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Femtosecond Laser-Assisted Cataract Surgery: A Current Review  

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To evaluate the safety, efficacy, advantages, and limitations of femtosecond laser-assisted cataract surgery through a review of the literature. A PubMed search was conducted using topic-appropriate keywords to screen and select articles. Initial research has shown appropriate safety and efficacy of femtosecond laser-assisted cataract surgery, with improvements in anterior capsulotomy, phacofragmentation, and corneal incision. Limitations of these studies include small sample size and short-t...

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

2011-01-01

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Cataract Surgery  

Medline Plus

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

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Cataract Surgery  

Science.gov (United States)

... with a clear artificial lens implant (called an intraocular lens or IOL) . Cataract surgery is often performed as ... removed, the surgeon will replace it with an intraocular lens (IOL) implant made of plastic, silicone or acrylic. ...

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Femtosecond-laser assisted cataract surgery: a review.  

Science.gov (United States)

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

Abouzeid, Hana; Ferrini, Walter

2014-11-01

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[Cataract surgery in Togo].  

Science.gov (United States)

Cataract remains a major cause of blindness in sub-Sahara and a major public health problem. Blindness prevalence in Togo is equal to 1%, more than half of it is due to cataract, while the number of cataract surgeries is low because of the lack of resources. We assessed the eye healthcare in Togo by cataract surgery. The aim was to estimate the number of cataract surgeries and the Cataract Surgery Rate (CSR) in the administrative regions. The demographic data (denominator) was collected from the Demography and Health Survey (1998) while the number of cataract surgeries (numerator) was obtained from medical registers. The Cataract Surgery Rate (CSR, operated cataracts per million) was assessed from 1995 to 2001. From 1995 to 2001, 3,885 cataract surgeries were performed. Public services predominated with 53.03% (n=2061) of the cataracts operated followed by confessional hospitals with 37.1% (n=1443) and private clinics 3.4% (n=143). Decentralised eye healthcares provided 241 cataract extractions. The University hospital centre of Lome Tokoin was the leader, with 32.5% (n=1,262) of operated cataracts followed by the confessional hospital of Glei, 27.2% (n=1,058). The average per centre per year was 43 cataract surgeries. The mean CSR was 126 and varied from 52 to 163 cataract surgeries per million people per year. There was an important concentration of cataract services in Lome where 41% (n=1,586) of cataracts were operated and the CSR was 334. The unequal distribution of cataract services (41% in Lome) leaves many regions without any resources. Since 1999, the CSR increased by 37% in 2000 and 14% in 2001. The Togolese eye healthcare system is poor and substantial further efforts are necessary to make it accessible and affordable to all those in need. This may be the way to reduce cataract surgery barriers and the unacceptable high prevalence of operable cataract blindness. PMID:12925316

Mensah, A; Balo, K P; Kondi, G; Banla, M; Koffigue, K B; Resnikoff, S; Astagneau, P; Brücker, G

2003-01-01

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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 ...

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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 ...

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Cataract Surgery  

Medline Plus

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

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

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

Chen, Ming

2013-01-01

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Cataract and glaucoma surgery in pseudoexfoliation syndrome: a review.  

Science.gov (United States)

Pseudoexfoliation syndrome is a risk factor in cataract surgery because of the increased weakness of zonular apparatus and reduced pupillary dilatation. The surgical outcome of using phacoemulsification in the central zone, inducing minimal stress on the zonules, inserting a capsular tension ring in selected cases, and stretching the pupil mechanically in eyes with miotic pupils, may turn out to be uneventful in most cases. Postoperative fibrosis with subsequent shrinkage of the capsule is increased in these eyes, and these centripetal forces will further loosen the zonular fibres. Late in-the-bag intraocular lens dislocation is therefore anticipated to become a growing problem in the future. Despite the dysfunctioning of the blood-aqueous barrier in eyes with pseudoexfoliation syndrome, the frequency of postoperative inflammatory reaction is low due to the improvements made in surgical technique and equipment in recent years. Glaucoma frequently occurs in eyes with pseudoexfoliation syndrome. Compared with primary open-angle glaucoma, optic damage is more pronounced in these eyes at the time of diagnosis and response to medical therapy is poorer. Although responses to argon laser therapy and filtering surgery are roughly similar between the two types of glaucoma, there are indications that primary laser trabeculoplasty has a higher success rate in pseudoexfoliation glaucoma than in primary open-angle glaucoma. PMID:17376188

Drolsum, Liv; Ringvold, Amund; Nicolaissen, Bjørn

2007-12-01

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Viscoless microincision cataract surgery  

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

Guy Sallet

2008-06-01

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

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

Chatziralli Irini P

2012-06-01

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EARLY COMPLICATIONS OF CATARACT SURGERY  

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Full Text Available BACKGROUND: There are different complications of the cataract surgery described in the literature. The impact of these complications on the visual function is in correlation with many factors, some of them being imprecise and unable to be used as prognostic factors before and after the surgery. The modern technique and the surgeon’s experience lowers the complications incidence to a minimum, but even so, some problems cannot be avoided. AIM: The aim of this study is to analyse the early cataract surgery complications for patients operated in 2012 at the Ophthalmology Unit, Railway Hospital, Ia?i. MATERIAL AND METHOD: We conducted a retrospective analysis of the medical records of the patients who underwent cataract surgery in 2012. There were a total of 480 cataract surgeries, the majority of them (92,7% being age related cataracts in different stages of evolution, of which 31.45% being mature cataracts. In 476 eyes, artificial lens was inserted per-primam (474 eyes with posterior chamber intraocular lens and 2 eyes with anterior chamber intraocular lens, in one case the posterior chamber intraocular lens was sutured to the sclera, in 3 cases the eyes remained without lens. RESULTS: The incidence of severe complications or with potential of severe development was: severe corneal oedema 0.83% (4 cases, remaining lens fragments in the vitreous cavity 0.62% (3 cases, toxic anterior segment syndrome (TASS 0.41% (2 cases. There were no endophthalmitis, expulsive haemorhage or retinal detachment after cataract surgery. CONCLUSIONS: The number of early complications of our patients is the same with numbers shown in other studies. With a better surgical technique, a good examination of the patient, a thorough explanation of the procedure to the patient, the use of high quality substances during surgery and proper technology we can lower even more the incidence of the complications.

C. Constantin

2013-06-01

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Secondary glaucoma after pediatric cataract surgery  

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AIM:To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery. METHODS: Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL) implantation (group 1), and 220 eyes of 129 patients underwent cataract surgery with IOL implantation (group 2) retrospectively, were evaluated between 2000 and 2011.The outcome measure was the presence or absence of post-cataract surgery glaucoma, defined as an intraocular ...

Yasin Çinar; Muhammed ?ahin; Harun Yüksel; Fatih Mehmet Türkcü; Abdullah Kür?at Cingü; Ihsan Çaça,; Alparslan ?ahin,; ?eyhmus Ari

2013-01-01

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Patient satisfaction with cataract surgery  

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

Wasfi Ehab I

2008-10-01

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The impact of cataract surgery on AMD development and progression.  

Science.gov (United States)

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

Qian, Cynthia X; Young, Lucy H

2014-01-01

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

Science.gov (United States)

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

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

2014-01-01

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Do patients like day case cataract surgery?  

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One hundred and fifty consecutive questionnaires following day case cataract surgery showed that 87% of the patients would choose day surgery again. The questionnaires were directed at the patients' attitudes to day surgery for their cataracts. There was overwhelming acceptance of the travelling and inconvenience involved.

Davies, B.; Tyers, A. G.

1992-01-01

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

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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...

Bunce Catey; Michaelides Michel; Gw, Adams Gillian

2007-01-01

 
 
 
 
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New technology update: femtosecond laser in cataract surgery  

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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

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Cataracts  

Medline Plus

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

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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

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Cataracts  

Medline Plus

Full Text Available ... Surgery Cataract surgery is a very safe and successful operation. The operation usually lasts less than one ... Complications Cataract surgery is a very safe and successful operation. Risks and complications are, however, possible; knowing ...

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Vitreous surgery for macular hole-related retinal detachment after phacoemulsification cataract extraction: 10-year retrospective review  

Science.gov (United States)

Purpose To evaluate the visual and anatomical results of surgery for macular hole-related retinal detachment (MHRD) after phacoemulsification cataract extraction. Methods Data for all patients who underwent surgery for MHRD after phacoemulsification cataract extraction from 1 December 1998 to 30 September 2008 in one hospital were evaluated. Patient characteristics, best-corrected visual acuity (VA) preoperatively and at last examination, surgical technique, anatomical success, and follow-up period were extracted and analysed statistically. Results A total of 13?625 eyes of 10?076 patients who had phacoemulsification cataract surgery were included. In the follow-up period, 10 cases of MHRD in nine patients were observed, of which seven eyes had high myopia. The mean axial length was 30.97±1.36?mm (29.19, 32.97) and mean myopia was?19.35±1.93 (?7.5,?3.5) dioptres. Overall anatomical success was achieved in 90% (9 out of 10 eyes). There was no statistically significant difference (P=0.240) between the logarithm of the MAR VA before the phacoemulsification cataract extraction and after MHRD surgical repair. VA increased in three eyes but decreased in the other seven after MHRD surgery. Conclusions As a primary procedure, vitreous surgery combined with other necessary adjunct procedures such as membrane peeling and retinal tamponade seems to be successful in achieving anatomical success. However, VA improvement is dependent on the type of macular lesion and not the surgical procedure. PMID:22595907

Zheng, Q; Yang, S; Zhang, Y; Wu, R; Pang, J; Li, W

2012-01-01

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Manual small incision cataract surgery in eyes with white cataracts  

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

Venkatesh Rengaraj

2005-01-01

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Secondary glaucoma after pediatric cataract surgery  

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

Yasin Çinar

2013-04-01

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Role of mannitol in cataract surgery  

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Full Text Available Hypertonic mannitol solution has been found to be most effec-tive in preventing vitreous loss in cataract surgery due to profound hypotony and detergence of vitreous following intravenous in-fusion. Routine use of mannitol is hence recommended prior to cataract surgery, especially in all one-eyed patients or in cases where there is an increased risk of vitreous disturbances.

Shah B

1978-01-01

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Intraocular adrenaline maintains mydriasis during cataract surgery.  

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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

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Intraocular lens employed for cataract surgery  

Science.gov (United States)

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

Roszkowska, A. M.; Torrisi, L.

2014-04-01

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Patient education before cataract surgery  

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The diploma thesis describes in detail the anatomy and physiology of an eye. It provides the description of cataract, the types of cataract as well as the operation procedure as the only treatment for it. The role of the nurse before, during and after the cataract operation is described as well as the education of a patient. The empirical part presents a research performed among the patients of the Eye surgical center of dr. Primož Logar , specialist ophthalmologist in Ljubljana in March and...

Koros?ec, Mirijam

2009-01-01

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Cataracts  

Medline Plus

Full Text Available ... recommend cataract surgery to enhance your vision. The decision to have cataract surgery will be reached by ... to put you to sleep if needed. After making a small incision in the cornea, the doctor ...

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Recent advances in the surgery of silicone oil filling complicated cataract  

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

Ruo-Fang Wang

2014-04-01

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Recent advances in the surgery of silicone oil filling complicated cataract  

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

Ruo-Fang Wang; Wei Gao; Wei Cui

2014-01-01

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MRSA and cataract surgery – reflections for practice  

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Full Text Available LF Porter1, RU Khan2, A Hannan3, SP Kelly11Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Departments of Microbiology, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 3Haughton Thornley Medical Centers, NHS Tameside and Glossop, UKIntroduction: Postoperative bacterial endophthalmitis is a devastating complication of cataract surgery. Methicillin-resistant Staphylococcus aureus (MRSA endophthalmitis is rare. Recent debate over MRSA screening in United Kingdom (UK National Health Service (NHS hospital services has implications for cataract patients and ophthalmology services.Aims: To discuss issues for clinical practice as based on reflective experience at a UK district general NHS hospital in relation to care of MRSA-positive cataract patients.Methods: Retrospective case series and reflective practice.Results: Three cases presented highlight practice points around cataract patients colonized with MRSA. Known or determined MRSA-colonized patients should be treated with anti-microbial agents at time of cataract surgery known to be active against MRSA. Preventative treatment with intracameral vancomycin or intravenous teicoplanin alongside appropriate topical treatments may be of merit. Importantly fluoroquinolones, often prescribed by cataract surgeons, may have a selective effect favoring the proliferation of MRSA.Conclusion: MRSA screening may cause unnecessary delays in cataract care and may represent a patient safety concern in its own right. Patients colonized with MRSA may safely undergo cataract surgery provided there is no evidence of periorbital infection and provided appropriate infection control and antibiotic prophylaxis measures are used. The well-prepared cataract surgeon needs to be aware of developments in infection control and should liaise with local clinical microbiology colleagues in relation to bacterial resistance to antibiotics.Keywords: methicillin-resistant Staphylococcus aureus (MRSA, endophthalmitis, screening

LF Porter

2010-10-01

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Retinal detachment following cataract surgery with capsulorhexis.  

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PURPOSE: To estimate the incidence of retinal detachment after cataract surgery with capsulorhexis. METHODS: A consecutive series of 2,150 cataract operations were followed for incidence of retinal detachment. A series of 1,000 patients from this group were analyzed for high risk factors: myopia, age, sex, operative complications and capsulotomy. RESULTS: With minimum one year follow up in 90% of patients the incidence of retinal detachment was 0.25% (5 cases). CONCLUSION: The true incidence ...

Kelley, J. S.; Doxanas, M. T.

1995-01-01

37

Posterior polar cataract: A review  

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

Kalantan, Hatem

2011-01-01

38

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

39

Investigation of cataract surgery in Leshan, Sichuan Province  

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AIM: To comprehensively investigate the current status of cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future. METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to...

Yu Han; Jing Tang; Hong-Quan Ye

2014-01-01

40

Recent advances in femtosecond laser-assisted cataract surgery  

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Perfect vision and fewer complications is our goal in cataract surgery, femtosecond laser-assisted cataract surgery hold the promise. Applications of femtosecond laser technology for capsulotomy, nuclear fragmentation and corneal incision in cataract surgery bring a new level of accuracy, reproducibility and predictability over the current cataract surgery. The femtosecond laser produces capsulotomies that are more precise, accurate, reproducible, and stronger than those created with the conv...

Zhao-Jie Chu; Dan-Yu Gao

2013-01-01

 
 
 
 
41

Prevention of complications in pediatric cataract surgery  

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

Kugelberg, Maria

2004-01-01

42

Is the first day postoperative review necessary after cataract extraction?  

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BACKGROUND--In current ophthalmic practice day-case surgery cataract patients are conventionally discharged and then reviewed the following morning thus limiting the advantages of what 'true' day-case surgery strives to achieve. The aim of this study was to see if there was a difference in outcome between 'true' day-case cataract surgery and non-day-care surgery. METHODS--A total of 387 consecutive cataract operations were followed, comprising 122 local anaesthetic day-cases, 149 local anaest...

Tufail, A.; Foss, A. J.; Hamilton, A. M.

1995-01-01

43

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

44

Cataracts  

Medline Plus

Full Text Available ... onto the back of the eye. The capsule holds the lens in place. Cornea Iris Lens Vitreous ... the IOL after removing the cataract. The capsule holds the eye lens in place. During cataract surgery, ...

45

Cataracts  

Medline Plus

Full Text Available ... your vision. The decision to have cataract surgery will be reached by you and your doctor together. This reference summary will help you understand what cataracts are and how ...

46

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

47

New technology update: femtosecond laser in cataract surgery  

Science.gov (United States)

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. PMID:24970994

Nagy, Zoltan Z

2014-01-01

48

Endothelial trauma in the surgery of cataract  

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

?urovi? Branislav M.

2004-01-01

49

Intracameral vancomycin following cataract surgery: An eleven-year study  

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

Deepa R Anijeet

2010-04-01

50

Posterior polar cataract: A review.  

