative total and higher order aberrations and values were not significantly different in two groups. Conclusion: The results of our study showed that paired opposite incisions is an effective procedure for reducing pre-existing corneal astigmatism in cataract surgery. Paired incisions did not show any beneficial effect regarding wavefront aberrations compared with conventional single incision method. PMID:25221766

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

2014-01-01

210

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

Directory of Open Access Journals (Sweden)

Full Text Available Edward F Hall1, Garrett R Scott1, David C Musch1,2, David N Zacks11Department of Ophthalmology and Visual Sciences, Medical School; 2Department of Epidemiology, School of Public Health; University of Michigan, Ann Arbor, MI, USAPurpose: Controversy exists regarding the use of intravitreal dexamethasone (IVD as an anti-inflammatory adjunct to intravitreal antibiotics in patients with acute endophthalmitis following cataract surgery. The purpose of this project was to evaluate our experience regarding the effect of adjunctive IVD use on visual outcomes in such patients.Design: Retrospective, comparative case series.Methods: Study population: Patients treated for acute endophthalmitis following cataract surgery from 1995–2004. Intervention: In addition to standard intravitreal antibiotic treatment, some patients also received a single adjunctive injection of IVD. Primary outcome measures: Median visual acuity at last follow-up and percentage of patients achieving a ?3-line improvement in visual acuity. Secondary outcome measures: Inflammatory index scoring, including amount of cell and flare, height of hypopyon, and presence of fibrin as a function of time after treatment.Results: Twenty-six eyes were treated with and 38 eyes without adjunctive IVD. Median presenting visual acuity was Hand Motion in both groups. Median visual acuity at last followup measured 20/40 in the IVD group and 20/50 in the No-IVD group (p = 0.75. Seventy-three percent of patients in the IVD group and 82% of patients in the No-IVD group achieved a ?3-line improvement in visual acuity (p = 0.42. No significant difference was detected between the IVD and No-IVD groups for any of the three measures of inflammation.Conclusion: The use of IVD did not significantly improve the final median visual acuity, the chance of achieving a ?3-line improvement in visual acuity, or the amount of intraocular inflammation. Based on these findings, and the possible detrimental effect of IVD on visual outcomes previously reported in the literature, the use of IVD does not appear to be warranted as a routine adjunctive treatment in postoperative endophthalmitis.Keywords: endophthalmitis, dexamethasone, intravitreal injection

Edward F Hall

2008-03-01

211

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

Science.gov (United States)

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 ±5?m 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

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

2013-02-22

212

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

OpenAIRE

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...

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

2014-01-01

213

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

Scientific Electronic Library Online (English)

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

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

2006-03-01

214

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

Directory of Open Access Journals (Sweden)

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

P. Merino

2006-03-01

215

A longitudinal cohort study of the impact of first- and both-eye cataract surgery on falls and other injuries in Vietnam  

Directory of Open Access Journals (Sweden)

Full Text Available Kien Gia To,1,2 Lynn Meuleners,1 Max Bulsara,3 Michelle L Fraser,1 Dat Van Duong,4 Dung Van Do,2 Van-Anh Ngoc Huynh,2 Tien Duy Phi,5 Hoang Huy Tran,5 Nguyen Do Nguyen51Curtin Monash Accident Research Centre (C-MARC, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; 3Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia; 4United Nations Population Fund, Hanoi, Vietnam; 5Eye Hospital, Ho Chi Minh City, VietnamAim: Little information exists on the impact of cataract surgery on falls and other injuries in Vietnam. The aim of this study was to determine the impact of first and both eye cataract surgery on the number of falls and other injuries among bilateral cataract patients in Ho Chi Minh City, Vietnam.Materials and methods: A longitudinal cohort study was conducted involving 413 bilateral cataract patients aged 50+ years. Participants were assessed at three time points: 1 week before, 1–3 months after, and 1 year after first-eye cataract surgery. Visual measures (visual acuity, contrast sensitivity and stereopsis were taken, and self-reported falls and injury data were collected. A multilevel longitudinal Poisson regression model was used to investigate change in the number of falls after surgery.Results: The risk of falls decreased by 78% (incidence-rate ratio [IRR] 0.22, 95% confidence interval [CI] 0.06–0.77; P=0.018 in the year after cataract surgery for participants who had first-eye surgery only and 83% (IRR 0.17, 95% CI 0.04–0.69; P=0.012 for participants who had the second eye operated on compared to before surgery. The risk of falls was three times higher for females than males (IRR 3.13, 95% CI 1.53–6.40; P=0.002. Improved binocular contrast sensitivity was also associated with a decrease in falls (IRR 0.40, 95% CI 0.17–0.97; P=0.042. The prevalence of other injuries also decreased after cataract surgery.Conclusion: Cataract surgery reduced the number of falls and other injuries in Vietnam. Contrast sensitivity may be important for ophthalmologists to consider when prioritizing patients for surgery and assessing their fall risk.Keywords: falls, injuries, cataract surgery, longitudinal, older population, Vietnam

To KG

2014-04-01

216

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

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

Moharra Montse

2008-04-01

217

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish 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.

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

2012-06-01

218

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

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

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

2010-04-01

219

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

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

Khumbo Kalua

2013-09-01

220

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

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

Md Shafiqul Alam

2014-01-01

221

Warfarin and cataract extraction.  

OpenAIRE

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.

Robinson, G. A.; Nylander, A.

1989-01-01

222

Training a cataract surgeon  

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

M Babar Qureshi

2014-07-01

223

Analysis of the effects of 50g/L povidone iodine in conjuncfival sac before cataract surgery  

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Full Text Available AIM: To evaluate the sterilizing effects of 50g/L povidone Iodine used in conjunctival sag before cataract surgery.METHODS: Totally, 58 eyes of 45 cataract patients underwent phacoemulsification aspiration with intraocular lens implantation. The cojunctival sac secretions at three time points(admission, before and after disinfection with povidone iodinewere obtained and then cultured under the same condition and at the same time. The results were observed and identified.RESULTS: At the three points, the positive rate of bacterial culture was 79.3%, 41.9% and 3.4%, respectively. The positive rate significantly reduced gradually. CONCLUSION: The application effect of 50g/L povidone iodine in killing conjunctival sac bacteria is remarkable, which can avoid the postoperative endophthalmitis effectively.

Wen Yang

2013-12-01

224

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

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Full Text Available Objetivos: Analizar cambios en la morfología macular tras cirugía no complicada de cataratas y su correlación con la edad y la hipertensi?n 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 cirug?a de catarata fueron 6,59 DE 0,67 ?m³; 0,16 DE 0,02 µm³ and 204,97 DE 29,79 ?m. Un mes después de la cirugía de cataratas las mediciones fueron TMV: 6,93 DE 0,56 µm³; FOVOL: 0,17 DE 0,06 µm³ y FOV: 218,07 DE 87,60 µm. Encontramos diferencias estadísticamente significativas (PObjective: To analyze morphological macular changes after uncomplicated cataract surgery and their correlation with age and arterial hypertension. Methods: Total macular volume (TMV, foveal volume (FOVOL and foveal thickness (FOV in patients who had undergone cataract surgery were measured using OCT3 Stratus® before surgery, the day after the intervention and one month later. The data were analyzed using SPSS 15.0 software. Results: The study group was composed of 114 eyes from 114 patients. The mean TMV, FOVOL and FOV in the subgroup of patients with signal strength over 6 before cataract surgery were 6.59 (SD0.67 µm?; 0.16 (SD0.02 µm³ and 204.97 (SD29.79 µm. One month after surgery the measurements were TMV: 6.93 (SD0.56 µm³; FOVOL: 0.17 (SD0.06 µm³ and FOV: 218.07 (SD87.60 µm. We found statistically significant differences (P<0.05 in TMV, but not in FOVOL or FOV. The group of patients under 74 years showed a greater increase in TMV. Patients with arterial hypertension did not show an increase in TMV or FOV compared to patients without arterial hypertension. Conclusions: We found a sub-morphological macular oedema one month after uncomplicated cataract surgery, with age being a risk factor for developing a greater increase in TMV. Arterial hypertension does not seem to be a risk factor for these changes.

J. Pareja-Esteban

2009-12-01

225

Pediatric cataract: challenges and future directions  

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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

Medsinge A

2015-01-01

226

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

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

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

2010-12-01

227

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

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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.

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

2014-06-01

228

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

Science.gov (United States)

Background The purpose of this study was to evaluate the correlation between contrast sensitivity and calculated higher-order aberrations based on individual natural pupil diameter after cataract surgery. Methods This prospective study included 120 eyes from 92 patients who were randomized to receive one of four lenses, including three aspheric lenses (Acrysof SN60WF, Tecnis ZA9000, and Hoya Py60AD) and one spherical lens (Acrysof SN60AT). Contrast sensitivity, higher-order aberrations of the whole eye, and pupil diameter under photopic and mesopic conditions were measured 1 month postoperatively. Higher-order aberrations were decomposed into Zernike coefficients, calculated according to individual pupil diameter. The correlation between higher-order aberrations and contrast sensitivity was evaluated. Results There were no significant differences in contrast sensitivity function between the four types of lenses under photopic conditions. However, the contrast sensitivity function and area under log contrast sensitivity function in the aspheric lenses were significantly better than in the spherical lens under mesopic conditions. Under mesopic conditions, spherical aberration in eyes with aspheric lenses was significantly lower than in eyes with spherical lenses (P < 0.05). Under photopic conditions, coma aberration had a significant negative correlation with contrast sensitivity at 12 cycles/degree. Under mesopic conditions, spherical aberration had a significant negative correlation with contrast sensitivity at 3, 6, and 12 cycles/degree with glare, and with contrast sensitivity at 6 and 18 cycles/degree without glare. Conclusion In terms of influence on visual function, coma aberration may be more significant under photopic conditions and spherical aberration under mesopic conditions. PMID:22205829

Yamaguchi, Takefumi; Negishi, Kazuno; Ohnuma, Kazuhiko; Tsubota, Kazuo

2011-01-01

229

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

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

Yamaguchi T

2011-12-01

230

Cataract development and outcome of surgery in bone marrow transplanted children.  

OpenAIRE

Cataract development in bone marrow transplanted (BMT) patients was studied prospectively. There were 61 children, transplanted before the age of 18 years, who survived more than 1 year after transplantation. Patients transplanted for leukaemia (n = 43) were conditioned before BMT with cyclophosphamide (Cy) and total body irradiation (TBI). Patients with severe aplastic anaemia (SAA) (n = 9) only received Cy. None of the patients with SAA developed cataracts. All children with leukaemia, who ...

