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Sample records for cataract surgery caused

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

    Directory of Open Access Journals (Sweden)

    Margaret Wong

    2015-12-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  3. Cataract Surgery

    Science.gov (United States)

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

  4. Cataract Surgery in Uveitis

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal

    2012-01-01

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

  5. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Guy Sallet

    2008-06-01

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

  6. Cataract surgery and anticoagulants

    NARCIS (Netherlands)

    Koopmans, SA; VanRij, G

    1996-01-01

    A questionnaire was sent to 240 members of the Netherlands Intraocular implant Club (NIOIC) to register their policy followed in 1993 with regard to anticoagulant therapy (ACT) and the use of aspirin in patients having cataract surgery. Ninety-one (32%) forms were suitable for analysis. Most eye sur

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

    Directory of Open Access Journals (Sweden)

    Takatoshi Tano

    2010-11-01

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

  8. Femtosecond laser cataract surgery

    OpenAIRE

    Nagy, Zoltan Z.; McAlinden, Colm

    2015-01-01

    Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages ...

  9. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte;

    2015-01-01

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

  10. [Keratoplasty combined with cataract surgery].

    Science.gov (United States)

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

    2012-09-01

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

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

    OpenAIRE

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

    2012-01-01

    Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income ...

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

    Science.gov (United States)

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

    2008-01-01

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

  13. Simulation-based certification for cataract surgery

    DEFF Research Database (Denmark)

    Thomsen, Ann Sofia Skou; Kiilgaard, Jens Folke; Kjaerbo, Hadi;

    2015-01-01

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

  14. Risk of Retinal Detachment After Pediatric Cataract Surgery

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Andersen, Elisabeth W; Oudin, Anna;

    2014-01-01

    , excluding cataract cases caused by trauma, or acquired systemic or acquired ocular pathology, and cases with ocular anomalies associated with the development of retinal detachment. Cases of cataract were ascertained from the mandatory Danish National Patient Register, and information on retinal detachment...... was based on medical chart review. RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3......%-11%) among cataract patients. In otherwise normal children having isolated cataract, the risk was 3% (95% CI: 0%-7%). A significantly higher risk of developing retinal detachment was found in children with mental retardation (23% [95% CI: 9%-35%]) or in cataract cases with other ocular or systemic anomalies...

  15. Glaucoma after Congenital Cataract Surgery

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    Mahmoodreza Panahi Bazaz

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Shaheer Aboobaker

    2016-01-01

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

  17. Cataract surgery in Southern Ethiopia: distribution, rates and determinants of service provision.

    OpenAIRE

    Habtamu, E.; Eshete, Z; Burton, MJ

    2013-01-01

    BACKGROUND Cataract is the leading cause of blindness worldwide, with the greatest burden found in low-income countries. Cataract surgery is a curative and cost-effective intervention. Despite major non-governmental organization (NGO) support, the cataract surgery performed in Southern Region, Ethiopia is currently insufficient to address the need. We analyzed the distribution, productivity, cost and determinants of cataract surgery services. METHODS Confidential interviews were conducte...

  18. Cataract surgery after Descemet stripping endothelial keratoplasty

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    Sunita Chaurasia

    2012-01-01

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

  19. Intraocular lens employed for cataract surgery

    International Nuclear Information System (INIS)

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

  20. Intraocular lens employed for cataract surgery

    Science.gov (United States)

    Roszkowska, A. M.; Torrisi, L.

    2014-04-01

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

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

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    Selçuk Sızmaz

    2013-10-01

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

  2. Sutureless Cataract Surgery: Principles and Steps

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    John Sandford-Smith

    2003-01-01

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

  3. Volume of Cataract Surgery and Surgeon Gender: The Florida Ambulatory Surgery Center Experience 2005 Through 2012.

    Science.gov (United States)

    French, Dustin D; Margo, Curtis E; Campbell, Robert R; Greenberg, Paul B

    2016-01-01

    Cataract is the most common surgically reversible cause of vision loss and the most common major surgical procedure performed in the United States. To understand how gender composition might affect differences in health services, we examined the surgeon gender-specific rates of routine cataract surgery performed in ambulatory surgical centers in Florida. Routine cataract surgeries were identified through the Florida Agency for Health Care Administration (AHCA) ambulatory surgery center dataset. The background of individual surgeons was determined by linking license numbers in the dataset to physician profiles publicly available from AHCA. From 2005 through 2012, women ophthalmologists in Florida performed roughly half the annual rate of cataract surgery as their male counterparts. This difference is not explained by greater time in clinical practice for men. Further investigation into the causes of this gender-volume disparity is warranted to determine what roles choice and barriers may play.