Science.gov (United States)

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

Kalantan, Hatem

2012-01-01

51

Recent status on femtosecond laser-assisted cataract surgery  

Directory of Open Access Journals (Sweden)

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

Xiao-Ming Wang

2014-05-01

52

Recent advances in femtosecond laser-assisted cataract surgery  

Directory of Open Access Journals (Sweden)

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

Zhao-Jie Chu

2013-07-01

53

Causes of low vision after small incision cataract surgery  

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

Pei-Pei Zhou

2013-11-01

54

Cataracts  

Medline Plus

Full Text Available ... home after resting for a while in a recovery area. Risks and Complications Cataract surgery is a ... instructions is essential for a good and speedy recovery. It may take six weeks before the eye ...

55

Cataracts  

Medline Plus

Full Text Available ... resting for a while in a recovery area. Risks and Complications Cataract surgery is a very safe and successful operation. Risks and complications are, however, possible; knowing about them ...

56

Recent status on femtosecond laser-assisted cataract surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Xiao-Ming Wang; Guo-Liang Mao; Xiu-Hua Zheng; Guang-Fu Dang

2014-01-01

57

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

58

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

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

Sandoval, Helga P.; Ferna?ndez Castro, Luis E.; Vroman, David T.; Solomon, Kerry D.

2007-01-01

59

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

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Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. Settings and Design: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. Materials and Methods: In this study, 28 eyes of 2...

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

2010-01-01

60

Cataract surgery in a case of carotid cavernous fistula  

Science.gov (United States)

A carotid-cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF. PMID:25370401

Nair, Akshay Gopinathan; Praveen, Smita Vittal; Noronha, Veena Olma

2014-01-01

 
 
 
 
61

Cataract surgery during active methicillin-resistant Staphylococcus aureus infection  

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Ahmad M Mansour,1,2 Haytham I Salti11Department of Ophthalmology, American University of Beirut, 2Rafic Hariri University Hospital, Beirut, LebanonAbstract: We present two patients with active, foul-smelling, methicillin-resistant ­Staphylococcus aureus (MRSA) wounds of the forehead and sternum following craniotomy or open heart surgery. Both had debilitating cataracts and were told by the infectious diseases team that cataract surgery is very risky. Both underwent sequential bilateral ph...

Am, Mansour; Hi, Salti

2014-01-01

62

Reducing older driver motor vehicle collisions via earlier cataract surgery.  

Science.gov (United States)

Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual's complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call "Current Practice" (CP) and "Earlier Surgery" (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost - all MVC costs plus cataract surgery expenditures - is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60-64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences. PMID:23369786

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

2013-12-01

63

Clinical significance of glycosylated hemoglobin determination on diabetic cataract surgery  

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AIM: To evaluate the efficacy and clinical significance ofglycosylated hemoglobin(HbAlc)determination on diabetic cataract surgery.METHODS: Totally 105 patients with diabetes(120 monocular)undergone phacoemulsification in our hospital from March 2012 to March 2013 were enrolled into the observation group(glycosylated hemoglobin determination group, HbA1c <6.5%). One hundred and eleven patients received diabetic cataract phacoemulsification surgery(126 monocular)in our hospital from January...

Hong-Fen Zhu; Jin Zhang

2013-01-01

64

Evaluation of povidone-iodine applications in cataract surgery  

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As a routine measure to prevent intraocular inflammation, rinsing conjunctival sac with povidone-iodine(PVP-I)has 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 off...

Xi Zhang; Ping Wang

2013-01-01

65

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

Directory of Open Access Journals (Sweden)

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

Thevi Thanigasalam

2014-08-01

66

Cataracts  

Medline Plus

Full Text Available ... you in greater length by your anesthesiologist. Other risks are associated with any type of surgery, such as infection. Infection can occur during or after cataract surgery. This may lead to scarring and deteriorating vision. Antibiotics can be used to treat infection. Bleeding and ...

67

Cataract surgery in Knobloch syndrome: a case report  

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

Bongiovanni CS

2011-06-01

68

Antibodies to lens antigens in cataract and after cataract surgery.  

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By means of an enzyme-linked immunosorbent assay (ELISA) antibodies to whole lens homogenate were found in 50.0% of 38 patients with senile cataract and in 57.3% of 75 controls. The antibody titres were in the range of 10-160 in both groups. IgG antibodies occurred in 44.7% of patients and in 45.3% of controls, whereas IgM antibodies were found in 21.1% of the patients and in 40.0% of the controls (not significant). Postoperative uveitis occurred in 5 (31.6%) of 19 patients, who had antibodie...

Nissen, S. H.; Andersen, P.; Andersen, H. M.

1981-01-01

69

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

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

2013-12-01

70

Evolution of cataract surgery: Smaller incision - less complications  

Directory of Open Access Journals (Sweden)

Full Text Available Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS. Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ? 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

Dragani? Vladimir

2012-01-01

71

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

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

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

1992-01-01

72

Cataract surgery combined with implantation of an artificial iris.  

Science.gov (United States)

We describe 6 patients who presented with cataract or aphakia and absent or nonfunctional irides. The etiologies included congenital aniridia, traumatic iris loss, and chronic mydriasis secondary to recurrent herpetic uveitis. In 5 eyes, a prosthetic iris was successfully implanted in combination with small incision cataract surgery. In 2 eyes, a single-piece iris diaphragm and optical lens was implanted. Artificial irides offer a safe alternative for patients who previously had no viable options for iris reconstruction. PMID:10569173

Osher, R H; Burk, S E

1999-11-01

73

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

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

Aasuri Murali

1999-01-01

74

VITREOUS LOSS IN CATARACT SURGERY: GENERAL ANESTHESIA VS LOCAL ANESTHESIA  

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

A.A MORTAZAVI

2000-03-01

75

Sutureless Cataract Surgery: Principles and Steps  

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

John Sandford-Smith

2003-01-01

76

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

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

Reddy RK

2011-06-01

77

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

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

Joshi RS

2013-08-01

78

Cataracts  

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Full Text Available ... their vision is impaired and interferes with daily activities such as reading, driving, and watching TV. Cataract surgery is very safe and successful in restoring vision. Rarely, however, some risks and complications can occur. Learning about them will help you detect them and ...

79

The Effects of Blunt Trauma and Cataract Surgery on Corneal Endothelial Cell Density  

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Purpose: This study was designed to investigate the effects of trauma and cataract surgery on corneal endothelial cell density (ECD) in patients with a traumatic cataract due to blunt trauma without globe laceration. Materials and Methods: In this prospective study, 31 subjects with traumatic cataract (traumatic cataract group) and 30 subjects with a senile cataract (control group) were enrolled. The subjects with traumatic cataract were subdivided into two groups: uncomplicate...

Yeniad Baris; Corum Isik; Ozgun Cahit

2010-01-01

80

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery  

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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...

Bi?, Ak Amp Ccedil Ay; Kt, Bozkurt; Güney E; Ünlü C; Erdogan G; Akcali G; Bayramlar H

2012-01-01

 
 
 
 
81

Comparison of treatments in a cataract surgery with circular response.  

Science.gov (United States)

Circular data are a natural outcome in many biomedical studies, e.g. some measurements in ophthalmologic studies, degrees of rotation of hand or waist, etc. With reference to a real data set on astigmatism induced in two types of cataract surgeries we carry out some two-sample testing problems with the possibility of common or different concentration parameters in the circular set up. Detailed simulation study and the analysis of the data set, including redesigning the cataract surgery data, are carried out. PMID:24463887

Biswas, Atanu; Dutta, Somak; Laha, Arnab Kumar; Bakshi, Partho K

2014-01-23

82

Topical use of indomethacin on the day of cataract surgery.  

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

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

1990-01-01

83

Cataract surgery: ensuring equal access for boys and girls  

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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 g...

Sylvia Shirima; Annie Bronsard

2009-01-01

84

Conjunctival inclusion cysts following small incision cataract surgery  

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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

85

Focussing both eyes on health outcomes: revisiting cataract surgery  

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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

86

Maximal mydriasis evaluation in cataract surgery  

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

Ho Tony

1992-01-01

87

Management of Intraoperative Miosis during Pediatric Cataract Surgery using Healon 5  

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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...

Jhanji Vishal; Sharma Namrata; Vajpayee Rasik

2011-01-01

88

Results of cataract surgery in the very elderly population  

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Full Text Available Katarzyna Michalska-Ma?ecka,1 Mariusz Nowak,2 Piotr Go?ciniewicz,1 Jacek Karpe,3 Ludmi?a S?owi?ska-?o?y?ska,4 Agnieszka ?ypaczewska,1 Dorota Romaniuk11Department of Ophthalmology, University Hospital No 5, Medical University of Silesia, Katowice, 2Pathophysiology Division, Department of Pathophysiology and Endocrinology, Medical University of Silesia, Zabrze, 3Department of Anesthesiology and Intensive Therapy, Medical University of Silesia, Zabrze, 4Department of Biophysics, Faculty of Medicine in Zabrze, Medical University of Silesia, Katowice, Silesia, PolandAim: The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL for patients aged 90 years or older, whom we define as “very elderly.”Methods: The study involved a total number of 122 patients (122 eyes with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old. Phacoemulsification (phaco was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE. Postoperative visual acuity and intraocular pressure (IOP were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery.Results: Best corrected visual acuity (BCVA improved in 100 of 122 eyes (82.0%. BCVA remained the same in 20 of 122 eyes (16.4% and decreased in 2 of 122 eyes (1.6%, mainly because of coexisting age-related macular degeneration (AMD. The BCVA 3 months after surgery was ?0.8 in 23 of 122 eyes (18.9%, between 0.5 and 0.7 in 28 of 122 eyes (22.3%, and between 0.2 and 0.4 in 33 of 122 eyes (27.1%. We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma.Conclusion: Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with IOL for very elderly patients are effective and safe.Keywords: very elderly patients, cataract surgery, postoperative best corrected visual acuity, intraocular pressure

Michalska-Ma?ecka K

2013-08-01

89

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

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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

90

Impact of cataract surgery on health?related quality of life in nursing home residents  

Science.gov (United States)

Aim To assess the impact of cataract surgery in nursing home residents on health?related quality of life, as compared to those who have cataracts but who do not undergo surgery. Methods A prospective cohort study enrolled 30 nursing home residents (?60 years old) who had cataracts and underwent cataract surgery, and evaluated vision?targeted and generic health?related quality of life and depressive symptoms before and approximately 4?months after surgery. This cataract surgery group was compared to 15 nursing home residents who had cataracts but who did not have surgery, over the same timeframe. Results Visual acuity for near and distance and contrast sensitivity improved following cataract surgery (p<0.001). Adjusting for age differences in the two groups, the cataract surgery group exhibited significant score improvement in the general vision (p?=?0.005), reading (p?=?0.001), psychological distress (p?=?0.015), and social interaction (p?=?0.033) subscales of the Nursing Home Vision?targeted Health?Related Quality of Life Questionnaire and the VF?14 (p?=?0.004). There were no group differences in the SF?36, Geriatric Depression Scale or the Cataract Symptom Score. Conclusion Nursing home residents who underwent cataract surgery because of functional problems experienced significant improvements in their vision?targeted health?related quality of life, in addition to dramatically improved vision. PMID:17522143

Owsley, Cynthia; McGwin, Gerald; Scilley, Kay; Meek, G Christine; Seker, Deidre; Dyer, Allison

2007-01-01

91

Postage stamp multiple anterior capsulorhexisotomies in pediatric cataract surgery  

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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 anteri...

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

2005-01-01

92

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

93

Argon laser photocoagulation of cyclodialysis clefts after cataract surgery  

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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.

Bauer, B. [Univ. of Lund, Dept. of Ophthalmology, Lund (Sweden)

1995-06-01

94

Safety and efficacy of intracameral mydriatics in cataract surgery  

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

Lundberg, Bjo?rn

2008-01-01

95

Peritopic anesthesia: a new alternative in cataract surgery  

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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

96

MRSA and cataract surgery – reflections for practice  

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

Lf, Porter; Ru, Khan; Hannan, A.; et al.

2010-01-01

97

Endophthalmitis: controlling infection before and after cataract surgery  

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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 fre...

Nuwan Niyadurupola; Nick Astbury

2008-01-01

98

Accuracy of intraocular lens power calculation in paediatric cataract surgery  

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

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

2001-01-01

99

Full OCT anterior segment biometry: an application in cataract surgery  

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In vivo three-dimensional (3-D) anterior segment biometry before and after cataract surgery was analyzed by using custom highresolution high-speed anterior segment spectral domain Optical Coherence Tomography (OCT). The system was provided with custom algorithms for denoising, segmentation, full distortion correction (fan and optical) and merging of the anterior segment volumes (cornea, iris, and crystalline lens or IOL), to provide fully quantitative data of the anterior segment of the eye. ...

Ortiz, Sergio; Pe?rez Merino, Pablo; Duran, Sonia; Velasco Ocan?a, Miriam; Birkenfeld, J.; Castro, Alberto; Jime?nez-alfaro, Ignacio; Marcos, Susana

2013-01-01

100

Sterile corneal perforation after cataract surgery in Sjögren's syndrome.  

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Painless, sterile, noninfiltrated corneal ulceration and perforation, which may occur after recent cataract surgery in patients with rheumatoid arthritis, and Sjögren's syndrome, appears to be a distinct clinical entity. The cause is probably multifactorial. Contributing factors may be the underlying systemic disease process in rheumatoid arthritis and Sjögren's syndrome, the associated keratoconjunctivitis sicca, the surgical procedure, and the postoperative use of oral and topical cortico...

Cohen, K. L.

1982-01-01

 
 
 
 
101

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

102

Abdominal Pain after Cataract Surgery with Remifentanil Based Anesthesia  

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Full Text Available Remifentanil is an ultra short acting opioid that is suitable for many operations and is wildly used for induction and maintenance of anesthesia. In this article we have reported the incidence of abdominal pain after cataract surgery in patients with remifentanil based anesthesia. This study is a randomized single blind clinical trial on 300 patients who were candidates for elective cataract surgery under general anesthesia. Patients were randomly divided into two groups. In the control group (N=150 after routine monitoring, general anesthesia was induced by fentanyl, propofol and atracurium. Anesthesia was maintained by propofol infusion and 60% N2O inhalation. In remifentanil group, general anesthesia was induced by remifentanil, propofol and atracurium. Anesthesia was maintained by remifentanil infusion and 60% N2O inhalation. Abdominal pain was observed in 79 patients (52.6% of the remifentanil group. Abdominal pain was severe in 10 cases (6.7%, which indicated a therapeutic intervention. Abdominal pain was observed in 3 cases (2% of control group patients. Abdominal pain incidence was significantly higher in remifentanil group (pP=0.0001. Postoperative nausea and vomiting (PNOV was reported in 7 patients (4.7% in remifentanil group and in 10 cases (6.7% of the control group (0.454. Briefly, remifentanil based anesthesia caused high incidence of abdominal pain in cataract surgery patients.

Alireza Bameshki

2009-01-01

103

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

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Abstract Background Despite recommendations for greater use of second-eye cataract surgery and the bilateral progression of the disease, there is a substantial proportion of unmet need for this treatment. Few studies have explored the factors associated with second-eye cataract surgery utilisation. The objective of our study was to estimate the proportion of second-eye cataract surgery, evaluate its time-trend, and explore differences in utilisation by patients' gender, age, ...

Bernal-Delgado Enrique; Cots Francesc; Comas Mercè; Román Rubén; Hoffmeister Lorena; Castells Xavier

2007-01-01

104

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

105

Cost effectiveness of foldable multifocal intraocular lenses compared to foldable monofocal intraocular lenses for cataract surgery  

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Aim: To analyse the cost effectiveness of foldable monofocal intraocular lenses (IOLs) compared to foldable multifocal IOLs in cataract surgery alongside a prospective, multicentre randomised clinical trial (RCT).