Calissendorff, B. M.; Bolme, P.

1993-01-01

231

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

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

MR Safavi

2007-11-01

232

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)

233

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

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

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

2012-06-01

234

Geographical variations in the benefit of applying a prioritization system for cataract surgery in different regions of Spain  

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Full Text Available Abstract Background In Spain, there are substantial variations in the utilization of health resources among regions. Because the need for surgery differs in patients with appropriate surgical indication, introducing a prioritization system might be beneficial. Our objective was to assess geographical variations in the impact of applying a prioritization system in patients on the waiting list for cataract surgery in different regions of Spain by using a discrete-event simulation model. Methods A discrete-event simulation model to evaluate demand and waiting time for cataract surgery was constructed. The model was reproduced and validated in five regions of Spain and was fed administrative data (population census, surgery rates, waiting list information and data from research studies (incidence of cataract. The benefit of introducing a prioritization system was contrasted with the usual first-in, first-out (FIFO discipline. The prioritization system included clinical, functional and social criteria. Priority scores ranged between 0 and 100, with greater values indicating higher priority. The measure of results was the waiting time weighted by the priority score of each patient who had passed through the waiting list. Benefit was calculated as the difference in time weighted by priority score between operating according to waiting time or to priority. Results The mean waiting time for patients undergoing surgery according to the FIFO discipline varied from 1.97 months (95% CI 1.85; 2.09 in the Basque Country to 10.02 months (95% CI 9.91; 10.12 in the Canary Islands. When the prioritization system was applied, the mean waiting time was reduced to a minimum of 0.73 months weighted by priority score (95% CI 0.68; 0.78 in the Basque Country and a maximum of 5.63 months (95% CI 5.57; 5.69 in the Canary Islands. The waiting time weighted by priority score saved by the prioritization system varied from 1.12 months (95% CI 1.07; 1.16 in Andalusia to 2.73 months (95% CI 2.67; 2.80 in Aragon. Conclusion The prioritization system reduced the impact of the variations found among the regions studied, thus improving equity. Prioritization allocates the available resources within each region more efficiently and reduces the waiting time of patients with greater need. Prioritization was more beneficial than allocating surgery by waiting time alone.

Gutiérrez-Moreno Santiago

2008-02-01

235

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

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

Juan Raúl Hernández Silva

2010-06-01

236

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

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

DeMill DL

2011-08-01

237

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

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

Modi SS

2011-09-01

238

Function of filtering bleb after Cataract Surgery in Eyes with Previous Successful Trabeculectomies  

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Full Text Available Background: It has been reported that cataract surgery can compromise the function of a filtering bleb, resulting in loss of control of intraocular pressure (IOP. In a number of retrospective studies a rise of IOP after extra capsular extraction and even after phacoemulsification in filtered glaucoma eye was shown. Objective: To evaluate the effect of temporal clear corneal Phacoemulsification with Intraocular Lens implantation (IOL on IOP control in glaucoma patients who had previous successful trabeculectomy. Methods: The clinical course of 60 patients (60 eyes who underwent temporal clear corneal phacoemulsification after successful trabeculetomy was studied over a period of 3 years. The number of Primary Open Angle Glaucoma (POAG and Primary Angle Closure Glaucoma (PACG cases was equal in our study. Comparison of pre-operative and post-operative IOP, visual acuity, bleb morphology and the number of medications was made at follow up interval of 1 month, 3 months, 6 months and 12 months respectively.Results: The mean ± SD IOP before phacoemulsification was 12.2 ± 4.608 mmHg and it increased to 14.98, 14.47, 15.44 and 15.71 after 1, 3, 6 and 12 months respectively. At each interval the mean IOP was significantly higher than the pre-operative value (p = 0.000, 0.015, 0.000, 0.001 respectively There was also an increase in the number of antiglaucoma medications used after phacoemulsification. The mean ± SD of medication before phacoemulsification was 0.57 + 0.62 and it increased to 0.65, 0.70, 0.68, 0.67 after 1, 3, 6 and 12 months respectively. But the difference was not statistically significant. Conclusion: Temporal clear corneal phacoemulsification significantly increases IOP in eyes with pre-existing functioning filtering bleb. No statistically significant difference was found between the outcomes of POAG and PACG groups. There is a statistically significant improvement in visual acuity following phacoemulsification with intraocular lens implantation.

Sneh S. Dhannawat

2013-07-01

239

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

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

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

2009-12-01

240

Agreement between optical coherence tomography and fundus fluorescein angiography in post-cataract surgery cystoid macular edema  

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Full Text Available PURPOSE: To evaluate the agreement between optical coherence tomography (OCT and fundus fluorescein angiography (FFA regarding the detection of cystoid macular edema (CME following cataract surgery. METHODS: Retrospective comparative observational series of 25 eyes with suspected CME. Patients with low visual acuity and alterations in fundus biomicroscopy after cataract surgery underwent OCT scanning followed by FFA on the same visit. The diagnosis of CME was established considering fluorescein leakage on FFA and retinal thickness and/or cystoid spaces and/or subretinal fluid on OCT. RESULTS: Twenty-five eyes of 25 patients were enrolled. Twenty-two eyes had similar results on both OCT and FFA, of which 15 eyes had CME and 7 eyes had no CME. Two eyes had CME detected only by FFA and one eye only by OCT. The agreement between the two examinations was good (Kappa = 0.7331; p=0.0001 with no tendency to have neither more positive nor negative findings (p=1.0. CONCLUSION: According to these preliminary data, OCT seems to be as effective as FFA to detect CME with a good agreement between the two techniques.

Mitne Somaia

2003-01-01

241

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

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

Mansoori Tarannum

2005-12-01

242

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

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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.

Rafael, Iribarren; Guillermo, Iribarren.

2013-06-01

243

Facts about Cataract  

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... detected through a comprehensive eye exam that includes: Visual acuity test. This eye chart test measures how well ... you have lost some sight from cataract or cataract surgery, ask your eye ... people with visual impairments. A nearby school of medicine or optometry ...

244

Are cataracts associated with osteoporosis?  

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

Nemet AY

2013-10-01

245

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

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

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

2008-12-01

246

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

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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.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 keratometric values before the cataract surgery, the refractive surgery and the excimer laser technique used in patients who were operated on from May 2005 to July 2007 at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology. METHODS: A prospective, longitudinal and descriptive study was conducted in those patients operated on from cataract, who developed a residual refractive defect - error or refractive surprise- and were performed an excimer laser surgery. The characteristics of the studied persons by their age, the biometric and keratometric values prior to the cataract surgery and the refractive surgery as well as the used excimer laser technique were evaluated. RESULTS: This study revealed the prevalence of the 40-59 years-old age group, the most frequent refractive error was myopia, the axial length induced a refractive surprise contributed by the keratometric error; LASIK was the refractive technique that managed to correct the found refractive surprises. CONCLUSIONS: The refractive surprise present in all the patients was myopia. It was shown that the axial length induced a refractive surprise that was the most important outcome derived from a keratometric error, despite the latter being not significant.

Juan Raúl Hernández Silva

2008-12-01

247

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)

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.

Fidel Saúl, Ricardo Suárez.

2010-08-01

248

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

Science.gov (United States)

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

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

2010-01-01

249

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

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

I. Coloma-González

2007-09-01

250

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

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

2008-01-01

251

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

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

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

2012-12-01

252

Cataract surgery: expectations of patients assisted during a community project in São Paulo, state of São Paulo, Brazil Cirurgia de catarata: expectativas de pacientes atendidos por projeto comunitário em São Paulo, estado de São Paulo, Brasil  

OpenAIRE

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...

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

2001-01-01

253

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish 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.

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

2010-06-01

254

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

Scientific Electronic Library Online (English)

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

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

2013-04-01

255

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

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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.

Phuc Huynh

2011-09-01

256

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

Scientific Electronic Library Online (English)

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

Amaryllis, Avakian; Edmea Rita, Temporini; Newton, Kara-José.

2005-10-01

257

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

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

Amaryllis Avakian

2005-10-01

258

Review: minimally invasive strabismus surgery.  

Science.gov (United States)

This article reviews the principles and different techniques used to perform minimally invasive strabismus surgery (MISS). This term is used for strabismus surgeries minimizing tissue disruption. Muscles are not accessed through one large opening, but using several keyhole openings placed where needed for the surgical steps. If necessary, tunnels are created between cuts, which will allow performing additional surgical steps. To keep the keyhole openings small, transconjunctival suturing techniques are used. The cuts are always placed as far away from the limbus as feasible. This will reduce the risk for postoperative corneal complications and it will ensure that all cuts will be covered by the eyelids, minimizing postoperative visibility of surgery and patient discomfort. Benefits from minimizing anatomical disruption between the muscle and the surrounding tissue are a better preservation of muscle function, less swelling, and pain, and more ease to perform reoperations. MISS openings allow to perform all types of strabismus surgeries, namely rectus muscle recessions, resections, plications, reoperations, retroequatorial myopexias, transpositions, oblique muscle recessions, or plications, and adjustable sutures, even in the presence of restricted motility. PMID:25431106

Mojon, D S

2015-02-01

259

Amsler-Verrey sign during cataract surgery in Fuchs heterochromic uveitis  

OpenAIRE

Fuchs heterochromic uveitis (FHU) in its classic presentation is a unilateral, chronic, low grade, often asymptomatic anterior uveitis. It is characterized by a classic triad of iris heterochromia, cataract and keratic precipitates. Neovascularization of the iris and the anterior chamber (AC) angle (radial and circumferential) occurs in 6–22% of cases. This angle and iris new vessels can sometimes lead to a characteristic filiform haemorrhage and formation of hyphaema after AC paracentesis ...

Srinivasan, Sathish; Lyall, Douglas; Kiire, Christine

2010-01-01

260

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

OpenAIRE

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

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

2008-01-01

261

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

OpenAIRE

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...

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

1995-01-01

262

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

Scientific Electronic Library Online (English)

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

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

2011-02-01

263

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

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

Ernesto Marrero Rodríguez

2011-02-01

264

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

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

Bagnis A

2011-04-01

265

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

OpenAIRE

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...