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

    Directory of Open Access Journals (Sweden)

    Arelys Caraballo Díaz

    2012-03-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    PURPOSE: To investigate the amount of endothelial cell loss (ECL) and refractive predictability by femtosecond laser-assisted cataract surgery (FLACS) compared to conventional phacoemulsification cataract surgery (CPS). METHODS: Forty-seven patients had one eye operated by FLACS and the contralat......PURPOSE: To investigate the amount of endothelial cell loss (ECL) and refractive predictability by femtosecond laser-assisted cataract surgery (FLACS) compared to conventional phacoemulsification cataract surgery (CPS). METHODS: Forty-seven patients had one eye operated by FLACS...

  6. Spontaneous corneal perforation post cataract surgery

    OpenAIRE

    Chaudhary, Rishika; Mushtaq, Bushra

    2011-01-01

    A 69-year-old female was referred for bilateral cataracts. Best-corrected visual acuity was 6/12 oculus dexter (OD) and 6/18 oculus sinister (OS). On examination, tear film breakup time was 8 s, signifying mild dry eyes; otherwise was unremarkable. The patient underwent uneventful left cataract surgery. At a 1 month postoperative examination vision was 6/9. The left cornea was dry with extensive punctuate epithelial erosions. There was no lagophthalmos. Lubricants were started to both eyes. T...

  7. Cataract surgery following KAMRA presbyopic implant

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    Tan TE

    2013-09-01

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

  8. Clinical-epidemiological behaviour of patients after cataract surgery

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    Leydi E. Jacomino Hernández

    2010-12-01

    Full Text Available Background: Cataract is the leading cause of blindness in the world. Its only effective treatment is surgery, with a high rate of efficiency, but it is not always practiced due to several reasons that limit access to health services.Objective: To identify clinical and epidemiological behaviour of patients after cataract surgery. Methods: An observational, descriptive and cross-sectional study conducted in the "José Joaquín Palma" Ophthalmology Center in the town of San Cristóbal, Guatemala. We included all patients over 18 years old meeting the inclusion criteria who had had a cataract surgery between July and December 2007. The following variables were analyzed: age, sex, skin color, place of origin, ocular and systemic personal medical history, etiologic type of cataract and intra and immediate postoperative complications. Results: 63.3% of the patients are in the 60 years on age group, with a slight predominance of females (51.89% and most of them come from the rural areas (66.66%. Among personal medical histories myopia was detected (14.17% and among systemic medical histories there were arterial hypertension (25.98% and diabetes mellitus (22.04%. Senile cataract was more frequent (52.75%. The most frequent intraoperative complications were posterior capsule ruptures with or without vitreous loss (29.548% and 3.37% respectively and corneal edema in the immediate postoperative (5.48%. Conclusions: The results of clinical and epidemiological characterization of patients after cataract surgery included in this series do not differ from those of similar studies, except for the personal glaucoma history.

  9. Femtosecond laser in refractive and cataract surgeries

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Robert Lindfield

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

    Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO). Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved. PMID:22944761

  12. Surgical magnification for intracapsular cataract surgery in a rural hospital

    OpenAIRE

    Braganza Andrew; Cheng Arthur; Thomas Ravi; Muliyil Jayaprakash

    1996-01-01

    Intracapsular cataract extraction is still the most common type of operation performed in India, especially in eye camps, and most of these are done without magnification. To assess the surgical outcome of intracapsular cataract surgery in a rural hospital with various magnifying systems, 121 consecutive eyes (121 patients) with uncomplicated cataract were randomly allocated to surgery with the operating microscope, binocular loupe or unaided eye. The surgery was performed by either consultan...

  13. How to prevent endophthalmitis in cataract surgeries?

    Directory of Open Access Journals (Sweden)

    Kelkar Aditya

    2008-01-01

    Full Text Available Postoperative endophthalmitis is a very devastating complication and every step should be taken to reduce its occurrence. Unattended air conditioning filter systems are often the culprits and regular maintenance of the filters is of paramount importance. Shedders of pathogenic organisms amongst the theater personnel should be identified by regular screening and should be promptly treated. In addition to the use of Povidone iodine 5% solution in the conjunctival sac few minutes prior to surgery, proper construction of wound, injectable intraocular lenses, use of prophylactic intracameral antibiotics or prophylactic subconjunctival antibiotic injection at the conclusion of cataract surgery, placing a patch after the surgery for at least 4 h and initiating topical antibiotics from the same day of surgery helps to lower the frequency of postoperative endophthalmitis. Intraoperative posterior capsule rupture and anterior vitrectomy are risk factors for acute endophthalmitis, and utmost care to prevent posterior capsular rent should be taken while performing cataract surgery. Also, in case of such complication, these patients should be closely monitored for early signs of endophthalmitis in the postoperative period. In the unfortunate event of endophthalmitis the diagnosis should be prompt and treatment must be initiated as early as possible.