Dolders, M. G. T.; Nijkamp, M. D.; Nuijts, R. M. M. A.; Den Borne, B.; Hendrikse, F.; Ament, A.; Groot, W.

2004-01-01

106

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

107

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

108

Preemptive analgesia in elective cataract surgery (Phacoemulcification  

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

H Zahedi

2005-03-01

109

Automated surgical step recognition in normalized cataract surgery videos.  

Science.gov (United States)

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

Charriere, Katia; Quellec, Gwenole; Lamard, Mathieu; Coatrieux, Gouenou; Cochener, Beatrice; Cazuguel, Guy

2014-08-01

110

Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery  

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Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%, had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.

Prajna N

1998-01-01

111

Peritopic anesthesia: a new alternative in cataract surgery  

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

Abreu JA

2013-03-01

112

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

113

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

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OBJECTIVES To compare the effects of fentanyl or remifentanil in combination with midazolam on hemodynamic parameters, pain, and satisfaction profile in cataract surgery. METHODS This randomized, double blind, prospective study was conducted between 10 and 20th July 2005 at Kudret Eye Hospital, Ankara, Turkey. Patients scheduled for cataract surgery by the phacoemulsification technique were randomly enrolled to receive sedation with mid...

Cok, Oya Y.; Aylin Ertan; Mehmet Bahadir

2008-01-01

114

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

115

Analysis of functional Magnetic Resonance Imaging : Activation Changes Related to Cataract Surgery  

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This project is concerned with the analysis of functional Magnetic Resonance Imaging (fMRI) in the brain of elderly subjects affected by cataract. The objective is to examine the changes in visual cortex activity after monocular cataract surgery. The subjects are scanned three times; before surgery, 2 days after surgery and again 6-8 weeks after surgery, which makes it possible to evaluate the changes in visual input and the functional activity as measured by Blood Oxygen Le...

Baruel Johansen, Louise; Linde Reislev, Nina

2010-01-01

116

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)

117

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

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

Gunvant P

2011-09-01

118

Using corneal topography design personalized cataract surgery programs  

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

Jin-Ou Huang

2014-08-01

119

Recognising ‘high-risk’ eyes before cataract surgery  

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

Parikshit Gogate

2008-03-01

120

Clinical significance of glycosylated hemoglobin determination on diabetic cataract surgery  

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

Hong-Fen Zhu

2013-08-01

 
 
 
 
121

Cataracts  

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Full Text Available ... are and how they can be treated surgically. Anatomy Our eyes are very sophisticated optical organs that ... patients to have cataracts. A personal or family history of cataracts can also increase the chances of ...

122

Cataracts  

Medline Plus

Full Text Available ... birth or after an eye injury. Diabetes and smoking can also predispose patients to have cataracts. A personal or family history of cataracts can also increase the chances of ...

123

Cataracts  

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

124

Functional Improvement After One- and Two-Eyed Cataract Surgery in the Salisbury Eye Evaluation  

Science.gov (United States)

Purpose To determine the impact cataract and cataract surgery have on clinical measurements of vision, reading speed, objective mobility performance, and subjective visual functioning. Design Prospective, population-based study Participants 1,739 Salisbury Eye Evaluation (SEE) participants without previous cataract surgery with bilateral baseline best corrected visual acuity (BCVA) of logarithm of the Minimum Angle of Resolution (logMAR) ? 0.3 (20/40 or better) or cataract surgery between round 1 and 2. Methods Participants were categorized based on cataract surgery by round 2 into: no surgery, unilateral surgery, or bilateral surgery. Visual performance, mobility-based tasks, and the Activities of Daily Vision Scale (ADVS) were measured at baseline and two years. Mobility score was converted into a z-score, by subtracting the participant’s time from the population baseline average then dividing by the standard deviation. Comparisons were made between the no surgery and surgery groups using multivariate linear regression. Main Outcome Measures Change in bilateral best corrected visual acuity in logMAR, contrast sensitivity, reading speed in words per minute (wpm), mobility score, and ADVS. Results During the study period, 29 participants had cataract surgery on both eyes, 90 had unilateral surgery, and 1,620 had none. After adjusting for baseline value, demographics, depression and mental status, the unilateral surgery group BCVA improved 0.04 logMAR (p=0.001) and the bilateral group improved 0.13 compared to no surgery (p<0.001). Overall mobility declined in all groups. The unilateral group z-score declined 0.18 more than the no surgery group (p=0.02), while the bilateral group showed a 0.18 z-score improvement compared to no surgery (p=0.19). Change in reading speed significantly improved in the unilateral and bilateral groups compared to no surgery (12 and 31 words per minute, respectively). The bilateral surgery group showed significant positive change in ADVS compared to no surgery (5 points relative improvement, p = 0.01), while the unilateral group showed a 5-point relative decline (p<0.001). Conclusions Cataract negatively affects both subjective quality of life and objective performance measures. Unilateral cataract surgery improves visual functioning, but the largest gains are found in patients who undergo second-eye cataract surgery. This finding supports second-eye cataract surgery for patients with visual or functional complaints even after successful first-eye surgery. PMID:23357620

Lee, Bryan S.; Munoz, Beatriz E.; West, Sheila K.; Gower, Emily W.

2012-01-01

125

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

126

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

Scientific Electronic Library Online (English)

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

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

2013-12-01

127

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

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Full Text Available Introduction: With the growing and rapid development of refractive surgery, researches focus increasingly on improvement of visual quality after cataract surgery. Intraocular lenses (IOLs were a successful effort in the field of cataract surgery. Despite significant advances in cataract surgery, several complications related to surgical technique and IOL design after surgery can cause vision changes and reduce accuracy. Improvements in IOL design and surgical technique have a significant impact on the rate and extent of Tilt and Decentration effects. Because of small movement in modern intraocular lenses (aspheric, its performance can be significantly reduced, therefore aberration correction in the eye with an artificial lens requires to be more careful on IOL centration and location. Methods: In this paper, the characteristics of intraocular lenses and devices used in the measurement and design of this lens are also taken into consideration. In addition, factors affecting the optical and visual acuity in cataract surgery such as Tilt and Decentration are presented. Additionally, materials in regard to computer simulation of optical models of the eye in research as well as optical computations in clinical situations are provided. Conclusion: Finally, the findings revealed that obtaining optimal vision in cataract surgery requires precise measurement and computational techniques as well as an awareness of aberrations that may be created during or after surgery. Moreover, further research and improvement in the process of measurement and calculation will enhance the visual acuity in cataract surgery.

A Asgari

2013-10-01

128

Postoperative conjunctival chemosis in cataract surgery caused by subconjunctival gentamicin injection.  

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A prospective study of 75 patients undergoing cataract surgery was conducted to identify the cause of postoperative conjunctival chemosis seen in patients with cataracts in this department. The patients were split in three groups of 25 each. Group G patients were given a subconjunctival injection of gentamicin at the end of the cataract procedure; group W patients did not receive subconjunctival gentamicin, but a cellulose wick drain was used during the procedure; and Group GW patients receiv...

Pande, M.

1991-01-01

129

Full OCT anterior segment biometry: an application in cataract surgery.  

Science.gov (United States)

In vivo three-dimensional (3-D) anterior segment biometry before and after cataract surgery was analyzed by using custom high-resolution high-speed anterior segment spectral domain Optical Coherence Tomography (OCT). The system was provided with custom algorithms for denoising, segmentation, full distortion correction (fan and optical) and merging of the anterior segment volumes (cornea, iris, and crystalline lens or IOL), to provide fully quantitative data of the anterior segment of the eye. The method was tested on an in vitro artificial eye with known surfaces geometry at different orientations and demonstrated on an aging cataract patient in vivo. Biometric parameters CCT, ACD/ILP, CLT/ILT Tilt and decentration are retrieved with a very high degree of accuracy. IOL was placed 400 ?m behind the natural crystalline lens, The IOL was aligned with a similar orientation of the natural lens (2.47 deg superiorly), but slightly lower amounts (0.77 deg superiorly). The IOL was decentered superiorly (0.39 mm) and nasally (0.26 mm). PMID:23503926

Ortiz, Sergio; Pérez-Merino, Pablo; Durán, Sonia; Velasco-Ocana, Miriam; Birkenfeld, Judith; de Castro, Alberto; Jiménez-Alfaro, Ignacio; Marcos, Susana

2013-03-01

130

Postage stamp multiple anterior capsulorhexisotomies in pediatric cataract surgery  

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

Sharma Namrata

2005-03-01

131

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

Directory of Open Access Journals (Sweden)

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

132

Cataracts  

Science.gov (United States)

... Eye) Astigmatism Bacterial Keratitis Bell's Palsy Blepharitis Cataracts Contact Lens-Related Infections Detached & Torn Retina Diabetic Retinopathy Dry Eye Floaters & Flashes Glaucoma Hyperopia (Farsightedness) Low Vision ...

133

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

134

Measuring the effectiveness of cataract surgery: the reliability and validity of a visual function outcomes instrument  

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AIMS—To assess test-retest reliability and validity of the "TyPE" patient self assessed visual function questionnaire, as part of a study in two hospitals measuring the effectiveness of cataract surgery. The American TyPE questionnaire had minor adaptations made for use in Britain.?METHODS—Test-retest reliability was assessed on 63 out of 378 adult cataract surgery patients in the study, using Spearman correlation coefficients and kappa coefficients of agreement. "Construct" validity ...

Lawrence, D.; Brogan, C.; Benjamin, L.; Pickard, D.; Stewart-brown, S.

1999-01-01

135

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

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Moataz F Elsawy, Nermine Badawi, Hany A KhairyOphthalmology Department, Menoufia University Hospital, Menoufia, EgyptObjective: To evaluate the prophylactic role of topical non-steroidal anti-inflammatory drugs in reducing the incidence of central macular edema (CME) in diabetic eyes post-cataract surgery.Patients and methods: This study included 86 eyes (70 patients) with high risk characteristics for the development of CME after cataract surgery. All patients underwent phacoemulsification a...

Mf, Elsawy; Badawi N; Ha, Khairy

2013-01-01

136

Causes of cataract surgery malpractice claims in England 1995-2008  

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Abstract Aims: To analyse the causes of malpractice claims related specifically to cataract surgery in the National Health Service in England from 1995-2008. Methods: All the malpractice claims related to cataract surgery from 1995-2008 from the National Health Service Litigation Authority were analysed. Claims were classified according to causative problem. Total numbers of claims, total value of damages, mean level damages and paid:closed ratio (a measure of the likelihood of...

Ali, Nadeem; Little, Brian C.

2010-01-01

137

Randomised single blind trial to compare the toxicity of subconjunctival gentamicin and cefuroxime in cataract surgery.  

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Comparatively little attention has been paid to the conjunctival toxicity of antibiotics administered at the time of cataract surgery. We have observed the effect of subconjunctival gentamicin and cefuroxime injection, using colour photography in a randomised single blind trial of 121 patients undergoing routine cataract surgery. Our results suggest that a hyperaemic eye is likely to occur about twice as often in patients injected with gentamicin (p less than 0.001). Gentamicin is associated ...

Jenkins, C. D.; Mcdonnell, P. J.; Spalton, D. J.

1990-01-01

138

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

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Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid ...

Mh, Tarighat Monfared; Moezi H; Rajavi Zh

2001-01-01

139

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

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Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid ...

Mh, Tarighat Monfared; Moezi H; Rajavi Zh

2000-01-01

140

Minimizing Surgically Induced Astigmatism at the Time of Cataract Surgery Using a Square Posterior Limbal Incision  

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Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery. Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2?mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size. Results. Preoperative corneal astigmatism averaged 1.0?D and was not significantly di...

Richard Potvin; Paul Ernest; Warren Hill

2011-01-01

 
 
 
 
141

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

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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 ma...

Venkatesh Rengaraj; Veena Kannusamy; Ravindran Ravilla

2009-01-01

142

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

Directory of Open Access Journals (Sweden)

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

143

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery  

Science.gov (United States)

Purpose 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. PMID:23055671

Akçay, Betül ?lkay Sezgin; Bozkurt, Tahir Kansu; Güney, Esra; Ünlü, Cihan; Erdogan, Gürkan; Akcali, Gülünay; Bayramlar, Huseyin

2012-01-01

144

Cataracts  

Medline Plus

Full Text Available ... a small incision in the cornea, the doctor removes the lens. This document is for informational purposes ... 2013 3 There are two main ways to remove a cataract. The doctor may insert a tiny ...

145

Cataracts  

Medline Plus

Full Text Available ... to the brain, which translates these signals into images we see. Cataracts The lens of the eye ... can reduce vision to the extent that sharp images can no longer be formed. In cases such ...

146

Cataracts  

Medline Plus

Full Text Available ... cataracts also include seeing halo around lights, faded colors, or double vision. As the lens becomes more ... Rarely, however, some risks and complications can occur. Learning about them will help you detect them and ...

147

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

Scientific Electronic Library Online (English)

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

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

2013-04-01

148

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

149

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

150

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

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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

151

Changes of corneal endothelium in diabetes patients after cataract phacoemulsification surgery by confocal microscopy  

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Full Text Available AIM: To observe the changes of corneal endothelium in diabetes patients before and after cataract phacoemulsification surgery with confocal microscopy for exploring the variation and influencing factors. METHODS: Phacoemulsification were randomly divided into 50 aged-related cataract patients with diabetes mellitus(56 eyes, diabetes groupand 50 patients with senile cataract(60 eyes, control group. Cataract phacoemulsification and intraocular lens implantation were performed, central corneal thickness, the corneal endothelial cell density, coefficient of variation and percentage of hexagonal cell were measured before surgery, 1 week, 1 month and 3 months after surgery by confocal microscopy. RESULTS: Before surgery, there was no statistical difference between the two groups of central corneal thickness, corneal endothelial cell density, coefficient of variation and percentage of hexagonal cell(P>0.05. Compared with pre-operation, the central corneal thickness and coefficient of variation were increased post-operation, but the corneal endothelial cell density and percentage of hexagonal cell decreased gradually. The central corneal thickness of diabetes group was more significantly than control group 1 week, 3 months after surgery(P<0.05, and the corneal endothelial cell density was less significantly than control group(P<0.05. One week, 3 months after surgery, the percentage of hexagonal cell was less than control group(P<0.01. The coefficient of variation was significantly higher than control group(P<0.01. CONCLUSION: Aged-related cataract patients with diabetes mellitus were much more poor tolerability on cataract phacoemulsification surgery. Compared with senile cataract patients, the corneal endothelium injury was more serious and the velocity and validity of recovery were lower comparatively.

Chao Zhao

2013-05-01

152

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

LENUS (Irish Health Repository)

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

Dooley, I

2012-02-01

153

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

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

Morkin MI

2014-08-01

154

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

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A prospective comparative study was undertaken to compare the patients’ pain experience, surgical outcome and surgeon’s experience in phacoemulsification and manual small incision cataract surgery (MSICS) under topical anesthesia supplemented with intracameral lignocaine (TASIL). In Group 1 (n=88) phacoemulsification was done and in Group 2 (n=92) MSICS was done. Pain scores were marked by the patients on a Visual analog scale (VAS) after the surgery. The surgical experience was noted on ...

Gupta, Sanjiv K.; Kumar, Ajai; Agarwal, Swati

2010-01-01

155

Cataract surgery under topical anesthesia: Gender-based study of pain experience  

Directory of Open Access Journals (Sweden)

Full Text Available Background : Pain perception, expression, tolerance, and the healthcare provider?s evaluation and management of pain are affected by the gender of the patient. To the best of our knowledge, there is lack of gender-based evaluation of pain during cataract surgery under topical anesthesia. Aims : This study has been initiated to evaluate and determine pain experience during cataract surgery under topical anesthesia and to study the gender-based differences of the same. Settings and Design : Hospital-based study involving cataract surgery under topical anesthesia using standard cataract surgery. It was an interventional comparative case series. Materials and Methods : One hundred and sixty patients were included in four groups, according to the gender and choice of surgery. Patients underwent either phacoemulsification with foldable intra ocular lens (IOL or manual small incision cataract surgery with rigid IOL under topical anesthesia. Patients ranked their pain experience on VAS scale after the surgery and the surgeon recorded the ease/difficulty accordingly using a questionnaire. Statistical Analysis Used : MedCalc version 10.2.0.0 ( www.medcalc.be for windows was used to analyze the results. Analysis of variance (ANOVA test and Kruskal-Walis test were used to analyze the data. Results : The overall visual analog scale (VAS score was 0.8 (SD 1.3 range 0-8, with no statistical difference among the groups (P=0.5. The average surgeon?s score was 3.3 (SD 0.71 range 3-7, with no statistical difference between the groups (P=0.37.There were no sight threatening complications during the surgery in any group. Conclusions : The outcome of the study demonstrates that the patients undergoing cataract surgery under topical anesthesia perceive comparable pain and discomfort irrespective of their gender.