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

2013-01-01

266

Agreement between optical coherence tomography and fundus fluorescein angiography in post-cataract surgery cystoid macular edema Concordância entre tomografia de coerência óptica e angiofluoresceinografia no edema macular cistóide secundário a cirurgia de catarata  

OpenAIRE

PURPOSE: To evaluate the agreement between optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) regarding the detection of cystoid macular edema (CME) following cataract surgery. METHODS: Retrospective comparative observational series of 25 eyes with suspected CME. Patients with low visual acuity and alterations in fundus biomicroscopy after cataract surgery underwent OCT scanning followed by FFA on the same visit. The diagnosis of CME was established considering fluore...

Somaia Mitne; Augusto Paranhos Júnior; Ana Paula Silvério Rodrigues; Tércio Guia; Arnaldo Bordon; Nilva Simeren Bueno Moraes; Michel Eid Farah; Pedro Paulo Bonomo

2003-01-01

267

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

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

Stephen Smith

2010-08-01

268

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

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

Pajic B

2014-12-01

269

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

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

Xiao-Ning Peng

2014-04-01

270

Comparison of 5% povidone-iodine solution against 1% povidone-iodine solution in preoperative cataract surgery antisepsis: a prospective randomised double blind study  

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Background/aim: Povidone-iodine (PI, Betadine) is routinely used as a preoperative topical antiseptic in cataract surgery as it has been shown to reduce the incidence of postoperative endophthalmitis. However, the concentration used clinically is variable. In vitro studies have shown that PI is paradoxically more effective at lower concentration. This study was undertaken to determine if this effect was reproducible in vivo.

Ferguson, A. W.; Scott, J. A.; Mcgavigan, J.; Elton, R. A.; Mclean, J.; Schmidt, U.; Kelkar, R.; Dhillon, B.

2003-01-01

271

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

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

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

2011-06-01

272

Clinical study Carbomer eye gel and rhEGF in treating dry eye after cataract surgery in diabetics  

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Full Text Available AIM: To investigate the effect of Carbomer eye gel and recombinant human epidermal growth factor(rhEGFon dry eye after cataract surgery in diabetics.METHODS:A total of 160 patients(160 eyeswith diabetes undergone phacoemulsification with a diagnosis of dry eyes were randomized divided into two groups, treatment group(80 cases, 80 eyesand control group(80 cases, 80 eyes. In treatment group, the patients were treated by Carbomer eye gel and rhEGF. In control group, the patients were treated by Carbomer eye gel. The subjective dry eye symptoms, tear break-up time(BUT, Schirmer I test(S?tand cornea fluorescein staining(FLwere observed before treatment, 1, 4wk after treatment.RESULTS: There was no significant difference between groups before treatment(P>0.05. After treatment at 1, 4wk, the subjective dry eye symptoms and the results of three examination(BUT, S?t and FLin two groups better than those before treatment(PPPPCONCLUSION: Carbomer eye gel can relieve the dry eye symptoms of diabetes after phacoemulsification effectively, and it can be more effective to combine Carbomer eye gel with rhEGF at early stage after phacoemulsification.

Yong-Li Yang

2014-09-01

273

Three cases of extracapsular cataract extraction for radiation cataract  

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

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

1996-02-01

274

Three cases of extracapsular cataract extraction for radiation cataract  

International Nuclear Information System (INIS)

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

275

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

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

Hai-Jiang Qiu

2014-05-01

276

Corneal optical quality following sub 1.8 mm micro-incision cataract surgery vs. 2.2 mm mini-incision coaxial phacoemulsification  

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Full Text Available Purpose: To study and compare the effects of the micro-incision cataract surgery (MICS-sub 1.8 mm and mini-incision coaxial phacoemulsification (2.2 mm on the optical quality of the cornea characterized in terms of corneal aberrations. Materials and Methods: Fifty eyes underwent MICS and 50 mini-incision phacoemulsification, by the same surgeon. Both types of cataract surgery were performed using low ultrasound power and through a clear corneal incision, placed on the steepest corneal meridian ranging from 1.6 to 1.8 in MICS (Group I and from 2.12 to 2.3 mm in mini-incision coaxial phacoemulsification (Group II. Seidel and Zernike aberration coefficients and RMS values were obtained for a 6-mm pupil preoperatively and one month after surgery. Results: The corneal astigmatism did not show statistically significant changes in either of the two groups: (MICS: -0.73 ± 0.63, -0.65 ± 0.53 D, P = 0.25, (mini-incision phacoemulsification; -1.21 ± 1.52, -1.00 ± 1.19 D, P = 0.12. The total RMS remained unchanged after MICS (1.77 ± 1.7, 1.65 ± 1.3 µm, P = 0.18 and mini-incision phacoemulsification (2.00 ± 1.87, 2.09 ± 1.8 µm, P = 0.41. Statistically significant changes were found for coma (P = 0.004 and higher-order aberrations (P < 0.001, showing MICS significantly less changes in cornea. Conclusions: Both MICS and mini-incision phacoemulsification do not degrade the optical quality of the cornea. Both surgeries do not induce a modification of the corneal astigmatism, even in the axis. It seems that 2 mm is the limit around which no optical changes are induced by cataract surgery in the human cornea.

Alio Jorge

2010-01-01

277

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

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

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

2011-12-01

278

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

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

Kova? Bojan

2014-01-01

279

Comparative outcomes of manual small incision cataract surgery and phacoemulsification performed by ophthalmology trainees in a tertiary eye care hospital in India: a retrospective cohort design  

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Objective To compare the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification performed by ophthalmology trainees. Design Retrospective cohort design. Setting Tertiary eye care centre. Participants A total of 1029 subjects underwent cataract surgeries with MSICS technique or phacoemulsification by trainees during one quarter (July–September 2007). Only 484 (47%) subjects were males. Surgeries which were primarily large incision extracapsular or intracapsular cataract extraction and performed on patients less than 20?years of age were excluded. Outcome measures The postoperative best corrected visual acuity (BCVA) along with the rates and types of complications were compared between both the groups. Results A total of 1029 surgeries were performed by 22 resident surgeons. In all, 522 (50.7%) were done using MSICS technique and 507 (49.2%) were done by phacoemulsification. Those in the MSICS group were significantly older (age >70?years; 5.7% vs 3.4%; p<0.001) and had worse preoperative visual acuity (visual acuity <6/60; 69.3% vs 40.4%; p<0.001). Postoperatively, the number of patients having BCVA?6/12 was similar in both the groups (84.3% vs 88%; p=0.09). The complication rates were higher in MSICS group (15.1% vs 7.1%, p<0.001). Most common risk factor for poor outcome (postoperative BCVA<6/60) in both the groups was presence of associated ocular pathologies (OR 7.4 95% CI 3.4 to 16.4) and having a complications (OR 5.7 95% CI 3.0 to 10.8). Conclusions Although the complication rate was higher in the MSICS group, there was no difference in BCVA in both the groups. PMID:23059846

Khanna, Rohit C; Kaza, Srivalli; Palamaner Subash Shantha, Ghanshyam; Sangwan, Virender S

2012-01-01

280

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

Scientific Electronic Library Online (English)

Full Text Available A partir de material ocular coletado de 46 pacientes submetidos à cirurgia de catarata foram realizados isolamento, identificação e teste de susceptibilidade de microrganismos frente a antimicrobianos, utilizando-se suabes e lentes intraoculares (LIO). Foram obtidos 76 isolados e identificados 7 tip [...] os de microrganismos. Estafilococos coagulase-negativos (CNS) foram os microrganismos mais freqüentemente detectados de suabes (71,4% dos casos), lentes de PMMA (81,3%) e lentes de silicone (77,8%). Isolados de CNS apresentaram elevada resistência à penicilina G, seguida por tetraciclina, cloranfenicol e aminoglicosídeos. No entanto, estes isolados mostraram grande sensibilidade à vancomicina, cefalotina e ofloxacina. Com exceção da penicilina G, os isolados de Staphylococcus aureus foram bastante sensíveis aos agentes antimicrobianos, incluindo a oxacilina. Entre as gram-negativas, Proteus mirabilis foi a bactéria mais freqüente e também se mostrou bastante resistente à tetraciclina e ao cloranfenicol. Os isolados de Enterococcus se mostraram sensíveis à vancomicina. Abstract in english Bacterial isolation, identification and antimicrobial susceptibility tests were carried out in ocular material collected with swab and polimethylmethacrylate (PMMA) or silicone intraocular lenses (IOL) from forty six patients submitted to cataract surgery. Seventy six isolates and seven different mi [...] croorganisms were identified. Coagulase-negative staphylococci (CNS) were the predominant microorganisms isolated from swabs (71.4% of cases), PMMA lenses (81.3%) and silicon lenses (77.8%). Coagulase-negative staphylococci isolates revealed high resistance to penicillin G followed by tetracycline, chloramphenicol and aminoglicosides. However, these isolates displayed great susceptibility to vancomycin, cephalothin and ofloxacin. Except for penicillin G, Staphylococcus aureus was very sensitive to the antimicrobial agents including oxacillin. Among Gram-negatives, Proteus mirabilis was prevalent and presented high resistance to tetracycline and chloramphenicol. Enterococcus isolates were vancomycin sensitive.

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

2003-07-01

281

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

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Full Text Available Bacterial isolation, identification and antimicrobial susceptibility tests were carried out in ocular material collected with swab and polimethylmethacrylate (PMMA or silicone intraocular lenses (IOL from forty six patients submitted to cataract surgery. Seventy six isolates and seven different microorganisms were identified. Coagulase-negative staphylococci (CNS were the predominant microorganisms isolated from swabs (71.4% of cases, PMMA lenses (81.3% and silicon lenses (77.8%. Coagulase-negative staphylococci isolates revealed high resistance to penicillin G followed by tetracycline, chloramphenicol and aminoglicosides. However, these isolates displayed great susceptibility to vancomycin, cephalothin and ofloxacin. Except for penicillin G, Staphylococcus aureus was very sensitive to the antimicrobial agents including oxacillin. Among Gram-negatives, Proteus mirabilis was prevalent and presented high resistance to tetracycline and chloramphenicol. Enterococcus isolates were vancomycin sensitive.A partir de material ocular coletado de 46 pacientes submetidos à cirurgia de catarata foram realizados isolamento, identificação e teste de susceptibilidade de microrganismos frente a antimicrobianos, utilizando-se suabes e lentes intraoculares (LIO. Foram obtidos 76 isolados e identificados 7 tipos de microrganismos. Estafilococos coagulase-negativos (CNS foram os microrganismos mais freqüentemente detectados de suabes (71,4% dos casos, lentes de PMMA (81,3% e lentes de silicone (77,8%. Isolados de CNS apresentaram elevada resistência à penicilina G, seguida por tetraciclina, cloranfenicol e aminoglicosídeos. No entanto, estes isolados mostraram grande sensibilidade à vancomicina, cefalotina e ofloxacina. Com exceção da penicilina G, os isolados de Staphylococcus aureus foram bastante sensíveis aos agentes antimicrobianos, incluindo a oxacilina. Entre as gram-negativas, Proteus mirabilis foi a bactéria mais freqüente e também se mostrou bastante resistente à tetraciclina e ao cloranfenicol. Os isolados de Enterococcus se mostraram sensíveis à vancomicina.

Claudete I. Locatelli

2003-07-01

282

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

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

Ding Chen

2012-12-01

283

Lens surgery in infancy and childhood.  

OpenAIRE

The medical records of 224 children who had lens surgery performed at the Hospital for Sick Children during the 10-year period 1978-88 were reviewed. There were 12 children with ectopia lentis; these patients achieved a mean postoperative acuity of 0.68 (6/8.8), and no operative or postoperative complications were noted. Two hundred and twelve children had lens surgery for cataracts or for retrolental abnormalities with a clear lens. Children with bilateral congenital cataracts achieved a mea...

Hing, S.; Speedwell, L.; Taylor, D.

1990-01-01

284

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

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

McDonnell Peter J

2011-02-01

285

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

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Verificar reações emocionais relacionadas à cirurgia de catarata entre pacientes com visão monocular (Grupo 1) e binocular (Grupo 2). MÉTODOS: Foi realizado um estudo tranversal, comparativo por meio de um questionário estruturado respondido por pacientes antes da cirurgia de catarata. RES [...] ULTADOS: A amostra foi composta de 96 pacientes no Grupo 1 (69.3 ± 10.4 anos) e 110 no Grupo 2 (68.2 ± 10.2 anos). Consideravam apresentar medo da cirugia 40.6% do Grupo 1 e 22.7% do Grupo 2 (p Abstract in english PURPOSE: To analyze emotional reactions related to cataract surgery in two groups of patients (monocular vision - Group 1; binocular vision - Group 2). METHODS: A transversal comparative study was performed using a structured questionnaire from a previous exploratory study before cataract surgery. R [...] ESULTS: 206 patients were enrolled in the study, 96 individuals in Group 1 (69.3 ± 10.4 years) and 110 in Group 2 (68.2 ± 10.2 years). Most patients in group 1 (40.6%) and 22.7% of group 2, reported fear of surgery (p

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

2012-12-01

286

Post-operative endophthalmitis caused by Acremonium falciforme with orbital and extra-orbital involvement following combined cataract and glaucoma surgery: a case report  

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Introduction In this report, we describe an unusual case of post-operative Acremonium falciforme endophthalmitis with orbital and extra-orbital involvement following combined cataract and glaucoma surgery. Case presentation A 68-year-old Caucasian man with glaucoma presented with endophthalmitis characterized by pain, redness and impaired vision in the left eye fifteen days after combined cataract and filtering surgery. He subsequently underwent a pars plana vitrectomy, with vitreous sampling, silicone oil placement and intra-vitreal injection of antibiotics, but only after a second vitrectomy we identified Acremonium falciforme as the causative agent for the endophthalmitis. An antifungal systemic and topical therapy was started, but meanwhile the infection extended to orbital and peri-orbital tissues. Following these procedures, even if the eye went slowly in phthisis, we were able to limit the further extension and circumscribe the orbital and extra-orbital involvement. Conclusion To our knowledge, this report is the first describe Acremonium falciforme endophthalmitis with orbital and extra-orbital involvement, following anterior segment combined surgery. Ophthalmologists and physicians should be aware of the extension risk of a fungal panophthalmitis, but also to potentially serious side effects related to systemic therapy. PMID:25406374

2014-01-01

287

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

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

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

2011-06-01

288

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

Scientific Electronic Library Online (English)

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

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

2013-08-01

289

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

OpenAIRE

David L DeMill1, Majid Moshirfar1, Marcus C Neuffer1, Maylon Hsu1, Shameema Sikder21John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USABackground: To compare the average values of the American Society of Cataract and Refractive Surgery (ASCRS) and Ocular MD intraocular lens (IOL) calculators to assess their accuracy in predicting IOL power in patients with prior laser-in-situ keratomileusis (LASIK) or photor...

Hsu M; Mc, Neuffer; Moshirfar M; Dl, Demill; Sikder S

2011-01-01

290

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

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

Belmary Aragonés Cruz

2007-12-01

291

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

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

Tiago Eugênio Faria e Arantes

2008-04-01

292

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

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

Silverstein SM

2014-05-01

293

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

Scientific Electronic Library Online (English)

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

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

2011-09-01

294

Development of visual acuity in infants with congenital cataracts.  

OpenAIRE

The visual acuity of 4 infants with congenital cataracts was measured serially during the first year of life by a preferential looking technique. Two infants with bilateral cataracts and no measurable acuity before surgery showed rapid development of acuity to normal levels for age after surgery and optical correction. In an infant with a unilateral cataract and an infant with a cataract and persistent hyperplastic primary vitreous marked differences in monocular acuities were found after sur...

Jacobson, S. G.; Mohindra, I.; Held, R.

1981-01-01

295

Flora bacteriana conjuntival após uso tópico de ciprofloxacino e gatifloxacino em cirurgia de catarata / Conjunctival bacterial flora after topical use of ciprofloxacin and gatifloxacin in cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available OBJETIVO: Avaliar alterações da flora conjuntival após uso dos colírios de ciprofloxacino e gatifloxacino 0,3% na profilaxia dos pacientes submetidos à facectomia. MÉTODOS: Quarenta pacientes submetidos a facectomia foram alocados em dois grupos, conforme o colírio antibiótico utilizado: Grupo A: ci [...] profloxacino 0,3% e Grupo B: gatifloxacino 0,3%. Os pacientes usaram os colírios 1 hora antes da cirurgia e nos primeiros 14 dias pós-operatórios. Foi coletado material da conjuntiva em cinco momentos: 1 hora antes da cirurgia, sem medicações tópicas (t0); imediatamente antes da aplicação de iodopovidona (PVPI) (t1), antes do início da cirurgia, após iodopovidona (t2), 14 dias após a cirurgia (t3) e 28 dias após a cirurgia (t4). RESULTADOS: O uso de antibióticos no pré-operatório diminuiu a positividade das culturas anteriores ao uso do iodopovidona em ambos os grupos; no Grupo A esta redução não alcançou significância estatística (Grupo A - p=0,07 e Grupo B - p=0,04). A positividade das culturas foi reduzida nos dois grupos após aplicação de iodopovidona e 14 dias após a cirurgia (p Abstract in english PURPOSE: To evaluate alterations of the conjunctival flora after the use of 0.3% ciprofloxacin and gatifloxacin in the prophylaxis of patients undergoing cataract surgery. METHODS: 40 patients undergoing cataract surgery were distributed into two groups according to the use of antibiotic eye drops: [...] Group A: 0.3% ciprofloxacin and Group B: 0.3% gatifloxacin. Both groups used antibiotic eye drops 1 hour before surgery and 14 days after surgery. Conjunctival material was collected at 5 time points: 1 hour before surgery, without any topical medication (t0); immediately before the application of povidone-iodine (PVPI) (t1), before the beginning of surgery, after povidone-iodine (t2), 14 days (t3) and 28 days after surgery (t4). RESULTS: Preoperative antibiotics reduced the positivity of the cultures before the use of PVPI in both groups, although in Group A this reduction was not significant (Group A - p=0.07 and Group B - p=0.04). The number of positive cultures was reduced in all groups after the use of povidone-iodine and on the 14th postoperative day (p

Tiago Eugênio Faria e, Arantes; Célia Maria Machado Barbosa de, Castro; Ronald Fonseca, Cavalcanti; Maiara Santos, Severo; Maria de Fátima Alves, Diniz; Ricardo Walber de Deus, Urtiga.

2008-04-01

296

Analysis and Modeling of Anatomical Changes of the Anterior Segment of the Eye After Cataract Surgery with Consideration of Different Phenotypes of Eye Structure.  

Science.gov (United States)

Abstract Purpose: To study the relationship between phacoemulsification-related changes and the baseline parameters of the anterior chamber. Setting: Military Institute of Medicine, Warsaw, Medical University of Lublin, Medical University of Bialystok. Material and methods: The study included 228 patients. Anterior chamber depth (ACD), trabecular-iris angle (TIA), central lens thickness (CLT) and axial length of the eye (AXL) were determined prior to and 6 months after surgery. These measurements were used to calculate the ACDindex describing the degree of postoperative changes in the anterior chamber. K-means clustering, multiple regression and neural networks were used for the analysis. Results: Cataract surgery was reflected by changes in ACD and TIA. The character of changes was described by ACDindex (p?Mean ACD0 was 2.51?±?0.45?mm and increased to 3.84?±?0.35?mm (p?mean TIA0 was 22.84?±?7.43° and increased to 30.97?±?7.99° (p?Cataract surgery-related changes in ACD and TIA are determined by the type of the eye. Although the linear model of the relationship between baseline parameters of the eye and their postoperative changes is correct, it does not explain the degree of the latter phenomenon. Preoperative consideration of other parameters characterizing anatomical relationships of the eye would enable the prediction of phacoemulsification-related changes in the anterior segment. PMID:25329357

R?kas, Marek; Barchan-Kucia, Kamilla; Konopi?ska, Joanna; Mariak, Zofia; Zarnowski, Tomasz

2014-10-20

297

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

Scientific Electronic Library Online (English)

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

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

2012-08-01

298

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

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

Hsu M

2011-09-01

299

Desprendimiento postquirúrgico de la membrana de descemet: a propósito de un caso Descemet's membrane detachment as a complication of cataract surgery  

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Full Text Available Caso clínico: Se presenta un caso de desprendimiento de la membrana de Descemet tras cirugía de la catarata mediante facoemulsificación tratado con éxito utilizando SF6 al 20% intracameral. Discusión: Se exponen los posibles mecanismos etiopatogénicos y se comentan las distintas opciones terapéuticas. Enfatizamos la necesidad de adopción de medidas preventivas de este trastorno y de la importancia de su detección inmediata para evitar complicaciones adicionales.Case: A case of Descemet’s membrane detachment after cataract surgery successfully treated with an injection of sulphur hexafluoride 20% is presented. Discussion: Possible pathogenic mechanisms and available therapeutic options are discussed. We highlight the need for prophylactic measures and the importance of an early detection to prevent further damage.