Gupta Sanjiv

2010-01-01

156

Impact of cataract surgery on sleep in patients receiving either ultraviolet-blocking or blue-filtering intraocular lens implants.  

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

Alexander, I.; Cuthbertson, Fm; Ratnarajan, G.; Safa, R.; Mellington, Fe; Foster, Rg; Downes, Sm; Wulff, K.

2014-01-01

157

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

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

Rabiu, M.

2001-01-01

158

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

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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

159

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

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AbstractPurpose: To evaluate the results and complications of phacoemulsification surgery due to various factors in patients with cataract formation after intravitreal injection of triamcinolone acetonide (IVTA). Materials and Methods: Forty-five eyes of 32 patients with cataract formation that had developed after one or multiple IVTA injections were included in the study. Among these patients, 28 eyes had diabetic macular edema, 7 eyes had branch retinal vein occlusion, 2 eyes had central re...

Esra Ayhan Tuzcu; Kuddusi Erk?l?ç; Recep Aksu; Abdullah Özk?r??; Özgür ?lhan

2008-01-01

160

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

 
 
 
 
161

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

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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

162

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

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

Xin He

2014-11-01

163

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

164

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

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

Wan-Soo Kim

2013-06-01

165

Combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery in cases with cataract and posterior segment diseases  

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Full Text Available Background: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. Aim: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. Settings and Design: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. Materials and Methods: In this study, 28 eyes of 28 patients underwent combined 23-gauge transconjunctival sutureless vitrectomy and phacoemulsification and IOL implantation for cataract and various posterior segment diseases. The outcome measures included, visual acuity, intraocular pressure changes, and anatomical success were evaluated. Results: The mean follow-up was 4.8 months (range, 3-15 months. Mean overall preoperative visual acuity was 20/333, and final acuity was 20/95 (P < 0.001. Mean intraocular pressure (IOP on the preoperative and first postoperative day was 15.6 ± 7.5 and 13.8 ± 3.3 mmHg, respectively (P > 0.05. Three eyes (10.7% had postoperative hypotony (<6 mmHgthat all recovered spontaneously within the first postoperative week. Three eyes (10.7% required laser treatment for iatrogenic retinal tears. Anatomical success was obtained in all cases. No serious complications such as endophthalmitis were observed during the follow-up period. Conclusion: Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in patients with significant lens opacities and vitreoretinal pathology. Although the anatomic and visual outcomes were satisfactory, the outcomes depended mainly on underlying vitreoretinal pathology.

Yazici Ahmet

2010-01-01

166

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

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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

167

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery  

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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

168

Effect of intracameral carbachol given during cataract surgery on macular thickness.  

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To evaluate the effect of intracameral carbachol on foveal thickness in patients who underwent uneventful cataract surgery. This retrospective study included two groups: the study group patients (group 1, n = 47 eyes) had uneventful cataract surgery and received only carbachol 0.01 % for miosis; the control group patients (group 2, n = 49 eyes) had uneventful cataract surgery without carbachol or any intracameral medication(s). The groups were compared for foveal thickness after cataract surgery. All phacoemulsification plus intraocular lens implantation surgeries were performed under local anesthesia via temporal clear corneal tunnel incisions. Mean values and standard deviations were calculated for preoperative and postoperative visual acuity (VA) and foveal thickness (FT) at 1 and 4 weeks. Optical coherence tomography was used for the FT measurements, with the MM6 map program. The patients in the study and control groups had a mean age of 57.78 ± 9.07 and 59.72 ± 8.96, respectively (p = 0.355). All eyes had a significant improvement in VA. In the study group, the mean FT at the visits before and 1 and 4 weeks after surgery was 216.87 ± 21.06, 228.81 ± 30.52, and 222.94 ± 29.91 ?m, respectively. For the control group, the mean FT, before and 1 and 4 weeks after surgery, was 222.53 ± 17.66, 231.67 ± 23.08, and 225.41 ± 22.59 ?m, respectively. Intracameral carbachol 0.01 % had no effect on foveal thickness in patients who underwent uneventful cataract surgery. PMID:22576110

Demir, Mehmet; Oba, Ersin; Dirim, Burcu; Can, Efe; Odabasi, Mahmut; Ozdal, Erhan

2012-10-01

169

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

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Full Text Available Atsushi Kawahara,1 Daijiro Kurosaka,2 Akitoshi Yoshida31Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, 2Department of Ophthalmology, Iwate Medical University, Morioka, 3Department of Ophthalmology, Asahikawa Medical University, Asahikawa, JapanBackground: The purpose of this study was to compare surgically induced astigmatism (SIA between one-handed and two-handed cataract surgery techniques.Methods: Eighty-eight eyes of 44 patients with no ocular disease other than cataract, who underwent cataract surgery by a single surgeon, were selected for this study. Cataract surgery was performed by coaxial phacoemulsification and intraocular lens implantation via a 2.4 mm transconjunctival single-plane sclerocorneal incision at the 12 o'clock position. In each patient, one eye was subjected to coaxial phacoemulsification using a one-handed technique while the fellow eye was subjected to coaxial phacoemulsification using a two-handed technique. For the two-handed technique, a corneal side port was created at the 2 o'clock position. The appropriate incision meridian was identified by a preoperative axis mark. SIA was calculated using the Alpins method.Results: Mean SIA was 0.40 ± 0.28 diopters (D in the one-handed technique group and 0.39 ± 0.25 D in the two-handed technique group. No statistically significant difference was found in the mean SIA score. The mean torque value was ?0.05 ± 0.26 D in the one-handed technique group and 0.11 ± 0.37 D in the two-handed technique group. Mean torque was significantly lower (P<0.05 in the one-handed technique group than in the two-handed technique group.Conclusion: The results indicate that the corneal side port in two-handed cataract surgery has a rotating effect on the axis of astigmatism.Keywords: cataract surgery, corneal side port, surgically induced astigmatism

Kawahara A

2013-10-01

170

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

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

Prasanna T

2007-01-01

171

Cataract prevalence and prevention in Europe: a literature review  

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

Prokofyeva, Elena; Wegener, Alfred; Zrenner, Eberhart; Institute For Ophthalmic Research, Centre For Ophthalmology

2012-01-01

172

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)

173

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

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

Bernal-Delgado Enrique

2007-04-01

174

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

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

Lou, Astrid R; Madsen, Kristoffer H

2013-01-01

175

Efficacy of diclofenac sodium solution in reducing discomfort after cataract surgery.  

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Two hundred consecutive patients were enrolled in a randomized, prospective clinical trial evaluating the efficacy of diclofenac sodium (Voltaren Ophthalmic) in reducing patient discomfort after cataract surgery. Other factors evaluated were the effect of preoperative flurbiprofen (Ocufen) in preventing intraoperative miosis and on postoperative discomfort and the effect of incision size and intraocular carbachol (Miostat) on postoperative comfort. Diclofenac significantly reduced discomfort during the first 24 hours after surgery but not two to three days postoperatively, although there was a trend toward reduction. Flurbiprofen given preoperatively did not affect postoperative discomfort. It also did not affect pupil size at the start of surgery but did reduce intraoperative miosis. Incision size (5.2 mm versus 7.0 mm) had no effect on discomfort. Miostat did not affect discomfort, although there was a trend toward more discomfort. The results indicate that topical diclofenac, given immediately after cataract surgery, significantly reduces discomfort during the first 24 postoperative hours. PMID:7791060

Fry, L L

1995-03-01

176

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

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AIM:To investigate the safety and efficacy of capsular tension ring(CTR)insertion combined with phacoemulsification and intraocular lens(IOL)implantation 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, 20...

Yi Zhang; Fan Zhang,; Tu'erhongjiang Maimaiti; Dilinu'er Kasimu; Yong-Xiang Jiang

2014-01-01

177

A Comparative Study of Surgically Induced Astigmatism in Superior and Temporal Scleral Incision in Manual Small Incision Cataract Surgery  

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Aim: To evaluate the amount and type of surgically induced astigmatism in superior and temporal scleral incision in Manual Small Incision Cataract Surgery (MSICS). Material and Methods: A prospective randomized comparative study was carried out in 100 cases of senile or pre-senile cataract. All the patients underwent MSICS under peribulbar anaesthesia. The patients with very hard cataract were excluded so as to keep the incision size uniformity (6-6.5mm). 50 cases received superior scleral in...

Magdum, Renu M.; Abha Gahlot; Maheshgauri, Rupali D.; Khevna Patel

2012-01-01

178

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

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Full Text Available AIM:To investigate the reasons of the barriers to free cataract surgery in suburban area of one city in middle China. METHODS: From 2008 to 2009, in Sight Rehabilitation Programme of Cataract in suburban district of one city in middle China, all visually significant cataract patients screened were questioned about why he/she did not accept free cataract surgery. The answers were recorded and analyzed. RESULTS: Of 892 screened patients, only 387 patients(43.39%wanted a free cataract surgery at first. At last 490 patients(54.93%accepted free surgery. The main reasons for patients who did not accept free surgery include: be afraid of surgery and wanting other treatments(193, 21.64%, thinking the eyesight was enough for daily life(148, 16.59%, worrying about that the result would not be good as those paid for surgery(147, 16.48%, and other reasons(17, 1.91%.CONCLUSION: The reasons of the barriers to free cataract surgery include patients' ignorance, surgery outcome of patients around, and working mode of designated surgical hospital.

Jian-He Xiao

2013-09-01

179

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

180

Modern cataract surgery in a highly myopic population.  

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A retrospective series of 117 highly myopic eyes with extracapsular cataract extractions and posterior chamber lens implants is presented. The results are analysed with reference to the current understanding of the complications anticipated. Of particular note is the use of low-powered posteriorly vaulted posterior chamber implants, with and without primary posterior capsulotomy. The results show a low retinal detachment rate (one eye, mean follow-up 12 months); low induced astigmatism (avera...

Gross, K. A.; Pearce, J. L.

1987-01-01

 
 
 
 
181

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

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

Malhotra Sumeet

2008-01-01

182

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

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

Yunis Muhammad H

2011-04-01

183

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

184

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

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Full Text Available Masahiko Shimura1, Toru Nakazawa2, Kanako Yasuda1, Takashi Shiono3, Kohji Nishida21Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan; 2Department of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Ophthalmology, Shiono Eye Center, Sendai, JapanPurpose: This study compares the effect of topical diclofenac with that of betamethasone against postoperative increase of intraocular pressure (IOP after cataract surgery in normal patients, and also investigated the risk factors for postoperative increase of IOP in each group.Methods: Fifty consecutive patients without systemic disease who have bilateral and symmetrical cataracts underwent uncomplicated cataract surgery in both eyes (100 eyes in total. Postoperatively, topical diclofenac was applied 4 times daily to one eye, and topical betamethasone to the other eye in each patient. IOP and best corrected logMAR visual acuity (BCVA in each eye were measured up to 8 weeks. Total surgery time and effective phacoemulsification time (EPT for each case was recorded.Results: BCVA in both diclofenac- and betamethasone-treated eyes significantly improved after the cataract surgery; however, no statistical difference in VA was noted between the diclofenac- and betamethasone-treated eyes throughout the observation period. IOP in the diclofenac-treated eyes decreased with time, in contrast to the IOP in the betamethasone-treated eyes, which showed a slight increase. At 4 and 8 weeks postoperatively, there was significant difference between these two eye groups. Multiple regression analysis revealed that postoperative increase in IOP at 8 weeks in the betamethasone-treated eyes was closely correlated with total surgery time and EPT, but the IOP in the diclofenac-treated eyes showed no correlation with any surgical or clinical parameters.Conclusions: Postoperative increase in IOP after cataract surgery was affected by total surgery time and EPT in the betamethasone-treated eye. The time for surgery and EPT is longer in complicated cases including patients with a hard nucleus or small pupils, and also longer for beginning surgeons and in older patients. In these cases, diclofenac in place of betamethasone as a postoperative topical antiinflammatory drug is recommended for the prevention of postoperative increase in IOP.Keywords: intraocular pressure, cataracts, visual acuity, betamethasone, diclofenac

Kohji Nishida

2008-10-01

185

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

186

Cataracts  

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Full Text Available ... drive you home after the surgery. Removal of Hard Lens This procedure is usually done under regional, ... the side of the cornea and remove the hard center of the lens in one piece. The ...

187

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

188

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

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Full Text Available Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid and globe movements, miosis and viterous bulg were observed more in topical anesthesia than the other techniques, but serious complications such as posterior capsular rupture and viterous loss were not seen. Because of less systemic and local complications and rapid return of vision and possibility of outpatient surgery, topical anesthesia should be considered as an alternative to local and general methods.

Tarighat Monfared MH

2001-07-01

189

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

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Full Text Available Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid and globe movements, miosis and viterous bulg were observed more in topical anesthesia than the other techniques, but serious complications such as posterior capsular rupture and viterous loss were not seen. Because of less systemic and local complications and rapid return of vision and possibility of outpatient surgery, topical anesthesia should be considered as an alternative to local and general methods.

Tarighat Monfared MH

2000-07-01

190

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

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

Esra Ayhan Tuzcu

2008-03-01

191

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

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

Eva I Mönestam

2008-03-01

192

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

193

Outcomes of cataract surgery in a rural and urban south Indian population  

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Full Text Available Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850 urban subjects from five randomly selected divisions were studied. All subjects underwent a comprehensive ophthalmic examination that included visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated retinal examination. Statistical Analysis: Chi square test, t test and multivariate analysis were used. Results: Five hundred and twenty-eight (216 males, 312 females, 781 eyes rural subjects (13.5%, 95% confidence interval (CI 12.4% to 14.6% and 406 (197 males, 209 females, 604 eyes urban subjects (10.5%, 95% CI 9.6-11.5% had undergone cataract surgery. Outcome of cataract surgery was defined based on visual acuity. Using best-corrected visual acuity for classification, the single most important cause for visual impairment was cystoid macular edema in the aphakic group and posterior capsule opacification in the pseudophakic group. Aphakia (visual acuity of < 20/60 to ? 20/400 - odds ratio (OR 1.8; 95% CI 1.3 to 2.6%, visual acuity of < 20/400 - OR 6.2; 95% 4.0 to 9.8%, rural residence (visual acuity of < 20/60 to ? 20/400 - OR 3.2; 95% CI 2.2 to 4.5% and visual acuity of < 20/400 - OR OR 3.5; 95% CI 2.3 to 5.5% were associated with visual impairment. The urban cataract-operated population had significantly more pseudophakics ( P < 0.001, men ( P = 0.02 and literates ( P < 0.001. In the rural group the prevalence of cataract surgery (13.5% vs. 10.5%, P < 0.001 and number of people that had undergone cataract surgery within three years prior to examination ( P < 0.001 were significantly greater. In 30% of rural and 16% of urban subjects uncorrected refraction was the cause of visual impairment. Conclusions: Surgery-related complications were major causes for visual acuity of < 20/60.

Vijaya Lingam

2010-01-01

194

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

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

Lambert, Scott R.; Lynn, Michael J.; Dubois, Lindreth G.; Cotsonis, George A.; Hartmann, E. Eugenie; Wilson, M. Edward

2012-01-01

195

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

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

Zhong-Yu Xu

2013-08-01

196

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

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

Luis Curbelo Cunill

2006-06-01

197

Measuring the Impact of Cataract Surgery on Generic and Vision-Specific Quality of Life  

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Purpose Cataracts are the leading cause of blindness worldwide and cause visual impairment for millions of adults in the US. We compared the sensitivity of a vision-specific health-related quality of life (HRQOL) measure to that of multiple generic measures of HRQOL before and at 2 two points after cataract surgery. Methods Participants completed 1 vision-specific and 5 generic quality of life measures before cataract surgery, and again 1-month, and 6-months after surgery. Random effects modeling was used to measure changes over the three assessment points. Results The NEI-VFQ25 total score and all 11 subscales showed significant improvements during the first interval (baseline and 1-month). During the second interval (1-month to 6-months post-surgery), significant improvements were observed on the total score and 5 of 11 NEI-VFQ25 subscales. There were significant increases in HRQOL during the first interval on some preference-based generic HRQOL measures, though changes during the second interval were mostly non-significant. None of the SF-36v2™ or SF6D scales changed significantly between any of the assessment periods. Conclusions The NEI-VFQ25 was sensitive to changes in vision-specific domains of QOL. Some preference-based generic HRQOL measures were also sensitive to change and showed convergence with the NEI-VFQ25, but the effects were small. The SF-36v2™ and SF-6D did not change in a similar manner, possibly reflecting a lack of vision-related content. Studies seeking to document both the vision-specific and generic HRQOL improvements of cataract surgery should consider these results when selecting measures. PMID:23015266

Groessl, Erik J.; Liu, Lin; Sklar, Marisa; Tally, Steven R.; Kaplan, Robert M.; Ganiats, Theodore G.

2012-01-01

198

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

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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

199

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

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

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

2012-01-01

200

Transient Corneal Edema is a Predictive Factor for Pseudophakic Cystoid Macular Edema after Uncomplicated Cataract Surgery  

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Purpose To report transient corneal edema after phacoemulsification as a predictive factor for the development of pseudophakic cystoid macular edema (PCME). Methods A total of 150 eyes from 150 patients (59 men and 91 women; mean age, 68.0 ± 10.15 years) were analyzed using spectral domain optical coherence tomography 1 week and 5 weeks after routine phacoemulsification cataract surgery. Transient corneal edema detected 1 week after surgery was analyzed to reveal any significant relationship with the development of PCME 5 weeks after surgery. Results Transient corneal edema developed in 17 (11.3%) of 150 eyes 1 week after surgery. A history of diabetes mellitus was significantly associated with development of transient corneal edema (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.41 to 11.54; p = 0.011). Both diabetes mellitus and transient corneal edema were significantly associated with PCME development 5 weeks after surgery (OR, 4.58; 95% CI, 1.56 to 13.43; p = 0.007; and OR, 6.71; CI, 2.05 to 21.95; p = 0.003, respectively). In the 8 eyes with both diabetes mellitus and transient corneal edema, 4 (50%) developed PCME 5 weeks after surgery. Conclusions Transient corneal edema detected 1 week after routine cataract surgery is a predictive factor for development of PCME. Close postoperative observation and intervention is recommended in patients with transient corneal edema.

Do, Jae Rock; Oh, Jong-Hyun; Chuck, Roy S.

2015-01-01

 
 
 
 
201

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

202

Irregular astigmatism after cataract surgery resulting from inadequate clear corneal incision formation.  

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A 66-year-old woman was referred to us due to visual complaints after cataract surgery. The patient's complaints were decreased visual acuity and a localized blur in her visual field. At slit lamp biomicroscopy, an unusually long and centrally located clear corneal incision was noted. Corneal topography revealed an irregular astigmatism in the optical axis, originating from the site of the incision. The patient's visual complaints were treated by fitting a rigid gas permeable contact lens, which increased her best corrected visual acuity to 20/16. This case report demonstrated that inadvertently long and centrally located corneal incisions should be avoided during cataract surgery to prevent high levels of irregular astigmatism. RGP contact lenses can lead to successful visual rehabilitation. PMID:19034136

de Vries, Niels E; Webers, Carroll A; Tahzib, Nayyirih G; Hendrikse, Fred; Nuijts, Rudy M M A

2008-12-01

203

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

204

Face-to-face upright seated positioning for cataract surgery in patients who cannot lie flat.  

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We describe a technique for cataract surgery in patients unable to adopt the conventional face-to-ceiling position. A standard reclining operating chair and operating microscope are used. Patients are seated instead of lying down, with the chair back elevated 30 to 80 degrees above the horizontal and the operating microscope rotated 45 to 60 degrees to vertical. The surgeon is seated or standing, facing the patient. A clear corneal incision is used via an inferior, temporal, or inferotemporal approach under topical intracameral anesthesia without sedation. Results of this technique in a case series comprising 32 eyes are reported. The technique is useful for patients unable to adopt the traditional approach for cataract surgery and at high risk for complications from general anesthesia. It is technically challenging so should be attempted by experienced surgeons only. PMID:21511148

Lee, Richard M H; Jehle, Thomas; Eke, Tom

2011-05-01

205

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

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Atsushi Kawahara,1 Daijiro Kurosaka,2 Akitoshi Yoshida31Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, 2Department of Ophthalmology, Iwate Medical University, Morioka, 3Department of Ophthalmology, Asahikawa Medical University, Asahikawa, JapanBackground: The purpose of this study was to compare surgically induced astigmatism (SIA) between one-handed and two-handed cataract surgery techniques.Methods: Eighty-eight eyes of 44 patients with no ocular disease other than catar...

Kawahara A; Kurosaka D; Yoshida A

2013-01-01

206

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

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

Elsawy MF

2013-06-01

207

Outcomes of cataract surgery in a rural and urban south Indian population  

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Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850 urban subjects from five randomly selected divisions were studied. All subjects underwent a comprehensive ophthalmic examination that included visual acuity, refraction, slit-lamp biomicroscopy, a...

Vijaya Lingam; George Ronnie; Rashima A; Raju Prema; Arvind Hemamalini; Baskaran Mani; Ve Ramesh

2010-01-01

208

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

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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...

Amp Ouml Zkurt, Yelda B.; Arzu Taskiran; Nadire Erdogan; Baran Kandemir; et al.

2009-01-01

209

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

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

Gunvant P; Ablamowicz A; Gollamudi S

2011-01-01

210

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

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Romualdo Malagola, Loredana Arrico, Rossella Giannotti, Luigi PattavinaDepartment of Ophthalmology, University of Rome "La Sapienza," Rome, ItalyAbstract: Idiosyncratic reactions to a large number of drugs have been reported to cause choroidal detachment and secondary angle-closure glaucoma (ACG). We report a case of bilateral acute ACG and peculiar choroidal effusion following administration of oral acetazolamide immediately after cataract surgery. Few cases of acute second...

Malagola R; Arrico L; Giannotti R; Pattavina L.

2013-01-01

211

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

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Abstract Background Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear) experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena. Methods This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers) attending the Ophthalmological Society of Pakistan Annual C...

Tauqir Mohammad Zain; Chaudhry Tanveer Anjum; Mumtaz Sehreen; Ahmad Khabir

2012-01-01

212

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

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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 succe...

Dhannawat, Sneh S.; Ramarishnan, R.

2013-01-01

213

Influence of IOL refractive index on straylight level following cataract surgery  

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

Yu-Wei Zheng

2015-01-01

214

Cataracts  

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

215

Cataracts  

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Full Text Available ... The lens of the eye is made of water and protein molecules. As we age, sometimes the ... ot020104 Last reviewed: 01/09/2013 2 Diagnosis & Treatment Options Your doctor will take a detailed medical ...

216

Cataracts  

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

217

Reduction in astigmatism in manual small incision cataract surgery through change of incision site  

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To compare the astigmatism induced by a superior, supero-temporal and temporal incision in manual small incision cataract surgery. Induced astigmatism was analysed by Cartesian coordinates based analysis, using Holladay?s system. Mean astigmatism induced by surgery was 1.28 D x 2.9 degrees for superior incision, 0.20 D x 23.7 degrees for supero-temporal incision and 0.37 D x 90 degrees for temporal incision. The study found that induced astigmatism was lower in the temporal an...

Gokhale Nikhil; Sawhney Saurabh

2005-01-01

218

Reduction in astigmatism in manual small incision cataract surgery through change of incision site  

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Full Text Available To compare the astigmatism induced by a superior, supero-temporal and temporal incision in manual small incision cataract surgery. Induced astigmatism was analysed by Cartesian coordinates based analysis, using Holladay?s system. Mean astigmatism induced by surgery was 1.28 D x 2.9 degrees for superior incision, 0.20 D x 23.7 degrees for supero-temporal incision and 0.37 D x 90 degrees for temporal incision. The study found that induced astigmatism was lower in the temporal and superotemporal groups compared to that in the superior group.

Gokhale Nikhil

2005-01-01

219

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

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

Yong - Hua Li

2013-04-01

220

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

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

Qin Yin

2015-01-01

 
 
 
 
221

Cataracts  

Medline Plus

Full Text Available ... for your specific condition. ©1995-2013, The Patient Education Institute, Inc. [www.X-Plain.com] ot020104 Last reviewed: 01/09/2013 4 Another operation may be necessary to place the IOL after removing the ...

222

Types of intraocular lenses for cataract surgery in eyes with uveitis  

Science.gov (United States)

Background Cataract formation often occurs in people with uveitis. It is unclear which intraocular lens (IOL) type is optimal for use in cataract surgery for eyes with uveitis. Objectives To summarize the effects of different IOLs on visual acuity, other visual outcomes, and quality of life in people with uveitis. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2013), EMBASE (January 1980 to August 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 August 2013. We also performed forward and backward searching using the Science Citation Index and the reference lists of the included studies, respectively, in August 2013. Selection criteria We included randomized controlled trials (RCTs) comparing hydrophobic or hydrophilic acrylic, silicone, or poly(methyl methacrylate) (PMMA) IOLs with or without heparin-surface modification (HSM), with each other, or with no treatment in adults with uveitis, for any indication, undergoing cataract surgery. Data collection and analysis We used standard methodological procedures expected by The Cochrane Collaboration. Two review authors screened the search results and for included studies, assessed the risk of bias and extracted data independently. We contacted study investigators for additional information. We did not perform a meta-analysis due to variability in reporting and follow-up intervals for the primary and secondary outcomes of interest. Main results We included four RCTs involving 216 participants (range of 2 to 140 participants with uveitic cataract per trial) and comparing up to four types of IOLs. The largest study was an international study with centers in Brazil, Egypt, Finland, France, Japan, the Netherlands, Slovak Republic, Spain, and the USA; two studies were conducted in Germany and one in Saudi Arabia. There was substantial heterogeneity with respect to the ages of participants and etiologies of uveitis within and across studies. The length of follow-up among the studies ranged from 1 to 24 months after cataract surgery. The studies were at low risk of selection bias, but two of the four studies did not employ masking and only one study included all randomized participants in the final analyses. The funding source was disclosed by investigators of the largest study (professional society) and not reported by the other three. Due to heterogeneity in lens types evaluated and outcomes reported among the trials, we did not combine data in a meta-analysis. In the largest study (140 participants), the study eye of each participant was randomized to receive one of four types of IOLs: hydrophobic acrylic, silicone, HSM PMMA, or unmodified PMMA. Proportions of participants with one or more Snellen lines of visual improvement were similar among the four treatment groups at one year' follow-up: 45 of 48 (94%) in the hydrophobic acrylic IOL group, 39 of 44 (89%) in the silicone IOL group, 18 of 22 (82%) in the HSM PMMA IOL group, and 22 of 26 (85%) in the unmodified PMMA IOL group. When comparing hydrophobic acrylic IOLs with silicone IOLs, the risk ratio (RR) was 1.06 (95% confidence interval (CI) 0.93 to 1.20). At one year' follow-up, fewer eyes randomized to hydrophobic acrylic IOLs developed posterior synechiae when compared with eyes receiving silicone IOLs (RR 0.18, 95% CI 0.04 to 0.79); the effects between these groups were less certain with respect to developing posterior capsule opacification (PCO) (RR 0.74, 95% CI 0.41 to 1.37), corneal edema (RR 0.4

Leung, Theresa G; Lindsley, Kristina; Kuo, Irene C

2014-01-01

223

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

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

Kanellopoulos AJ

2013-09-01

224

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

Scientific Electronic Library Online (English)

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

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

2012-06-01

225

Comparison of peristaltic and Venturi pumps in bimanual microincisional cataract surgery.  

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Comparison of peristaltic and Venturi pumps in bimanual microincision phacoemulsification on the success of the cataract surgery by using sleeveless phaco tip. Bimanual microincision phacoemulsification was done in 49 eyes using a 1.4-mm temporal clear corneal incision. A peristaltic pump was used in 23 eyes, and a Venturi pump was used in 26 eyes for phacoemulsification. Intraoperative complications, anterior chamber stability, and mean duration of surgery were recorded. Duration of surgery was shorter in the Venturi pump group. Anterior chamber stability could not be established in 17 eyes in the peristaltic pump group; it was established in all eyes in the Venturi pump group. Corneal burns were observed in two eyes in the peristaltic pump group and no eyes in the Venturi pump group. Use of a Venturi pump system and a vented gas-forced infusion system can significantly shorten surgery time and reduce risk of thermal burns. PMID:18853107

Karaguzel, Hande; Karalezli, Aylin; Aslan, Bekir Sitki

2009-12-01

226

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

227

Real-Time Task Recognition in Cataract Surgery Videos using Adaptive Spatiotemporal Polynomials.  

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This paper introduces a new algorithm for recognizing surgical tasks in real-time in a video stream. The goal is to communicate information to the surgeon in due time during a video-monitored surgery. The proposed algorithm is applied to cataract surgery, which is the most common eye surgery. To compensate for eye motion and zoom level variations, cataract surgery videos are first normalized. Then, the motion content of short video subsequences is characterized with spatiotemporal polynomials: a multiscale motion characterization based on adaptive spatiotemporal polynomials is presented. The proposed solution is particularly suited to characterize deformable moving objects with fuzzy borders, which are typically found in surgical videos. Given a target surgical task, the system is trained to identify which spatiotemporal polynomials are usually extracted from videos when and only when this task is being performed. These key spatiotemporal polynomials are then searched in new videos to recognize the target surgical task. For improved performances, the system jointly adapts the spatiotemporal polynomial basis and identifies the key spatiotemporal polynomials using the multipleinstance learning paradigm. The proposed system runs in realtime and outperforms the previous solution from our group, both for surgical task recognition (Az = 0:851 on average, as opposed to Az = 0:794 previously) and for the joint segmentation and recognition of surgical tasks (Az = 0:856 on average, as opposed to Az = 0:832 previously). PMID:25373078

Quellec, Gwenole; Lamard, Mathieu; Cochener, Beatrice; Cazuguel, Guy

2014-10-31

228

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

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

Alexandru Cosmin TUTUNARU

2012-01-01

229

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

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Purpose. To determine the impact of biometric characteristics on changes of biomechanical properties of the human cornea due to standard cataract surgery using biomechanical analysis. Patients and Methods. This prospective consecutive cross-sectional study comprised 54 eyes with cataract in stages I or II that underwent phacoemulsification and IOL implantation. CH, CRF, IOPg, and IOPcc intraocular pressure were measured by biomechanical analysis preoperatively and at 1 month postoperatively. ...

Xuefei Song; Achim Langenbucher; Zisis Gatzioufas; Berthold Seitz; Moatasem El-Husseiny

2014-01-01

230

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

Scientific Electronic Library Online (English)

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

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

2004-05-01

231

Astigmatic decay following small incision, self-sealing cataract surgery.  