C. Sevillano

2008-09-01

300

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

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

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

2013-08-01

301

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  

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

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

2011-06-01

302

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  

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

Ligia Santos Abreu Caligaris

2011-06-01

303

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

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

Cable M

2012-07-01

304

Keratopathy, cataract, and dry eye in a survey of aniridia subjects  

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Full Text Available David Shiple,1 Brenton Finklea,1 James D Lauderdale,2 Peter A Netland1 1Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, VA, USA; 2Department of Cellular Biology, University of Georgia, Athens, GA, USA Purpose: To determine the prevalence of keratopathy, cataract, and dry eye in a group of individuals with aniridia. Methods: We reviewed survey data from the Aniridia Foundation International (AFI registry, which included 99 subjects who self-reported on corneal disease, cataract, and dry eye disease. Results: The average age of respondents was 25.3±18.6 years, with a range of 0 to 67. Of 99 subjects, 46% stated they have corneal disease, 32% stated they did not, and 22% were unsure. The average age of diagnosis of keratopathy was 20.0±12.2 years. Keratolimbal allograft was reported in 20% and penetrating keratoplasty in 9%. Cataract was reported in 65%, with an average age of 9.4±14.0 years at time of diagnosis, and cataract surgery was reported in 32%. The average age of subjects at the time of cataract and corneal surgery was 28.4±13.7 and 33.5±11.4 years, respectively. Symptomatic dry eye was reported in 56% of subjects, with an average age at diagnosis of 23.8±13.3 years. Conclusion: There is a high prevalence of corneal disease in aniridia, with diagnosis in late childhood or early adulthood in nearly one-half of subjects, often requiring corneal surgery. Cataract and dry eye are commonly associated with aniridia. Although aniridia subjects may have been aware of the diagnosis of cataract at an early age, they usually were treated for cataract and keratopathy as adults. Keywords: aniridic keratopathy, ocular surface disease, corneal disease, keratolimbal allograft

Shiple D

2015-02-01

305

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

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

J López-Torres Hidalgo

2004-05-01

306

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

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

Béatrice Cochener

2010-02-01

307

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

Scientific Electronic Library Online (English)

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

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

2011-12-01

308

Review of the neuromonitoring in thyroid surgery  

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Full Text Available Introduction and Objectives: The identification of recurrent laryngeal nerve (RLN during thyroid surgery is considered gold standard to prevent their injury. Electromyographic recordings of the thyroarytenoid muscle activity after electrical stimulation of the vagus or RLN nerves aid during identification of the RLN and reports of their functional status at the end of thyroidectomy. For the record electromyographic two are the most useful techniques: using surface electrodes on the endotracheal tube (ETT and by needle electrodes inserted into the thyroarytenoid muscles across the cricothyroid membrane (transligamentary technique, TL. Objectives: To review the methods of identification of the RLN in thyroid surgery, the main techniques for neuromonitoring, their validity and summarize practical technical details.Conclusions: The neuromonitoring aid in the location, identification and dissection the RLN, aid in decision-making when there is loss of the electromyographic signal and provides information about the function of NLR at the end of surgery. The neuromonitoring has benefits in clinical practice, research, in teaching and in medical-legal.

Pardal-Refoyo JL

2012-04-01

309

Importance of Monitoring Cataract Surgical Outcomes  

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Full Text Available Visual loss from cataract represents an estimated 50% or more of the global burden of blindness. Time tested, safe and effective technologies are available that could restore near normal vision to a large majority of those affected. Despite this, the magnitude of the global burden of blindness from unoperated cataract continues to increase. The fact that nearly 20 million persons are currently blind from cataract is a reflection of the lack of access to surgical services for a majority of these persons, even though the knowledge and skills required for applying the technology exist. For this reason intervention against cataract blindness has received priority attention in Vision 2020: The Right to Sight. In this context, the monitoring of the outcome of cataract services in general, and cataract surgery in particular, has become imperative.

Ramachandra Pararajasegaram

2002-01-01

310

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

Scientific Electronic Library Online (English)

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

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

2010-10-01

311

Caracterización del endotelio corneal en pacientes con indicación de cirugía de catarata / Characterization of the corneal endothelium in patients requiring cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Objetivo: describir la morfología del endotelio corneal en pacientes con indicación de cirugía de catarata. Métodos: se estudiaron 200 ojos de 127 pacientes, 86 mujeres y 41 hombres, con indicación de cirugía de catarata en una investigación de tipo descriptiva y transversal realizada entre octubre [...] y diciembre de 2011. Se examinaron los pacientes en lámpara de hendidura buscando alteraciones de la morfología del endotelio y se les realizó microscopia especular con el Topcon SP3000P. Se analizaron las imágenes y se evaluaron la densidad celular, el coeficiente de variabilidad, la hexagonalidad celular y la paquimetría. Resultados: predominó el sexo femenino con 86 pacientes y en los dos grupos la mayoría tenían entre 60 y 79 años. La densidad celular media fue de 2 238,19 cél/mm2, disminuyó significativamente con la edad y no tuvo diferencias con el sexo. El coeficiente de variabilidad, la hexagonalidad y la paquimetría no tuvieron diferencias significativas con la edad, ni con el sexo. Las guttas corneales predominaron en las féminas (103; 76,9 %) con diferencia significativa entre los sexos. Conclusiones: a mayor edad hay disminución de la densidad celular, así como un aumento del coeficiente de variabilidad sin diferencias entre sexos. Se comprueba la estrecha relación entre la disminución de la densidad celular y el aumento de la paquimetría. Además, se muestran los parámetros de normalidad del endotelio corneal en pacientes con indicación de cirugía de catarata en nuestro medio. Abstract in english Objective: to describe the morphology of corneal endothelium in patients requiring cataract surgery. Methods: adescriptive, cross-sectional study was conducted in 200 eyes from 127 patients distributed into 86 females and 41 males, who required cataract surgery. All the patients were examined with s [...] lit-lamp method to look for corneal guttas and were performed Topcon specular microscopy SP3000P. Images were analyzed and the cell density, the variability coefficient, the cell hexagonality and pachymetry were all evaluated. Results: females predominated with 86 patients in both groups and most aged 60-79 years. The average cell density was 2238.19 cell/mm2 that significantly decreased with the age increase, and it did not show any differences between the sexes. The average variability coefficient, hexagonality and pachymetry did not show significant differences in terms of age and sex. The presence of corneal guttas predominated in females (103; 76.9 %.) but the difference between the sexes was significant. Conclusions: as the age increases, the cell density diminishes but the variability coefficient increases and there are no differences between the sexes. The close relationship between the decreased cell density and the increased pachymetry is proved. Additionally, the study presents the normal parameters of the corneal endothelium in patients requiring cataract surgery in our setting.

Taimi, Cárdenas Díaz; Yeni, Corcho Arévalo; Rosario, Torres Ortega; Armando, Capote Cabrera; Iván, Hernández López; Dunia, Cruz Izquierdo.

2013-04-01

312

Endoftalmitis tras cirugía de cataratas: epidemiología, aspectos clínicos y profilaxis antibiótica / Endophthalmitis after cataract surgery: epidemiology, clinical features and antibiotic prophylaxis  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Estimar la incidencia de endoftalmitis tras cirugía de cataratas, la clínica y el papel de los antibióticos intracamerales. Métodos: Se realizó un estudio descriptivo transversal en pacientes operados de cataratas en un hospital público durante 11 años. Se diseñó una base de datos de infec [...] ciones oculares para analizar los aspectos clínico-quirúrgicos. Las variables cualitativas se describen con su distribución de frecuencias y las cuantitativas con la media y la desviación estándar. Resultados: Desde enero de 1999 hasta diciembre de 2009, 15.173 pacientes se operaron de cataratas. Hubo 43 endoftalmitis postquirúrgicas con una incidencia global de 0,28% (IC 95%: 0,20-0,36%). Había 19 varones y 24 mujeres, con una edad media de 78,5 años. Se evaluaron distintos parámetros clínicos: un 25,58% eran diabéticos, un 44,18% tenían algún grado de inmunosupresión y hubo complicaciones con vitreorragia en el 18,6%. En cuanto a profilaxis antibiótica, se consideraron 2 grupos: el primer grupo no recibió antibiótico intracameral (8.099 pacientes) y el segundo grupo sí recibió cefuroxima (7.074 pacientes). De las 43 endoftalmitis, 39 pertenecieron al primer grupo y 4 al segundo, con lo que la incidencia de infección fue de 0,48% en el primer grupo y 0,056% en el segundo. El riesgo relativo (RR) tras la evaluación después-antes de cefuroxima fue de 0,12 (0,04-0,33) con una p Abstract in english Purpose: To estimate the incidence of endophthalmitis after cataract surgery and to describe the main epidemiological and clinical data, as well as the role of intracameral antibiotics. Methods: A cross-sectional descriptive study was conducted on patients who underwent cataract surgery in a public [...] hospital over an 11-year period. An ocular infection database was used to report endophthalmitis occurrences and to collect the clinical features. Qualitative variables are described with their frequency distribution and qualitative variables, with the mean and the standard deviation. Results: From January 1999 to December 2009, 15.173 patients underwent cataract surgery. A total of 43 patients suffered from postoperative endophthalmitis, giving an overall infection rate of 0.28% (95% CI: 0.20-0.36%). Among the 43 cases, there were 19 men and 24 women with a mean age of 78.5. Other clinical parameters evaluated were as follows: 25.58% were diabetic, 44.18% had some degree of immunosuppression and there were complications with posterior capsular tears in 18.6%. As regards antibiotic prophylaxis, 2 groups were considered: the first one did not receive intracameral antibiotic (8,099 patients) and the second group received intracameral cefuroxime (7,074 patients). There were 39 endophthalmitis in the first group with an infection incidence of 0.48% and 4 endophthalmitis in the second group with an infection incidence of 0.056%. The relative risk (RR) after-before cefuroxime was 0.12 (0.04-0.33) with P

M.C., García-Sáenz; A., Arias-Puente; G., Rodríguez-Caravaca; Y., Andrés Alba; J., Bañuelos Bañuelos.

2010-08-01

313

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

Scientific Electronic Library Online (English)

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

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

2011-10-01

314

Comparison of 5% povidone-iodine solution against 1% povidone-iodine solution in preoperative cataract surgery antisepsis: a prospective randomised double blind study  

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Background/aim: Povidone-iodine (PI, Betadine) is routinely used as a preoperative topical antiseptic in cataract surgery as it has been shown to reduce the incidence of postoperative endophthalmitis. However, the concentration used clinically is variable. In vitro studies have shown that PI is paradoxically more effective at lower concentration. This study was undertaken to determine if this effect was reproducible in vivo. Methods: A prospective randomised double blind study was carried out in the ophthalmic theatre in a district general hospital. 105 patients attending for routine cataract surgery were randomly allocated to have their conjunctival fornices irrigated preoperatively with either PI 1% (group A) or PI 5% (group B). Conjunctival swabs were taken, in identical fashion, both before and 1 minute after irrigation. The number and species of bacterial colonies cultured from each swab was counted. The difference in the median number of bacterial colonies from pre-irrigation to post-irrigation cultures was then compared between the groups. Results: Bacterial cultures were gained from 100 patients (33 male, 67 female, mean age 74 years, range 30–95 years). Group B (5% PI) showed a decrease in median colony forming units (CFU) pre-irrigation from 100 to 40 CFU post-irrigation (a drop of 60%). This was greater than in group A (1% PI) where the reduction was 120 CFU pre-irrigation to 100 CFU post-irrigation (a drop of 16.7%) (Mann-Whitney test, p1000), the difference in median between the two groups became larger as the number of pre-irrigation bacteria increased. In group B pre-irrigation CFU reduced from 3340 to 110 post-irrigation (a drop of 96.7%) compared with group A: 5000 CFU pre-irrigation to 3000 post-irrigation (a drop of 40%) (Mann-Whitney test, p=0.0014). Conclusion: Despite in vitro evidence of higher bactericidal efficacy of PI at more dilute concentrations, 5% PI is more effective than 1% PI in decreasing the human conjunctival bacterial flora in vivo, particularly in the presence of heavier initial bacterial load. PMID:12543744

Ferguson, A W; Scott, J A; McGavigan, J; Elton, R A; McLean, J; Schmidt, U; Kelkar, R; Dhillon, B

2003-01-01

315

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

Scientific Electronic Library Online (English)

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

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

2012-08-01

316

[Lactation after breast plastic surgery: literature review].  

Science.gov (United States)

The occurrence of lactation is a rare complication of breast plastic surgery. During the course of his practice, the plastic surgeon will probably encounter this complication. The goal of this article is to carry out a literature review of all published galactorrhea and/or galactocele cases following a breast-reduction or a breast-augmentation, representing a total of 34 cases reported in 21 articles. The physiopathology of this complication is linked to an inappropriate secretion of prolactin in a surgical context. The factors favoring this complication would be the number of pregnancies, a history of recent and extensive nursing, and the intake of certain medicines such as an oestro-progestative pill. The main symptom of this complication is the occurrence of a uni- or bilateral galactorrhea, on average 12.6 days after the surgery. The main differential diagnosis is a postoperative infection. The explorations presented a hyperprolactinemia in 69% of cases. No biological inflammatory syndrome was reported. A fluid collection evoking a galactocele was visible on the ultrasound in 65% of cases. One case of prolactin-secreting pituitary adenoma was reported. Depending on the case, the treatment varied from a simple surveillance to the association of a dopamine agonist, an antibiotic therapy, and a surgical revision. A diagnostic and therapeutic management strategy is proposed. PMID:25147123

Bouhassira, J; Haddad, K; Burin des Roziers, B; Achouche, J; Cartier, S

2015-02-01

317

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

LENUS (Irish Health Repository)

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

Barry, Peter

2012-02-01

318

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

Science.gov (United States)

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

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

2012-01-01

319

Minimally invasive spine surgery: systematic review.  

Science.gov (United States)

Minimally invasive procedures in spine surgery have undergone significant development in recent times. These procedures have the common aim of avoiding biomechanical complications associated with some traditional destructive methods and improving efficacy. These new techniques prevent damage to crucial posterior stabilizers and preserve the structural integrity and stability of the spine. The wide variety of reported minimally invasive methods for different pathologies necessitates a systematic classification. In the present review, authors first provide a classification system of minimally invasive techniques based on the location of the pathologic lesion to be treated, to help the surgeon in selecting the appropriate procedure. Minimally invasive techniques are then described in detail, including technical features, advantages, complications, and clinical outcomes, based on available literature. PMID:25199809

Banczerowski, Péter; Czigléczki, Gábor; Papp, Zoltán; Veres, Róbert; Rappaport, Harry Zvi; Vajda, János

2015-01-01

320

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

Directory of Open Access Journals (Sweden)

Full Text Available The detachment of Descemet's membrane can be a serious complication following cataract surgery, leading to severe corneal edema and reduced visual acuity. This report describes an unusual case of Descemet's membrane detachment 6 months after successful phacoemulsification, documented by anterior segment optic coherence tomography (OCT; RTVue, Optovue. The eye was treated successfully with pneumatic descemetopexy and transcorneal suturing, with reattachment of Descemet's membrane. This report should alert physicians that delayed corneal edema can be related to late-onset Descemet's membrane detachment, which requires proper treatment to avoid permanent corneal decompensation.O descolamento da membrana de Descemet pode ser uma complicação grave após a cirurgia de catarata, resultando em edema de córnea e redução da acuidade visual. Este relato descreve um caso raro de descolamento da membrana de Descemet seis meses após cirurgia de catarata com facoemulsificação sem intercorrências, documentado com tomografia de coerência óptica do segmento anterior (OCT; RTVue, Optovue. Foram realizadas descemetopexia pneumática e sutura corneana, com resolução do descolamento e recuperação visual. Este relato procura alertar os médicos que o edema de córnea tardio pode estar relacionado ao descolamento tardio da membrana de Descemet, que exige tratamento adequado para evitar descompensação corneana permanente.

Aileen Walsh

2012-10-01

321

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O descolamento da membrana de Descemet pode ser uma complicação grave após a cirurgia de catarata, resultando em edema de córnea e redução da acuidade visual. Este relato descreve um caso raro de descolamento da membrana de Descemet seis meses após cirurgia de catarata com facoemulsificação sem inte [...] rcorrências, documentado com tomografia de coerência óptica do segmento anterior (OCT; RTVue, Optovue). Foram realizadas descemetopexia pneumática e sutura corneana, com resolução do descolamento e recuperação visual. Este relato procura alertar os médicos que o edema de córnea tardio pode estar relacionado ao descolamento tardio da membrana de Descemet, que exige tratamento adequado para evitar descompensação corneana permanente. Abstract in english The detachment of Descemet's membrane can be a serious complication following cataract surgery, leading to severe corneal edema and reduced visual acuity. This report describes an unusual case of Descemet's membrane detachment 6 months after successful phacoemulsification, documented by anterior seg [...] ment optic coherence tomography (OCT; RTVue, Optovue). The eye was treated successfully with pneumatic descemetopexy and transcorneal suturing, with reattachment of Descemet's membrane. This report should alert physicians that delayed corneal edema can be related to late-onset Descemet's membrane detachment, which requires proper treatment to avoid permanent corneal decompensation.

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

2012-10-01

322

Simultaneous trabeculectomy and cataract extraction.  

OpenAIRE

A combined trabeculectomy and cataract extraction was performed on 46 eyes of 39 patients. The average follow-up period was of 27 months. The intraocular pressure remained controlled without the need of postoperative medication in 33 eyes (71.74%); 12 eyes (26.09%) needed further medical treatment; and in one eye the pressure remained uncontrolled and further surgery was necessary. After surgery the visual acuity improved considerably and the complications were few. The combined procedure has...

Ahmad Manzoor; Ahmad Gauhar; Dar Ghulam

1982-01-01

323

Influencia de la aberración esférica en la función visual tras cirugía de catarata: ensayo prospectivo aleatorio / Spherical aberration influence in visual function after cataract surgery: prospective randomized trial  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Propósito: Comparar los resultados obtenidos tras la implantación de una lente con óptica prolata modificada (Tecnis Z9000) con los de una lente plegable acrílica convencional (Acrysof SA60 AT) en cuanto a agudeza visual y sensibilidad al contraste. Métodos: En este estudio prospectivo 64 pacientes [...] fueron aleatorizados para recibir en sus dos ojos el mismo tipo de lente intraocular: 32 Tecnis Z9000 y 32 Acrysof SA60AT. La agudeza visual y sensibilidad al contraste se evaluó monocular y binocularmente en todos ellos antes de la cirugía y a los tres meses de evolución. Resultados: La agudeza visual monocular fue mejor en el grupo Tecnis (0,85) que en el Acrysof (0,78) (p Abstract in english Purpose: We compare the contrast sensitivity and visual acuity obtained with an anterior surface modified prolate intraocular lens (Tecnis Z9000) with the contrast sensitivity and visual acuity obtained with a standard acrylic foldable intraocular lens (Acrysof SA60 AT). Methods: In this prospective [...] trial, 64 patients presenting for cataract surgery were randomized to receive in both eyes either the Tecnis Z9000 intraocular lens or the the Acrysof SA60AT intraocular lens: 32 Tecnis Z9000 and 32 Acrysof SA60AT. Visual acuity and contrast sensitivity were monocular and binocularly tested in all of them preoperatively and three months after surgery. Results: The Tecnis Z9000 intraocular lens provided statistically significantly better monocular (Tecnis group: 0.85; Acrysof group: 0.78; p

A, Martínez Palmer; B, Palacín Miranda; M, Castilla Céspedes; M, Comas Serrano; A, Puntí Badosa.

2005-02-01

324

Comparative study of serum Na+ and K+ levels in senile cataract patients and normal individuals  

OpenAIRE

Many factors such as aging, changes in blood electrolytes levels, and possibly family history are involved in senile cataract formation. Changes in serum electrolytes levels can induce changes in aqueous electrolytes levels and effect on lens metabolism and probably cataract formation. In this paper, we study serum level of Na+ and K+ in senile cataract patients and normal individuals. Methods and materials: 155 senile cataract patients scheduled for cataract surgery in eye clinic of Rasoul h...

Mirsamadi, Mansour; Nourmohammadi, Issa; Imamian, Manuchehr

2004-01-01

325

Pregnancy after Bariatric Surgery: A Review  

OpenAIRE

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

Eugene Oteng-Ntim; Hezelgrave, N. L.