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A series of 22 consecutive patients had phacoemulsification using a small (3.5 to 4.0 mm), self-sealing incision. Preoperative keratometric analysis was performed using the EyeSys photokeratoscope. Results of this analysis were compared with keratometric data obtained at one week and at one month postoperatively. These comparisons were evaluated for surgery-induced cylinder and astigmatic decay at the 3, 5, and 7 mm corneal zones. At one week postoperatively, there was only mild against-the-rule change in cylinder at each corneal zone, and these changes showed minimal decay at the one month follow-up visit. PMID:8133478

Feil, S H; Crandall, A S; Olson, R J

1994-01-01

232

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

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

Singh R

2012-08-01

233

Preoperative and postoperative use of nonsteroidal antiinflammatory drugs in cataract surgery.  

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Nonsteroidal antiinflammatory drugs have unique properties that aid the cataract surgeon. In phacoemulsification surgery, patients routinely receive nonsteroidal antiinflammatory drugs along with their dilating drops to inhibit intraoperative miosis. After surgery, these drugs can control inflammation and inhibit the development of cystoid macular edema. We present two prospective randomized studies. In the first, diclofenac sodium was compared with prednisolone acetate for control of postoperative inflammation. In the second, diclofenac sodium was compared with flurbiprofen for inhibition of intraoperative miosis. Diclofenac sodium was found to be as effective as prednisolone acetate for control of postoperative inflammation and as effective as flurbiprofen for inhibition of intraoperative miosis. Thus, whereas in the past we used a nonsteroidal antiinflammatory drug before surgery for inhibition of intraoperative miosis and a steroid drop in the postoperative period to control postsurgical inflammation, we now have equal efficacy using the same drug in the entire perioperative period. PMID:8826226

Brown, R M; Roberts, C W

1996-04-01

234

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

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

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

2012-03-01

235

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

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

Luis, Curbelo Cunill; Marcelino, Río Torres; Juan Raúl, Hernández Silva; Armando, Capote Cabrera; Eneida, Pérez Candelaria; Meisy, Ramos López; Gilberto, Fernández Vázquez; Raúl, Barroso Lorenzo.

2006-06-01

236

Study of cystoid macular edema by optical coherent tomography following uneventful cataract surgery.  

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The objective of this paper is to study the incidence of cystoid macular edema (CME) using optical coherence tomography (OCT) following uneventful small incision cataract surgery (SICS) and phacoemulsification. This was a descriptive, prospective study where 200 patients undergoing cataract surgery were randomly divided into two groups over a period of 1 year. Patients undergoing uneventful small incision cataract surgery were included in group I and patient undergoing uneventful phacoemulsification were included in group II, with 100 patients in each group. Preoperative assessment included best corrected visual acuity, detailed anterior segment and posterior segment evaluation, and intraocular pressure measurement. Macular thickness was measured using RTVue 100 three dimensional Fourier domain OCT, using Enhanced Macular Map 5 (EMM5) protocol. In group II, all the phaco parameters were also noted. Postoperative examination was done at day 1, 1 week, 1 month and 3 months for BCVA and macular thickness. Preoperative and postoperative measurements were analyzed statistically using ANOVA test, paired samples t test, and Pearson's correlation coefficient was calculated for different variables like phaco time, phaco energy, and BCVA. Statistically significant increase in macular thickness was detected postoperatively at 1 week (p ? 0.05 for group I and p = 0.1 for group II) and 1 month (p = 0.001 for group I and p ? 0.05 for group II), in all patients. It returned to near normal values by 3 months post operatively. This increase was mostly sub clinical. Overall incidence of clinical CME was 1.5 %. Following SICS incidence of clinical CME was 2 % and after phacoemulsification was 1 %. BCVA was not affected in patients with subclinical CME but decreased vision was seen in patients with clinical CME. The incidence of subclinical and clinical CME was comparable in SICS and phacoemulsification, and subclinical CME did not have an impact on BCVA. PMID:25205061

Chaudhary, Charu; Bahadhur, Harsh; Gupta, Neeti

2014-09-10

237

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

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

Arantes Tiago Eugênio Faria e

2006-01-01

238

Impact of incisions of cataract surgery on patients with corneal astigmatism  

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

Jing Li

2013-05-01

239

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

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Idiosyncratic reactions to a large number of drugs have been reported to cause choroidal detachment and secondary angle-closure glaucoma (ACG). We report a case of bilateral acute ACG and peculiar choroidal effusion following administration of oral acetazolamide immediately after cataract surgery. Few cases of acute secondary ACG with choroidal effusion and anterior shift of the lens-iris diaphragm have been associated with acetazolamide compared with other sulfonamides. As far as we are aware, posterior involvement with retinal folds and papillary edema due to acetazolamide has not been described before. PMID:23378740

Malagola, Romualdo; Arrico, Loredana; Giannotti, Rossella; Pattavina, Luigi

2013-01-01

240

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

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

Sarah Polack

2008-01-01

 
 
 
 
241

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

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

Hjelmstad, David P.; Sayegh, Samir I.

2013-03-01

242

Use of a wick to deliver preoperative mydriatics for cataract surgery.  

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Before cataract surgery at our institution, we traditionally dilated the pupils with 5 drops: proparacaine 0.5%, cyclopentolate 1%, phenylephrine 2.5%, flurbiprofen sodium 0.03% (Ocufen), and ofloxacin 0.3% (Ocuflox) at 15-minute intervals given 3 times. This was work intensive for the nursing staff. Since September 2000, we have used a wick soaked in a dilating mixture containing cyclopentolate 1%, phenylephrine 2.5%, diclofenac sodium 0.1% (Voltaren), and Ocuflox. Use of the wick has been beneficial and time saving to hospital staff. PMID:14670412

Ong-Tone, Lindsay

2003-11-01

243

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

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

1986-01-01

244

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

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

Noryan Najaf Abadi

2006-01-01

245

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

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

Matsuura K

2014-09-01

246

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

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

Gupta Sanjiv

2010-01-01

247

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

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

Jovanovi? Miloš

2011-01-01

248

Minimizing surgically induced astigmatism at the time of cataract surgery using a square posterior limbal incision.  

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Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery. Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2?mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size. Results. Preoperative corneal astigmatism averaged 1.0?D and was not significantly different between the incision types. Surgically induced astigmatism with the 2.2?mm posterior limbal incision averaged 0.25 ± 0.14?D, significantly lower in magnitude than the aggregate surgically induced astigmatism produced by the 2.2?mm clear corneal incision (0.68 ± 0.49?D). Conclusion. The 2.2?mm square posterior limbal incision induced significantly less, and significantly less variable, surgically induced astigmatism relative to a similar-sized clear corneal incision. This is likely to improve refractive outcomes, particularly important with regard to premium intraocular lenses. PMID:22132310

Ernest, Paul; Hill, Warren; Potvin, Richard

2011-01-01

249

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

250

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

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

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

2014-12-01

251

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

252

Cataract Surgery  

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Full Text Available ... I feel fine. Announcer: It's amazing. Paul Wood: No pain, no nothing. Announcer: Yes, and has the drug that ... relaxed, has that worn off yet? Paul Wood: No, I still feel relaxed. Announcer: Good, good. Surgeon: ...

253

Cataract Surgery  

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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 ...

254

Cataract Surgery  

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Full Text Available ... an opening in the front part of that membrane, in the front part of the capsule. This ... come in the next day you say, "What kind of night did you have?" "Fine, no problems ...

255

Cataract Surgery  

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Full Text Available Surgeon: OK. I'm going to put this little cover over your right eye -- Announcer: Fifty-four ... steroids following a kidney transplant two years ago. Surgeon: So we're going to administer an intravenous ...

256

Cataract Surgery  

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Full Text Available ... 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 rolled up or folded up? Surgeon: It's folded up inside. Announcer: The new lens for Paul's eye has been calibrated and ...

257

Cataract Surgery  

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Full Text Available Surgeon: OK. I'm going to put this little cover over your right eye -- Announcer: Fifty-four year old ... inside. How do you feel now? Paul Wood: OK. I feel fine. Announcer: It's amazing. Paul Wood: ...

258

Cataract Surgery  

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Full Text Available ... over your right eye -- Announcer: Fifty-four year old Paul Wood, a former truck driver from Chandler, ... up? Surgeon: It's folded up inside. Announcer: The new lens for Paul's eye has been calibrated and ...

259

Uptake, Barriers and Outcomes in the Follow-up of Patients Referred for Free-of-cost Cataract Surgery in the Sao Paulo Eye Study.  

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Abstract Purpose: To determine uptake, barriers and outcomes in the follow-up of patients referred for free-of-charge, expedited cataract surgery in the Sao Paulo Eye Study (SPES). Methods: SPES was a population-based study of urban, low-middle income residents aged ?50 years. Presenting visual acuity (PVA), best-corrected visual acuity, refraction, and slit-lamp examination were performed in 3677 participants. For subjects with cataract as a principal cause of best-corrected visual acuity ?20/40, surgery was offered free of charge. Two years after the baseline study, surgery uptake, barriers to surgery, and visual outcomes were analyzed. Results: Among 210 (5.71%) participants who had a cataract surgery indication at baseline, 164 (78.1%) were successfully contacted and 55 (33.5%) reported being operated on for cataract, with 51 agreeing to be re-examined. In a multiple logistic regression model, age, sex, schooling, previous cataract surgery, and PVA at baseline were not significantly associated with surgery uptake. Co-existing health conditions (20.4%), fear of surgery (12.2%) and fear of losing eyesight (11.6%) were the most frequent barriers to cataract surgery adherence. Among the 69 eyes operated on in the interval between baseline and follow-up, PVA ?20/63 was observed in 50 (72.6%, 95% confidence interval, CI, 62.2-82.3%), PVA <20/63-20/200 in 11 (15.8%, 95% CI 8.9-22.9%) and PVA <20/200 in 8 (11.6%, 95% CI 5.3-17.9%). Conclusions: Quality of surgery is an increasing determinant of uptake rates. Although free-of-charge and expedited cataract surgery was offered, surgical outcomes might have influenced the low uptake. Aside from cataract surgery campaigns, improvement of surgeon skills, accurate biometry, treatment of ocular comorbidities, postoperative follow-up and eye-care education are needed. PMID:25310584

Mitsuhiro, Marcia H; Berezovsky, Adriana; Belfort, Rubens; Ellwein, Leon B; Salomao, Solange R

2014-10-13

260

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

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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

 
 
 
 
261

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

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

Edison Ferreira e Silva

2007-08-01

262

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

263

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

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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. PMID:25540754

Jauhari, Nidhi; Chopra, Deepak; Chaurasia, Rajan Kumar; Agarwal, Ashutosh

2014-01-01

264

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

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

Jun-Yi Xie

2013-07-01

265

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

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

Malagola R

2013-01-01

266

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

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

Dhillon Baljean

2005-10-01

267

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

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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; Ilkit, Macit

2014-11-01

268

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

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

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

2014-08-01

269

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

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

Ciftci S

2012-11-01

270

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

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Background The aim of this study was to assess the value of ultrasonic biomicroscopy in reporting decreases in intraocular pressure resulting from changes in anterior chamber depth and angle after phacoemulsification and intracapsular lens implantation in patients with cataract. Methods This prospective interventional case series included 50 eyes of 50 consecutive subjects operated at the same center. Patients with eye disease affecting visual acuity, a history of eye surgery, corneal surface irregularities, a pupil diameter < 5 mm after preoperative dilation, aged younger than 35 years, posterior capsule perforation, iris dialysis during surgery, intensive postoperative corneal edema, and inability to attend adequate follow-up were excluded. Intraocular pressure, anterior chamber depth and angle, and corneal thickness were measured before and one month after surgery. Results The mean preoperative intraocular pressure was 14 mmHg and postoperatively was 11 mmHg. Mean anterior chamber depth preoperatively was 2.8 mm and increased to 3.7 mm postoperatively. The mean anterior chamber angle was measured as 27° preoperatively and as 42° postoperatively. Conclusion After phacoemulsification and intracapsular lens implantation, ultrasonic biomicroscopy showed that the iris diaphragm had shifted backwards, widening the angle of the anterior chamber and decreasing intraocular pressure. PMID:23204837

Simsek, Ali; Ciftci, Süleyman

2012-01-01

271

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

272

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

273

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

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

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

2006-01-01

274

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

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AIM:To explore safety and effectiveness of stratified emulsion splitting technology in highly hard nuclear cataract ultrasonic emulsification. METHODS: Totally 43 cases(47 eyes)of highly hard nuclear cataract was performed cataract extraction combined IOL implantation with stratified emulsion splitting cataract ultrasonic emulsification technology. RESULTS:Postoperative visual acuity 1 day, 1 week and 1 month best-corrected visual acuity ?0.5 was accounted for 70.21%, 87.23% and 89....

Hui Na; Da-Guang Bi; Yong Wang

2013-01-01

275

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

Science.gov (United States)

Purpose. Although visual impairment is a well-recognized consequence of cataract development, little is known about the ability of the melanopsin-based photosensitive retinal ganglion cells (pRGCs) to regulate sleep–wake timing in the presence of cataract. In this study, we replaced a cataractous natural crystalline lens with two different types of artificial intraocular lenses, a UV-blocking lens or a blue-filtering lens. We investigated the level of sleep disturbance before cataract surgery and any change in sleep due to improved light transmission following surgery and compared this in both types of intraocular lens. Methods. Quality of sleep in 961 patients undergoing cataract surgery was assessed by administering the validated self-reported Pittsburgh Sleep Quality Index (PSQI) questionnaire. The PSQI distinguishes good sleepers from poor sleepers by scoring seven different sleep components over the last month, which are combined to produce an overall score for sleep quality. Patients received either an ultraviolet-blocking (UVB) clear intraocular lens (IOL) or a blue-filtering (BF) IOL. Questionnaires were completed four times: 1 month preoperatively and again 1, 6 (UVB-IOL only), and 12 months postoperatively. Results. Half of the patients reported poor sleep in the presence of cataract in both the UVB-IOL (mean PSQI = 6.35; SD = 3.82) and BF-IOL (mean PSQI = 6.39; SD = 4.04) groups. Cataract removal improved overall sleep quality significantly 1 month postoperatively in the UVB-IOL (mean PSQI = 5.89; SD = 3.71) and BF-IOL (mean PSQI = 6.08; SD = 3.88) groups. Sleep latency also improved for the UVB-IOL (preoperative mean = 1.16; SD = 1.003) and BF-IOL (preoperative mean = 1.17; SD = 1.03) groups at 1 month (UVB-IOL group mean = 1.01; SD = 0.923 and BF-IOL group mean = 1.00; SD = 0.95), which was sustained at 6 months for the UVB-IOL group (mean = 1.02; SD = 0.93) and 12 months for both the UVB-IOL and BF-IOL groups (6 months: UVB-IOL group mean = 0.96; SD = 0.92 and for the BF-IOL group mean = 0.99; SD = 0.96). Conclusions. Overall sleep quality and sleep latency improves after removal of cataract irrespective of the type of IOL implanted. These data show that implantation of BF-IOL does not have a negative impact on the sleep–wake cycle. PMID:24970263

Alexander, Iona; Cuthbertson, Fiona M.; Ratnarajan, Gokulan; Safa, Rukhsana; Mellington, Faye E.; Foster, Russell G.; Downes, Susan M.; Wulff, Katharina

2014-01-01

276

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

DEFF Research Database (Denmark)

ABSTRACT. Purpose: To estimate the long-term cumulative incidence of cataract surgery and associated risk factors in a 25-year follow-up of a population-based cohort of patients with type 1 diabetes. Methods: Based on insulin prescriptions, a population-based cohort of 727 patients with type 1 diabetes was identified in 1973. In 1981-1982 diabetic retinopathy was graded and other markers of diabetes were measured in 573 patients who participated in a clinical baseline examination. Based on data from the Danish National Patient Registry, patients were followed until November 2006 and cataract surgery was evaluated during follow-up. Results: The 25-year crude cumulative incidence of cataract surgery was 20.8% (117 of 562 patients at risk), corresponding to a mortality-adjusted incidence of 29.4% [95% confidence interval (CI) 25.6-33.1%]. Median age and duration of diabetes at the time of surgery were 59.3 and 42 years, respectively. Cataract surgery in the cohort took place approximately 20 years earlier compared to non-diabetic persons. In a multivariate regression analysis, baseline age [hazard ratio (HR) 1.89 per 10 years, 95% CI 1.46-2.27] and maculopathy (HR 1.89, 95% CI 1.05-3.40) were the only statistically significant predictors of cataract surgery. Duration of diabetes, gender, glycaemic regulation, proteinuria, smoking, blood pressure and level of retinopathy were not associated with cataract surgery. Conclusion: Type 1 diabetes is associated with a high long-term incidence of cataract surgery. The association between maculopathy and subsequent cataract surgery is a novel finding and should be addressed in future studies.