2011-01-01

326

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

Scientific Electronic Library Online (English)

Full Text Available OBJETIVO: Avaliar a flora bacteriana conjuntival e seu padrão de resistência a antibióticos em olhos de pacientes a serem submetidos a cirurgias de catarata. MÉTODOS: Foram avaliados, prospectivamente, os olhos de 50 pacientes a serem submetidos a facectomias na Fundação Altino Ventura, Recife (PE), [...] durante o período de agosto a outubro de 2004. Foi coletado material para cultura da conjuntiva no dia da cirurgia, antes da aplicação de anestésicos, antibióticos ou iodo povidona tópicos. A partir do material coletado foram realizados bacterioscopias e semeio. Em caso de crescimento bacteriano, foram realizadas culturas para isolamento e identificação das bactérias e preparação de antibiogramas. RESULTADOS: Entre os 50 olhos estudados, sete (14,0%) apresentaram culturas negativas e 43 (86,0%) culturas positivas. A bactéria mais freqüentemente isolada foi o Staphylococcus coagulase-negativo, encontrada em 27 olhos (54,0%). Entre os isolados desta bactéria, mais de 90% foram sensíveis a cefalotina, vancomicina, cloranfenicol, ofloxacino e gatifloxacino; 70 a 90% destes microrganismos foram sensíveis a gentamicina, cefotaxima, oxacilina e ciprofloxacino; menos que 70% deles foram sensíveis à neomicina. Encontrou-se quatro (10,5%) isolados de bactérias resistentes a quatro ou mais antibióticos, sendo que dois deles foram de Staphylococcus coagulase-negativo (7,4% dos isolados desta bactéria). CONCLUSÃO: A bactéria mais freqüentemente encontrada na conjuntiva foi o Staphylococcus coagulase-negativo, sendo que estes isolados mostraram alta resistência aos aminoglicosídeos, principalmente à neomicina, com alta suscetibilidade à cefalotina, vancomicina, cloranfenicol, ofloxacino e gatifloxacino. Abstract in english PURPOSE: To evaluate the conjunctival bacterial flora and its antibiotic resistance pattern in eyes of patients undergoing cataract surgery. METHODS: From August to October 2004, 50 patients undergoing cataract surgery in the "Fundação Altino Ventura", Recife, Brazil, were prospectively evaluated. C [...] onjunctival material was obtained on the day of surgery, before the application of topical anesthetic, antibiotic or povidone-iodine. The collected material was inoculated and bacterioscopic analysis was carried out. In the cases where there was bacterial growth, antibiotic susceptibility tests and cultures, for isolation and identification of the bacteria, were performed. RESULTS: Of the 50 eyes, 43 (86.0%) had positive cultures. The coagulase-negative Staphylococcus (CNS), found in 27 (54.0%) eyes, was the most frequent organism. More than 90% of the isolates of this bacterium were susceptible to cephalotin, vancomycin, chloramphenicol, ofloxacin and gatifloxacin; 70 to 90% were susceptible to gentamicin, cefotaxime, oxacillin and ciprofloxacin; and less than 70% were sensible to neomycin. Four (10.5%) of the bacterial isolates were resistant to four or more antibiotics, two of them were CNS. CONCLUSION: The most frequent bacterium in the conjunctival flora is the coagulase-negative Staphylococcus. The isolates of this organism showed low susceptibility rate to neomycin, and high susceptibility rates to cephalotin, vancomycin, chloramphenicol, ofloxacin and gatifloxacin.

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

2006-02-01

327

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

Scientific Electronic Library Online (English)

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

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

2012-06-01

328

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

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

M.C. Morales

2012-11-01

329

Complications of Bariatric Surgery: Presentation and Emergency Management – a Review  

OpenAIRE

The prevalence of obesity surgery is increasing rapidly in the UK as demand rises. Consequently, general surgeons on-call may be faced with the complications of such surgery and need to have an understanding about how to manage them, at least initially. Obesity surgery is mainly offered in tertiary centres but patients may present with problems to their local district hospital. This review summarises the main complications that may be encountered.

Monkhouse, Sjw; Morgan, Jdt; Norton, Sa

2009-01-01

330

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar a variação do astigmatismo entre o pré-operatório, 1º mês e 12º mês pós-operatórios dos pacientes submetidos à cirurgia de catarata, com realização de incisões relaxantes limbares para redução do astigmatismo pré-operatório. MÉTODOS: Foram avaliados 16 pacientes submetidos a cirurg [...] ia de catarata pela técnica de facoemulsificação através de incisão escleral tunelizada de 5,5 mm, na Fundação Altino Ventura, no período entre abril e julho de 2002, na qual foram realizados incisões relaxantes no limbo (IRL), seguindo o nomograma modificado de Gills (1D - 1 IRL de 6 mm; 1-2D - 2 IRL de 6 mm; 2-3D - 2 IRL de 8 mm), nos meridianos corneanos mais curvos determinados por topografia corneana pré-operatória. RESULTADOS: Ocorreu redução significante do astigmatismo pré-operatório no 1º mês pós-operatório, no grupo de 2 incisões relaxantes no limbo de 6 mm (57% do astigmatismo topográfico e 87% do refracional) e o de 2 incisões relaxantes no limbo de 8 mm (50% do astigmatismo topográfico e 65% do refracional), mantendo-se sem alteração significante este astigmatismo até o 12º mês pós-operatório. O grupo de 1 incisão relaxante no limbo de 6 mm não alcançou redução significante do astigmatismo, no entanto, não houve alteração significante até o 12º mês pós-operatório. Não foram observadas, ainda, complicações pós-operatórias como "glare", aniseiconia, diplopia, desconforto, infecção da ferida e afinamento ou ectasia corneana. CONCLUSÃO: A realização de 2 incisões relaxantes no limbo de 8 e 6 mm, para correção de astigmatismo pré-operatório de 2 a 3 e 1 a 2 dioptrias, respectivamente, mostraram-se eficazes, seguras e com efeito estável ao longo do primeiro ano de acompanhamento pós-operatório. A realização de 1 incisão relaxante no limbo de 6 mm para redução de 1 dioptria de astigmatismo pré-operatório não se mostrou eficaz, no entanto, não levou a complicações pós-operatórias significativas. Abstract in english PURPOSE: To evaluate astigmatism variation between preoperative, 1st and 12th postoperative month of patients who underwent cataract surgery with limbal relaxing incisions (LRI) aiming to reduce the preoperative astigmatism. METHODS: Sixteen patients who underwent cataract surgery by the phacoemulsi [...] fication technique with a 5.5 mm escleral incision, at the Altino Ventura Foudation, between April and July of 2002. The limbal relaxing incisions were performed according to Gills' modified nomogram (1D - 1 LRI of 6 mm; 1-2D - 2 LRI of 6 mm; 2-3D - 2 LRI of 8 mm). They were done in the most curved meridians, determined by preoperative corneal topography. RESULTS: Significant reduction in preoperative astigmatism was observed in the 1st postoperative month in 2 limbal relaxing incisions of the 6 mm group (57% topographic astigmatism and 87% refractional) and in 2 limbal relaxing incisions of the 8 mm group (50% topographic astigmatism and 65% refractional), maintaining the reduction with no significant alteration until the 12th postoperative month. The 1 limbal relaxing incision of the 6 mm group did not yield significant astigmatism reduction, but there was no significant alteration until de 12th postoperative month. There were also no complications such as postoperative discomfort, glare, aniseiconia, diplopia, incision infection and corneal thinning or ectasia. CONCLUSION: Two limbal relaxing incisions of 8 and 6 mm aiming to correct preoperative astigmatism of 2 to 3D and 1 to 2D, respectively, were safe and effective with a stable effect in the first postoperative follow-up year. The 1 limbal relaxing incision of 6 mm aiming to reduce 1 diopter of preoperative astigmatism was not effective, but it did not induce any significant postoperative complications.

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

2006-06-01

331

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

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Full Text Available OBJETIVO: Avaliar a variação do astigmatismo entre o pré-operatório, 1º mês e 12º mês pós-operatórios dos pacientes submetidos à cirurgia de catarata, com realização de incisões relaxantes limbares para redução do astigmatismo pré-operatório. MÉTODOS: Foram avaliados 16 pacientes submetidos a cirurgia de catarata pela técnica de facoemulsificação através de incisão escleral tunelizada de 5,5 mm, na Fundação Altino Ventura, no período entre abril e julho de 2002, na qual foram realizados incisões relaxantes no limbo (IRL, seguindo o nomograma modificado de Gills (1D - 1 IRL de 6 mm; 1-2D - 2 IRL de 6 mm; 2-3D - 2 IRL de 8 mm, nos meridianos corneanos mais curvos determinados por topografia corneana pré-operatória. RESULTADOS: Ocorreu redução significante do astigmatismo pré-operatório no 1º mês pós-operatório, no grupo de 2 incisões relaxantes no limbo de 6 mm (57% do astigmatismo topográfico e 87% do refracional e o de 2 incisões relaxantes no limbo de 8 mm (50% do astigmatismo topográfico e 65% do refracional, mantendo-se sem alteração significante este astigmatismo até o 12º mês pós-operatório. O grupo de 1 incisão relaxante no limbo de 6 mm não alcançou redução significante do astigmatismo, no entanto, não houve alteração significante até o 12º mês pós-operatório. Não foram observadas, ainda, complicações pós-operatórias como "glare", aniseiconia, diplopia, desconforto, infecção da ferida e afinamento ou ectasia corneana. CONCLUSÃO: A realização de 2 incisões relaxantes no limbo de 8 e 6 mm, para correção de astigmatismo pré-operatório de 2 a 3 e 1 a 2 dioptrias, respectivamente, mostraram-se eficazes, seguras e com efeito estável ao longo do primeiro ano de acompanhamento pós-operatório. A realização de 1 incisão relaxante no limbo de 6 mm para redução de 1 dioptria de astigmatismo pré-operatório não se mostrou eficaz, no entanto, não levou a complicações pós-operatórias significativas.PURPOSE: To evaluate astigmatism variation between preoperative, 1st and 12th postoperative month of patients who underwent cataract surgery with limbal relaxing incisions (LRI aiming to reduce the preoperative astigmatism. METHODS: Sixteen patients who underwent cataract surgery by the phacoemulsification technique with a 5.5 mm escleral incision, at the Altino Ventura Foudation, between April and July of 2002. The limbal relaxing incisions were performed according to Gills' modified nomogram (1D - 1 LRI of 6 mm; 1-2D - 2 LRI of 6 mm; 2-3D - 2 LRI of 8 mm. They were done in the most curved meridians, determined by preoperative corneal topography. RESULTS: Significant reduction in preoperative astigmatism was observed in the 1st postoperative month in 2 limbal relaxing incisions of the 6 mm group (57% topographic astigmatism and 87% refractional and in 2 limbal relaxing incisions of the 8 mm group (50% topographic astigmatism and 65% refractional, maintaining the reduction with no significant alteration until the 12th postoperative month. The 1 limbal relaxing incision of the 6 mm group did not yield significant astigmatism reduction, but there was no significant alteration until de 12th postoperative month. There were also no complications such as postoperative discomfort, glare, aniseiconia, diplopia, incision infection and corneal thinning or ectasia. CONCLUSION: Two limbal relaxing incisions of 8 and 6 mm aiming to correct preoperative astigmatism of 2 to 3D and 1 to 2D, respectively, were safe and effective with a stable effect in the first postoperative follow-up year. The 1 limbal relaxing incision of 6 mm aiming to reduce 1 diopter of preoperative astigmatism was not effective, but it did not induce any significant postoperative complications.

João Carlos Arraes

2006-06-01

332

New technique to demonstrate corneal magnification using trypan blue in cataract surgery Nova técnica para demonstrar a magnificação corneana utilizando azul de tripan na cirurgia de catarata  

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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.OBJETIVO: Demonstrar a magnificação corneana utilizando o azul de tripan na cirurgia de catarata. MÉTODOS: Oito olhos de oito pacientes submetidos à facoemulsificação com implante de lente intraocular foram envolvidos neste estudo. Após corar a cápsula anterior do cristalino com azul de tripan 0,1% e realizar a capsulotomia circular contínua, a cápsula excisada foi colocada sobre a superfície corneana. Após observar e aferir a relação entre a borda da cápsula anterior excisada e a abertura da cápsula intracameral, o efeito da magnificação corneana foi claramente demonstrada e calculada através do método linear. RESULTADOS: A média estimada da magnificação corneana foi de 20,88% com uma média de magnificação de área de 47,53%. CONCLUSÃO: A capsulorrexis corada pelo azul de tripan é útil na demonstração da magnificação corneana, auxiliando assim na correta confecção do seu tamanho.

Frederico F. Marques

2011-08-01

333

New technique to demonstrate corneal magnification using trypan blue in cataract surgery / Nova técnica para demonstrar a magnificação corneana utilizando azul de tripan na cirurgia de catarata  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Demonstrar a magnificação corneana utilizando o azul de tripan na cirurgia de catarata. MÉTODOS: Oito olhos de oito pacientes submetidos à facoemulsificação com implante de lente intraocular foram envolvidos neste estudo. Após corar a cápsula anterior do cristalino com azul de tripan 0,1% [...] e realizar a capsulotomia circular contínua, a cápsula excisada foi colocada sobre a superfície corneana. Após observar e aferir a relação entre a borda da cápsula anterior excisada e a abertura da cápsula intracameral, o efeito da magnificação corneana foi claramente demonstrada e calculada através do método linear. RESULTADOS: A média estimada da magnificação corneana foi de 20,88% com uma média de magnificação de área de 47,53%. CONCLUSÃO: A capsulorrexis corada pelo azul de tripan é útil na demonstração da magnificação corneana, auxiliando assim na correta confecção do seu tamanho. Abstract in english 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 th [...] e 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.

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

2011-08-01

334

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar prospectivamente com o uso da tomografia de coerência óptica se o uso tópico de latanoprosta induz alterações retinianas em pacientes submetidos à cirurgia de catarata. MÉTODOS: Estudo clínico randomizado, com observador mascarado e um mês de duração. Pacientes pseudofácicos foram [...] tratados com latanoprosta (n=10) ou lubrificante ocular uma vez ao dia (grupo controle - placebo) (n=10). Metade dos pacientes de cada grupo possuía capsulotomia posterior (Nd:YAG laser). Avaliamos o status da barreira hemato-retiniana pela medida da espessura retiniana na fóvea com a tomografia de coerência óptica. Exames de tomografia de coerência óptica e medida da acuidade visual foram realizados antes do início do estudo e com 15 e 30 dias de tratamento. RESULTADOS: Não foi observada alteração significante na média da espessura foveal do grupo controle (p>0,0610). Houve aumento significante na média da espessura foveal nos pacientes tratados com latanoprosta (p Abstract in english PURPOSE: To study prospectively using optical coherence tomography whether topical latanoprost induces retinal disorders in patients that underwent cataract surgery. METHODS: Randomized, masked-observer, one-month clinical trial. Pseudophakic patients were treated with latanoprost (n=10) or lubrican [...] t drop q.d. (control group) (n=10). Half of the patients of each group presented ruptured posterior capsule (Nd:YAG laser). We evaluated the blood-retinal barrier status assessed by optical coherence tomography measurement of retinal thickness in the fovea. Before the beginning of the study and after 15 and 30 days of treatment, optical coherence tomography images were taken, and the visual acuity examination was performed. RESULTS: There was no statistically significant increase in mean foveal thickness when patients instilled placebo (P>0.0610). A statistically significant increase in retinal thickness in the fovea was observed when patients instilled latanoprost (P

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

2008-10-01

335

Análisis retrospectivo del bloqueo peribulbar en la cirugía de cataratas / A retrospective analysis of the peribulbar blockade use in cataract surgery  

Scientific Electronic Library Online (English)

Full Text Available Introducción: El bloqueo peribulbar, fue por primera vez descrito por Davis y Mandel en 1986. Se considera seguro y eficaz, por lo que estaría indicado tanto en pacientes ancianos con enfermedades asociadas, como en el paciente ambulatorio Objetivo: Identificar la eficacia y seguridad del bloqueo pe [...] ribulbar para la procedimiento quirúrgico de cataratas. Material y método: Se realizó un estudio retrospectivo que incluyó 470 pacientes que recibieron bloqueo peribulbar para procedimiento quirúrgico de cataratas durante el periodo 1995-2000 en Grey's Hospital, Sudáfrica: Todas las historias clínicas y anestésicas fueron revisadas y la información obtenida analizada cuidadosamente. Resultados: 74.5 % de los pacientes era mayor de 70 años, y 66.8 % padecía de enfermedades crónicas; solo 23.2 % recibió sedación durante la realización del bloqueo. Como parte de la técnica y para la analgesia, se administró alfentanilo. 94.6 % de los pacientes recibió una inyección única y en todos se empleó la combinación de lidocaína y bupivacaina. 97.5 % de los bloqueos fueron exitosos y 16.11 % sufrió algún tipo de complicación. Todas fueron complicaciones menores excepto dos casos de infarto agudo del miocardio (IMA). Conclusiones: El bloqueo peribulbar tiene una alta eficacia, pero aunque menos frecuentes que con el bloqueo retrobulbar, sus complicaciones pueden variar desde triviales hasta devastadoras tanto para la vida como para la visión. Abstract in english Introduction: Peribulbar blockade was first described by Davis and Mandel in 1986. It is a safe and effective procedure and thus is indicated in patients presenting with associated diseases and in ambulatory patient. Objective: To identify the effectiveness and safety of peribulbar blockade for surg [...] ical procedure of cataract. Material and Methods: We made a retrospective study including 470 patients underwent to peribulbar blockade for surgical procedure of cataract during 1995-2000 in Grey's Hospital, South Africa. All medical records and anesthesia were reviewed and the information was carefully analyzed. Results: The 74.5% of patient were older than 70 years old, and the 66.8% presenting with chronic diseases' only the 23.2% had sedation during performing of blockade. As part of technique and for analgesia, we administered Phentanyl. The 94.6% of patients had an only injection, and in all of them we used Lidocaine and Bupivacaine combined. The 97.5% of blockades was successful, and the 16.11% there was some type of complication. All of complications were minor but two cases of myocardial acute infarction. Conclusions: Peribulbar blockade has a high efficacy, but although less frequent than the retrobulbar blockade one; its complications may to vary from trivial to devastating for life and for vision.

Caridad, Velázquez Cardona; Juan A, Depestre Menejias; Juana M, velázquez Cardona.

2009-04-01

336

Principles and paradigms of pediatric cataract management  

OpenAIRE

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

Basti Surendra; Greenwald Mark

1995-01-01

337

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

Scientific Electronic Library Online (English)

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

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

2011-12-01

338

Cytotoxicity of topical medications used for infection and inflammation control after cataract surgery in cultured corneal endothelial cells.  

Science.gov (United States)

Postoperative vision-threatening corneal edema sometimes occurs after eye surgery, and corneal endothelial damage may be caused or exacerbated by drug toxicity. A range of commercially available antibiotic and anti-inflammatory ophthalmic solutions used postoperatively, namely levofloxacin, moxifloxacin, gatifloxacin, cefmenoxime, diclofenac, bromfenac, pranoprofen, betamethasone, and fluoromethorone, were assessed by using human corneal endothelial cells (HCECs). Propylparaoxybenzoate and methylparaoxybenzoate were also examined. Cell survival after 48 h exposure to the drugs was evaluated using the WST assay. Cefmenoxime and betamethasone were the least toxic antibiotic and anti-inflammatory drug, respectively. Cell survival was concentration dependent and increased markedly to ? 80% with dilutions of 100-fold or more. Two preservatives seemed to cause minimal cytotoxicity among those tested. Antibiotic cytotoxicity to HCEC was ranked as cefmenoxime < levofloxacin = gatifloxacin < moxifloxacin, while the toxicity of anti-inflammatory drugs was dependent on benzalkonium chloride and polysorbate. These drugs are unlikely to cause HCEC damage at the concentrations used under the usual conditions. Preservatives are essential ingredients in ophthalmic solutions to control postoperative infection and inflammation and we should be aware of their toxicity as well as efficacy. PMID:20938094

Ayaki, Masahiko; Taguchi, Yoko; Soda, Mitsutaka; Yaguchi, Shigeo; Iwasawa, Atsuo; Koide, Ryohei

2010-09-01

339

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

Directory of Open Access Journals (Sweden)

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

Roberta Ferrari Marback

2010-10-01

340

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

Scientific Electronic Library Online (English)

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

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

2010-10-01

341

Measuring the impact of cataract services in the community  

Directory of Open Access Journals (Sweden)

Full Text Available In many low-income countries, a substantial number of people remain needlessly visually impaired or blind from cataract as a result of not accessing surgical services.1 In this article, we will discuss how Rapid Assessment of Avoidable Blindness (RAAB surveys can play a role in improving cataract services, and the impact that sight-restoring cataract surgery can have on people’s lives.

Sarah Polack

2014-04-01

342

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

Directory of Open Access Journals (Sweden)

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

R. Acosta

2006-09-01