Grauslund, Jakob; Green, Anders

2011-01-01

277

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

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Lee Teak Tan1,2, Huw Jenkins1,2, John Roberts-Harry2, Michael Austin11Singleton Hospital, Swansea, UK; 2West Wales General Hospital, Carmarthen, UKPurpose: To ascertain the level of information relating to specific risks desired by patients prior to cataract surgery.Setting: Dedicated cataract surgery pre-assessment clinics of 2 hospitals in South West Wales, UK.Methods: Consecutive patients (106) were recruited prospectively. Of these, 6 were formally excluded due to deafness or disorientati...

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

2008-01-01

278

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

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

Rodrigo Pessoa Cavalcanti Lira

2001-10-01

279

[Posterior vitreous detachment and cystoid macular oedema post-cataract surgery: a case report].  

Science.gov (United States)

The posterior vitreous detachment consists in the separation between the posterior vitreal cortex and internal limiting membrane of the retina. This is the peak of the vitreal para-physiological age-related modifications. This problem occurs in 6% of normal people of age between 45 and 65 years and in 65% of individuals between 65 and 85 years. Several elements can be responsible for vitreous modifications, such as senility, myopia, aphakia, pseudophakia, diabetes, degeneration vitreous retinal hereditary, traumatisms, inflammation. A 75 year old male patient has come to our attention for a left eye cataract. He has undergone to a series of OCT: the first before surgery showed a perifoveal vitreous detachmen; the following ones until six months after surgery put in evidence the DPV progression accompanied by EMC, relating it with visual symptomatology. Therefore, OCT is a useful tool for a clinical analysis but also for the contribution to research concerning the pathogenesis of diseases due to vitreo-retinal modification. PMID:22555828

Malagola, R; Ganino, C; Bianchi, S; Carlesimo, S C; Bianchi, G; Guerriero, A; Giannotti, R

2012-01-01

280

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

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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

 
 
 
 
281

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

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

Grand, M. Gilbert

2003-01-01

282

Pathogenic conjunctival bacteria associated with systemic co-morbidities of patients undergoing cataract surgery  

Science.gov (United States)

Purpose To identify the risk of patients undergoing cataract surgery of having pathogenic conjunctival bacteria associated with their systemic co-morbidities. Methods Retrospective study of consecutive patients undergoing their first cataract operation from July 2005 to April 2010. Their preoperative conjunctival bacteria were cultured, identified, and classified in bacterial groups. Their co-morbidities were defined from their clinical data and the answers to systematic questions asked in the anaesthetic evaluation. The Microsoft Access databases of the two data sets were merged for carrying out the statistical analysis. Univariate association of each bacterial group with each co-morbidity was studied by using ?2-test for categorical data and Student's t-test for continuous variables. Also, logistic regression models were used adjusting for age and sex. SPSS statistic programme, version 18 was used for all these analyses. Endophthalmitis cases in this surgical series were searched. Results In the 8333 selected patients, age was associated with increased conjunctival bacteria in all groups except for Streptococcus pneumoniae and Propionibacteriae. However, male sex was associated with these two groups and also with coagulase-negative Staphylococci, Corynebacterium xerosis, Staphylococcus aureus, and Gram-negative rods. After adjusting for age and sex, S. aureus was associated with diabetes, lung diseases, and renal and heart insufficiency; Gram-negative rods with smoking habit; Enterococci with diabetes; Streptococcus pneumoniae with kyphoscoliosis; and other Streptococci with diabetes and handicapped patients. Conclusion The more pathogenic conjunctival bacteria were more likely associated with patients' co-morbidities, such as diabetes, lung diseases, renal and heart insufficiency, kyphoscoliosis, and smoking habit, than the less pathogenic ones. PMID:23703631

Fernández-Rubio, M-E; Cuesta-Rodríguez, T; Urcelay-Segura, J-L; Cortés-Valdés, C

2013-01-01

283

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

284

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 previos 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.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 cataract 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

2010-12-01

285

The sandwich theory : a bioactivity based explanation for posterior capsule opacification after cataract surgery with intraocular lens implantation  

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Abstract This study was undertaken to identify mechanisms of adhesion of intraocular lenses (IOLs) to the capsular bag after cataract surgery and IOL implantation. It was also done to challenge the sandwich theory presented for posterior capsular opacification (PCO): If the IOL is made of a bioactive material it would allow a single lens epithelial cell layer to bond both to the IOL and the posterior capsule at the same time. This would produce a sandwich pattern including ...

Linnola, Reijo

2001-01-01

286

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

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Nicolás E Quintana,* Alejandro R Allocco,* Julia A Ponce,* Mauricio GB Magurno Instituto Santa Lucía, Paraná, Argentina *These authors contributed equally to this work 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) to...

Ne, Quintana; Ar, Allocco; Ja, Ponce; Mgb, Magurno

2014-01-01

287

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

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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 wa...

Xiao-Ning Peng; Ying-Long Li; Gang-Sheng Liu

2014-01-01

288

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

Directory of Open Access Journals (Sweden)

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

Rajiv D. Sha

2011-06-01

289

Insertion of a foldable hydrophobic IOL through the trabeculectomy fistula in cases with Microincision cataract surgery combined with trabeculectomy  

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Abstract Background The use of conventional foldable hydrophobic intraocular lenses (IOLs) in microincision cataract surgery (MICS) currently requires wound enlargement. We describe a combined surgical technique of MICS and trabeculectomy with insertion of a foldable IOL through the trabeculectomy fistula. Methods After completion of MICS through two side port incisions, a 3.2 mm keratome is used to enter the anterior chamber under the previously outlined sclera...

Sethi Harinder S; Muralidhar Rajamani; Dada Tanuj

2006-01-01

290

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

DEFF Research Database (Denmark)

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

Solborg Bjerrum, SØren; Kiilgaard, Jens Folke

2014-01-01

291

Insertion of a foldable hydrophobic IOL through the trabeculectomy fistula in cases with Microincision cataract surgery combined with trabeculectomy  

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Full Text Available Abstract Background The use of conventional foldable hydrophobic intraocular lenses (IOLs in microincision cataract surgery (MICS currently requires wound enlargement. We describe a combined surgical technique of MICS and trabeculectomy with insertion of a foldable IOL through the trabeculectomy fistula. Methods After completion of MICS through two side port incisions, a 3.2 mm keratome is used to enter the anterior chamber under the previously outlined scleral flap. An Acrysof multi piece IOL (Alcon labs, Fort Worth, Tx is inserted into the capsular bag through this incision. The scleral flap is then elevated and a 2 × 2 mm fistula made with a Kelly's punch. The scleral flap and conjunctival closure is performed as usual. Results Five patients with primary open angle glaucoma with a visually significant cataract underwent the above mentioned procedure. An IOL was implated in the capsular bag in all cases with no intraperative complications. After surgery, all patients obtained a best corrected visual acuity of 20/20, IOL was well centered at 4 weeks follow up. The mean IOP (without any antiglaucoma medication was 13.2 + 2.4 mm Hg at 12 weeks with a well formed diffuse filtering bleb in all the cases. Conclusion The technique of combining MICS with trabeculectomy and insertion of a foldable IOL through the trabeculectomy fistula is a feasible and valuable technique for cases which require combined cataract and glaucoma surgery.

Sethi Harinder S

2006-03-01

292

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

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

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

2008-10-01

293

Pediatric cataract: challenges and future directions.  

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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

294

Pediatric cataract: challenges and future directions  

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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

295

Comparação a longo prazo entre a facectomia extracapsular combinada à trabeculectomia e à facotrabeculectomia / Longterm comparison between extracapsular cataract extraction combined with trabeculectomy and combined phacofiltration surgery  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Objetivo: Comparar os resultados a longo prazo entre a cirurgia extracapsular da catarata combinada à trabeculectomia (FEC/TREC) e a facotrabeculectomia (FACO/TREC). Métodos: Os prontuários de 46 pacientes (53 olhos) submetidos à cirurgia combinada na Santa Casa de São Paulo entre janeiro de 1996 e [...] novembro de 1999 foram revisados; dados relativos à pressão ocular (PO), acuidade visual (AV) e número de medicações foram analisados. Resultados: Em ambos os grupos, após seguimento médio de 18 meses, a acuidade visual melhorou e a pressão ocular diminuiu em relação aos valores pré-operatórios (P Abstract in english Purpose: To compare the safety and efficacy of extracapsular cataract extraction (ECCE) combined with trabeculectomy and combined phacoemulsification/trabeculectomy. Methods: The records of 46 patients (53 eyes) who underwent combined glaucoma and cataract surgery at the Santa Casa de São Paulo betw [...] een January 1996 and November 1999 were reviewed. Results: After a mean follow-up of 18 months, visual acuity improved and intraocular pressure decreased in both groups after surgery (P

Carmo, Mandia Jr.; Niro, Kasahara; Francisco Soares, Seixas; Maurício Della, Paolera; Geraldo Vicente de, Almeida; Ralph, Cohen.

2002-12-01

296

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

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

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

2004-11-01

297

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

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

M Suárez-Tatá

2004-11-01

298

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

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

Li X-R

2011-06-01

299

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

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

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

2012-04-01

300

Outbreak of fungal endophthalmitis due to Fusarium oxysporum following cataract surgery.  

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Outbreak of exogenous Fusarium endophthalmitis after cataract surgery was evaluated. Twenty patients developed postoperative endophthalmitis. In 19 eyes, pars plana vitrectomy (PPV) was performed, in 14 cases (74 %) with primary intraocular lens explantation. In one case, the PPV was not performed because of poor general condition of the patient. Symptoms of endophthalmitis (damaged vision, iritis, tyndallization in anterior chamber, hypopyon) occurred at intervals of 16-79 days (mean 31.3 days). Fungal etiology was documented in 12 eyes (60 %). Fusarium oxysporum was evidenced by culture and/or microscopy and confirmed by PCR and sequencing analysis. Eighteen (90 %) patients were treated with oral voriconazole (400 mg/day) for a period of 4-6 weeks. The final visual acuity was 6/15 in 1 case (5 %), 6/60 and worse in 17 eyes (85 %), and in 2 cases (10 %), enucleation had to be performed. Viscoelastic filling material was suggested the most likely source of infection. Endophthalmitis caused by Fusarium spp. are a potentially big threat for patients with serious impact on vision. Successful management of the infection is highly dependent on early diagnosis including species identification and antifungal susceptibility testing, and on aggressive and long-term treatment. PMID:24381050

Buchta, Vladimír; Feuermannová, Alena; Váša, Martin; Bašková, Lenka; Kutová, Radka; Kubátová, Alena; Vejsová, Marcela

2014-02-01

 
 
 
 
301

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

Scientific Electronic Library Online (English)

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

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

2006-03-01

302

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

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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

303

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

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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

304

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

305

A Comparative Study of Surgically Induced Astigmatism in Superior and Temporal Scleral Incision in Manual Small Incision Cataract Surgery  

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Full Text Available Aim: To evaluate the amount and type of surgically induced astigmatism in superior and temporal scleral incision in Manual Small Incision Cataract Surgery (MSICS. Material and Methods: A prospective randomized comparative study was carried out in 100 cases of senile or pre-senile cataract. All the patients underwent MSICS under peribulbar anaesthesia. The patients with very hard cataract were excluded so as to keep the incision size uniformity (6-6.5mm. 50 cases received superior scleral incision and 50 cases received temporal scleral incision. Post operative astigmatism was studied in both groups using Bausch & Lomb Keratometer on 1st day, 7th day, 6th week and 3rd month. Results: After 3 months of surgery, out of 50 patients in superior scleral incision group 74% patients had ATR astigmatism and 16% patients had WTR astigmatism whereas in temporal scleral incision group 56 % of the patients had WTR astigmatism and 36 % had ATR astigmatism. The mean surgically induced astigmatism (SIA in temporal incision group was significantly less than the superior incision group after 3 months postoperatively (t=2.33, p<0.05. Conclusion: This study reveals that temporal approach MSICS produces less postoperative astigmatism and has manifold advantages over superior incision MSICS with excellent visual outcome. [Natl J of Med Res 2012; 2(4.000: 497-500

Renu M Magdum

2012-08-01

306

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

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

Hui Na

2013-04-01

307

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

308

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

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Full Text Available 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 increasing number of patients will suffer from cataract and AMD at the same time. This coincidence leads to a greater interest in the question of a mutual influence of both diseases, respectively their therapies, on each other. Objectives: The aim of this report was the evaluation of the medical and health economic effects of cataract operations on the development and progression of an age related macular degeneration (AMD. It was differentiated between first manifestations of AMD, progression of early stages of AMD and influence on further impairment in late stages of AMD. Methods: The relevant publications for this report were identified by DIMDI via structured database enquiry as well as common, self-made enquiry and were evaluated, based on the criteria of evidence based medicine. The present report included German and English literature published since 1983. Results: The database enquiry generated a record of 2769 issue-related publications. Eight medical publications were eligible for analysis in the course of the present HTA report. No relevant studies on health economical, ethical, social or legal issues could be included. Three epidemiological cohort studies provided some evidence for a promoting influence of cataract extractions on the progression of early types of AMD. Two of the epidemiological studies assessed the risk of first manifestation of AMD after cataract extraction. Both came up with up with increased incidences that did not reach statistical significance despite a large number of participants. Only one out of two clinical studies looked at further impairment in late stages of AMD and could not find an interrelation with cataract extraction. Thus the available evidence was not sufficient to come to a conclusion on the contribution of cataract extractions to the first manifestation of AMD and to the further impairment in late stages. Discussion: The presentation of the evaluated literature made clear that only a small number of publications dealt with the development of age related macula degeneration in consequence of a cataract extraction. The overall scientific level of evidence of these articles was not very high. Therefore it was not possible to obtain a well-defined conclusion on the effect of a cataract extraction on the development or progression of an age related macula degeneration. Conclusion: Additional well conducted clinical trials, that offer a sufficient number of patients, length of study period and adequate control for confounding variables like age and severity of cataract, are urgently needed. Health economic, ethical, social and legal aspect of the problem could and should be investigated after clarification of the mentioned medical issues.

Willich, Stefan N.

2006-12-01

309

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

310

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

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

J. Pareja-Esteban

2009-12-01

311

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

312

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

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

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

2010-12-01

313

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

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Conocer la efectividad de varios antibióticos en colirio para eliminar la flora conjuntival de los pacientes que se operan de cataratas y diferenciar los fracasos del tratamiento debidos a la falta de sensibilidad «in vitro» de las bacterias, de otras posibles causas. Método: Estudio retro [...] spectivo de la flora conjuntival preoperatoria de 4.876 pacientes consecutivos; análisis de su sensibilidad «in vitro» agrupando las bacterias en ocho categorías; comparación de los porcentajes de susceptibilidad de la flora total a 5 antimicrobianos. Evaluación de la eficacia de los tratamientos con colirio de un solo antibiótico (Aureomicina, Cloranfenicol, Gentamicina, Norfloxacina ó Rifamicina), de sensibilidad probada, en los pacientes con bacterias conjuntivales patógenas. Resultados: La sensibilidad «in vitro» de nuestra flora a Rifampicina (83,9%) y Cloranfenicol (84,4%) fue similar (p Abstract in english Objective: To ascertain the effectiveness of various antibiotic eye-drops in eradicating the preoperative conjunctival bacteria of patients undergoing cataract surgery and to differentiate the failure of these treatments due to the lack of «in vitro» sensibility from other possible causes. Methods: [...] Retrospective study of the preoperative conjunctival flora of 4876 consecutive patients; «in vitro» sensibility was analysed by grouping bacteria into eight categories; the susceptibility percentages of the total conjunctival flora to five antibacterial agents were compared. The effectiveness of the eye-drop treatment with a single sensitive tested antibiotic (Aureomicin, Chloramphenicol, Gentamicin, Norfloxacin or Rifamicin) was evaluated in patients with pathogen bacteria. Results: The «in vitro» sensibilities of Chloramphenicol (84.4%) and Rifampicin (83.9%) were similar (p

E, Fernández Rubio; T, Cuesta Rodríguez; C, Cortés Valdés.

2004-05-01

314

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

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

H Zahedi

2004-10-01

315

Influence of two types of cataract surgery on corneal endothelial cells  

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

Li-Ping Chen

2013-11-01

316

Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial  

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BACKGROUND—Cataract extraction constitutes the largest surgical workload in ophthalmic units throughout the world. Extracapsular cataract extraction (ECCE), through a large incision, with insertion of an intraocular lens has been the most widely used method from 1982 until recently. Technological advances have led to the increasing use of phacoemulsification (Phako) to emulsify and remove the lens The technique requires a smaller incision, but requires substantial capital investment in the...

Minassian, D.; Rosen, P.; Dart, J.; Reidy, A.; Desai, P.; Sidhu, M.

2001-01-01

317

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

318

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

319

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

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

320

Long-Term Efficacy and Rotational Stability of AcrySof Toric Intraocular Lens Implantation in Cataract Surgery  

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Purpose To evaluate the long-term efficacy and rotational stability of the AcrySof toric intraocular lens (IOL) in correcting preoperative astigmatism in cataract patients. Methods This prospective observational study included 30 eyes from 24 consecutive patients who underwent implantation of an AcrySof toric IOL with micro-coaxial cataract surgery between May 2008 and September 2008. Outcomes of visual acuity, refractive and keratometric astigmatism, and IOL rotation after 1 day, 1 month, 3 months, and long-term (mean, 13.3±5.0 months) follow-up were evaluated. Results At final follow-up, 73.3% of eyes showed an uncorrected visual acuity of 20/25 or better. The postoperative keratometric value was not different from the preoperative value; mean refractive astigmatism was reduced to -0.28±0.38 diopter (D) from -1.28±0.48 D. The mean rotation of the toric IOL was 3.45±3.39 degrees at final follow-up. One eye (3.3%) exhibited IOL rotation of 10.3 degrees, the remaining eyes (96.7%) had IOL rotation of less than 10 degrees. Conclusions Early postoperative and long-term follow-up showed that implantation of the AcrySof toric IOL is an effective, safe, and predictable method for managing corneal astigmatism in cataract patients. PMID:20714383

Kim, Myung Hun; Chung, Tae-Young

2010-01-01

 
 
 
 
321

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

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Jian-Guo Wu, Rui-Hua Wei, Ai-Hua Liu, Xiao-Xu Zhou, Guo-Ling Sun, Xiao-Rong LiTianjin Medical University Eye Center, Tianjin, ChinaBackground: The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery.Methods: We developed a ring consisting of a single silicone component with three footplates...

X-r, Li; G-l, Sun; X-x, Zhou; A-h, Liu; R-h, Wei; J-g, Wu

2011-01-01

322

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.Eye advance online publication, 28 November 2014; doi:10.1038/eye.2014.281. PMID:25431106

Mojon, D S

2014-11-28

323

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

324

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

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

E Fernández Rubio

2004-05-01

325

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

326

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

327

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

328

Manual small incision cataract surgery under topical anesthesia with intracameral lignocaine: Study on pain evaluation and surgical outcome  

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Full Text Available The authors here describe manual small incision cataract surgery (MSICS by using topical anesthesia with intracameral 0.5% lignocaine, which eliminates the hazards of local anesthesia, cuts down cost and time taken for the administration of local anesthesia. Aims: To evaluate the patients? and surgeons? experience in MSICS using topical anesthesia with intracameral lignocaine in terms of pain, surgical complications, and outcome. Settings and Design: Prospective interventional case series. Materials and Methods: Ninety-six patients of senile cataract were operated by MSICS under topical anesthesia with intracameral lignocaine using "fish hook technique." The patients and the single operating surgeon were given a questionnaire to evaluate their experience in terms of pain, surgical experience, and complications. Statistical Analysis Used: Statistical analysis software "Analyseit." Results: There were 96 patients enrolled in the study. The mean pain score was 0.7 (SD ± 0.97, range 0-5, median 0.0, and mode 0.0. Fifty-one patients (53% had pain score of zero, that is, no pain. Ninety-one patients (~95% had a score of less than 3, that is, mild pain to none. All the surgeries were complication-free except one and the surgeon?s experience was favorable in terms of patient?s cooperation, anterior chamber stability, difficulty, and complications. The ocular movements were not affected, and hence, the eye patch could be removed immediately following the surgery. Conclusions: MSICS can be performed under topical anesthesia with intracameral lignocaine, which makes the surgery patient friendly, without compromising the outcome.

Gupta Sanjiv

2009-01-01

329

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

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

Rafael, Iribarren; Guillermo, Iribarren.

2013-06-01

330

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

331

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

332

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

333

Structural Analysis of Different Incision Sizes and Stromal Hydration in Cataract Surgery Using Anterior Segment Optical Coherence Tomography  

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Purpose To analyze healing changes of corneal wounds of different corneal incision sizes with or without stromal hydration in cataract surgery using anterior segment optical coherence tomography. Methods Cataract surgeries were performed by a single surgeon and 2.2- and 2.8-mm corneal incisions were made using a diamond blade (ME-759; Meyco, Biel-Bienne, Swiss). Patients were divided into four groups according to incision size (2.2 and 2.8 mm), and with/without stromal hydration. Fifteen eyes were assigned to each group and incision wounds were measured using anterior segment optical coherence tomography at 2 hours, 1 day, 1 week, 1 month, and 3 months postoperatively. Corneal thickness, incision length and incision angle were measured and existence of epithelial, endothelial gaping and Descemet's membrane detachment was evaluated. Results Incision thickness was greater in the group with stromal hydration than in the group without on operation day (p < 0.05). Stromal hydration exerted greater influence in the 2.2-mm incision group than in the 2.8-mm incision group. Corneal thickness decreased more rapidly in the stromal hydration group than in the group with no hydration (p = 0.022). Endothelial gaping was greater in the 2.2-mm incision group than in the 2.8-mm incision group 1 day, 1 month, and 3 months after surgery (p = 0.035, p = 0.009, and p = 0.008, respectively). No other statistical significance was observed between the two groups (2.2 and 2.8 mm) during follow-up regarding corneal thickness, epithelial gaping and Descemet's membrane detachment. Conclusions Corneal wounds with a smaller incision could be more vulnerable to external stimuli such as stromal hydration and are less stable than those with a larger incision. PMID:25646057

Bang, Jong-Wook; Lee, Jong-Hyun; Kim, Jin-Hyoung

2015-01-01

334

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

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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

335

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

336

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

337

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

338

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

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

Sérgio, Jacobovitz; Alair Rodrigues de, Araújo Júnior; Cristiano Menezes, Diniz; Heryberto da Silva, Alvim; Patrick Frensel de Moraes, Tzelikis; Roberto Martins, Gonçalves.

2003-06-01

339

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

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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

340

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

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

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

2013-04-01

 
 
 
 
341

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

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

El-Moatassem Kotb Ahmed; Gamil Mohamed

2010-01-01

342

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

343

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 SciELO Cuba | Language: Spanish Abstract in spanish 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

344

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

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

Madge Simon

2006-11-01

345

Can drugs or micronutrients prevent cataract?  

Science.gov (United States)

Cataract is the major cause of blindness and of visual impairment worldwide, so its prevention is of the greatest importance. At present no drug therapy is licensed for use in the UK or the US, so the only treatment for cataract is by surgery, which is expensive and has adverse effects. This article reviews research on prevention of cataract by a variety of agents, including micronutrients as well as drugs. Benefits have been claimed for many compounds or mixtures and this review concentrates on those most extensively studied. Information on possible benefits of putative anticataract agents comes from a variety of approaches, from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients. Sorbitol-lowering drugs were the first to be examined systematically and progressed to clinical trials which were disappointing, and now the entire rationale for their use in prevention of cataract is questionable. Micronutrients showed little promise in animals but came to clinical trial in patients with cataract without the publication of any major benefit. Pantethine showed more promise in animal studies but the only clinical trial was abandoned early. A variety of laboratory and epidemiological evidence supports the benefits of aspirin-like drugs but there has been no trial specifically in patients with cataract. Add-on studies to trials of aspirin for other indications have not been encouraging. Research into other compounds is interesting but less advanced. PMID:11482741

Harding, J J

2001-01-01

346

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

347

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

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Full Text Available Yoshiaki Kabata,1 Genichiro Takahashi,1 Hiroshi Tsuneoka21Department of Ophthalmology, Jikei University School of Medicine, Katsushika Medical Center, 2Department of Ophthalmology, Jikei University School of Medicine, Tokyo, JapanBackground: The purpose of this study was to examine neodymium:yttrium-aluminum garnet (Nd:YAG capsulotomy rates after combined cataract surgery with implantation of a three-piece 4% water content hydrophobic acrylic intraocular lens (X-70, Eternity® and vitrectomy, and compare diabetic retinopathy with nondiabetic retinopathy.Methods: Nd:YAG capsulotomy rates were evaluated for 72 eyes of 72 patients with diabetic retinopathy and 81 eyes of 81 patients with nondiabetic retinopathy (50 eyes with retinal detachment, 13 eyes with macular hole, nine eyes with epiretinal membrane, seven eyes with branch retinal vein occlusion, and two eyes with uveitis who underwent combined cataract surgery and vitrectomy and implantation of X-70.Results: Two years after combination surgery, four of 72 eyes (5.6% in the diabetic retinopathy group and four of 81 eyes (5.0% in the nondiabetic retinopathy group required Nd:YAG capsulotomies. Kaplan–Meier survival analysis showed no statistically significant differences between the two groups (P=0.30, Mantel–Cox log-rank test.Conclusion: The rate of Nd:YAG capsulotomy did not significantly differ between diabetic retinopathy and nondiabetic retinopathy after combined cataract surgery with implantation of the X-70 and vitrectomy. X-70 is an acceptable intraocular lens for patients undergoing combined cataract surgery and vitrectomy.Keywords: Nd:YAG capsulotomy rates, combined surgery, diabetic retinopathy, hydrophobic acrylic intraocular lens

Kabata Y

2013-11-01

348

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

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

Lee Teak Tan

2008-08-01

349

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

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

Yan-Xia Shi

2013-12-01

350

Comparison of clinical efficacy between phacoemulsification and small incision extracapsular cataract extraction for senile cataract  

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Full Text Available AIM: To evaluate the clinical therapeutic effects of senile cataract on phacoemulsification and small incision cataract surgery and the influence of corneal endothelium.METHODS: A retrospective analysis was performed in 296 cases of senile cataract in our hospital from Jan. 2009 to Jan. 2013 in the "Cataract extraction project". One hundred and forty cases underwent phacoemulsification treatment, whereas 156 cases received small incision extracapsular cataract extraction. The therapeutic efficacy and effects on corneal endothelial cells of the two groups were compared. RESULTS: After 3d operation, the visual acuity and corneal astigmatism in phacoemulsification group were much better than that in small incision cataract surgery group(PPP>0.05. CONCLUSION: Both phacoemulsification and small incision extracapsular cataract extraction are effective methods of treatment of cataract. However, the method of small incision cataract surgery is more economic, and it is valuable in primary hospital and the “Cataract extraction project”.

Yong Li

2014-04-01

351

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  

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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

352

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

Scientific Electronic Library Online (English)

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

Luis, Curbelo Cunill; Juan Raúl, Hernández Silva; Luis, Lanz; Meysi, Ramos López; Marcelino, Río Torres; Gilberto, Fernández Vázquez; Belkys, Rodríguez Suárez.

2007-12-01

353

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

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

Luis Curbelo Cunill

2007-12-01

354

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

355

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

356

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

357

If I Had - A Cataract at Age 70 and Had Blurred Vision  

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Full Text Available ... is a Cataract Surgery Recommended? Dr. Greenstein: The indication for cataract surgery is vision that does not ... year or two and we would have some indication as to whether a cataract had been growing ...

358

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

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Full Text Available Purpose: To compare various outcome measures using torsional mode and longitudinal mode in the phacoemulsification of cataract with different nuclear densities. Setting: Magrabi Eye Hospitals, Kingdom of Saudi Arabia. Design: A randomized comparative clinical study. Materials and Methods: This study includes 200 eyes of 156 patients (100 in the ultrasound longitudinal "US" group and 100 in the torsional group. All eyes received AcrySof® single piece intraocular lens (Alcon Surgical, Fort Worth, TX. The primary outcome measures were ultrasound time (UST, cumulative dissipated energy (CDE, and surgical complications. Postoperative outcome measures were the degree of corneal edema on the first postoperative day and final best corrected visual acuity (BCVA and CCT (central corneal thickness. Results: The differences in UST and CDE between subgroups of nucleus hardness were statistically significant (P < 0.01. The UST and CDE consistently increased in eyes with higher grades of nucleus density. On day one, the mean BCVA was 0.61 ± 0.13 decimals in the ultrasound (US group and 0.67 ± 0.11 decimals in the torsional group (significant P < 0.05.Corneal edema was significantly less in the torsional group (P < 0.05. At 30 days, the mean BCVA was 0.94 ± 0.22 decimals in the US group and 1.0 ± 0.12 decimals in the torsional group but this difference was not statistically different (P > 0.05. Conclusions: The torsional mode provides an effective and safe method for cataract removal with lower energy usage as compared to longitudinal traditional phacoemulsification. However, the final visual outcome was similar for both study groups.

El-Moatassem Kotb Ahmed

2010-01-01

359

Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial  

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Full Text Available Pipat KongsapDepartment of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandPurpose: To evaluate the effectiveness of subconjunctival anesthesia as compared to retrobulbar anesthesia for pain control during manual small-incision cataract surgery (MSICS performed by third-year residents.Design: A randomized, controlled trial.Patients and methods: A total of 150 patients undergoing routine cataract surgery were randomly assigned to receive either subconjunctival anesthesia (group 1, n = 75 or retrobulbar anesthesia (group 2, n = 75. Third-year residents performed MSICS using the modified Blumenthal technique. Subconjunctival anesthesia was administered by injecting 2% xylocaine with adrenalin into the superior conjunctiva, and retrobulbar anesthesia by injecting 2 mL of 2% xylocaine with adrenalin into the retrobulbar space. We studied the following variables: intraoperative pain score rated on a 100-point visual analog scale (VAS, operative time, and injection and operative complications.Results: A mean age of 69 vs 70 years, an operative time of 47.1 (SD, 9.9 min vs 47.7 (10.9 min, and a median (interquartile range pain score of 40 (range, 20–70 vs 40 (range, 20–50 were observed in the subconjunctival and the retrobulbar groups, respectively. The injection complication of subconjunctival hemorrhage was significantly higher in the subconjunctival group (25.3% compared to the retrobulbar group (1.3%. The operative complication rate between groups was not different (P > 0.05.Conclusion: Both, superior subconjunctival anesthesia and retrobulbar anesthesia were effective during MSICS when used in a residency training program.Keywords: subconjunctival anesthesia, retrobulbar anesthesia, cataract surgery, small-incision cataract surgery, visual analog scale, pain score

Kongsap P

2012-11-01

360

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

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

Kabata Y; Takahashi G; Tsuneoka H

2013-01-01