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

    Science.gov (United States)

    Ogawa, Tomoichiro; Shiba, Takuya; Tsuneoka, Hiroshi

    2016-01-01

    Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on the surgical video. We examined whether use of SMC is able to demonstrate the differences in technique between experienced and trainee operators, to identify inappropriate phacoemulsification techniques from analyzing the graphs, and to elucidate the cause of intraoperative complications. Results. Significant differences in the time taken to reach maximum vacuum and the speed of increase in vacuum during irrigation and aspiration were observed between experienced and trainee operators. Analysis of the graphs displayed by SMC detected inappropriate phacoemulsification techniques mostly in cases operated by trainee operators. Conclusions. Using SMC, it was possible to capture details of cataract surgery objectively. This recording device allows surgeons to review cataract surgery techniques and identify the cause of intraoperative complication and is a useful education tool for cataract surgery. PMID:26881060

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

    Directory of Open Access Journals (Sweden)

    Tomoichiro Ogawa

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Udaya Kumar

    2015-11-01

    had difficulty in aspiration of cortical matter at subincisional area of which 2 eyes (3.3% required side port. Intraoperative miosis was prevented (100% by Adrenalin mixed BSS in study group, but it was in 8(13% eyes of controls. Postoperatively, minimal lens matter was seen in 1(1.6% eye with no post-operative reaction or Posterior Capsular Opacification (PCO at 6 months followup. Descemet’s membrane separation was nil (100% in study group, which was seen in 8(13% cases of controls at final followup of 6 months, which might be the cause for some postoperative discomfort in some patients in an otherwise normal eye. CONCLUSION Without side port cortical clean up in 360 degrees is possible in small incision cataract surgery by taking adequate measures. Use of side port may be limited to some selective cases of small pupil especially in those having exfoliation.

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

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    Lawuyi LE

    2015-07-01

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

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

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    Rajiv Khandekar

    2015-01-01

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

  19. Are entry criteria for cataract surgery justified?

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    Daniel Böhringer

    Full Text Available PURPOSE: The German Ophthalmological Society (GOS recently proposed surgical entry criteria, i.e. 300 cataract surgeries. We herein correlate the surgical hands-on experience with the risk of posterior capsule ruptures in order to assess whether this number is appropriate. METHODS: We identified all cataract operations that had been performed at the University Eye Hospital Freiburg since 1995. For each surgeon, we assigned a running number to his/her procedures in the order they had been performed. Thereafter, we excluded all combined procedures and the second eyes. We then selected the 5475 surgical reports between November 2008 and November 2012 for detailed review. We additionally classified each surgery into low- vs. high- à priori risk for posterior capsule ruptures. We fitted a multifactorial logistic regression model to assess the GOS recommendation of 300 surgeries under supervision. In the low-risk group, we additionally visualized the 'typical' learning curve by plotting the posterior capsule ruptures against the respective rank numbers. RESULTS: The odds ratio for posterior capsule ruptures of 'learning-mode' (one of the respective surgeon's 300 first procedures vs. the non-learning-mode was 3.8 (p<0.0001. By contrast, classification into the low-risk group lowered the risk of posterior capsule ruptures three fold (p<0.0001. According to the low-risk plot, the surgeons started with a complication rate of 4% and continuously improved towards 0.5% after 1500 operations. Thereafter, the rate increased again and stabilized around one percent. CONCLUSION: The learning curve with respect to posterior capsule ruptures is surprisingly flat. The GOS entry criterion of 300 cataract procedures is therefore most likely justified. Careful selection of low-risk patients for the training surgeons may help in reducing the rate of posterior capsule ruptures during training.

  20. VISUAL OUTCOME FOLLOWING SURGERY OF TRAUMATIC CATARACT

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    Prasad Rao

    2015-04-01

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

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

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    Dhaliwal Upreet

    2007-01-01

    Full Text Available Purpose: To assess the barriers for the acceptance of surgery among patients with cataract and visual disability. Materials and Methods: A short-term descriptive study was conducted in patients with cataract presenting to a hospital. Socio-demographic data were entered in a proforma. An interviewer-assisted questionnaire, surveying knowledge about cataract and barriers to cataract surgery, was administered by one of the authors (SKG in the local language (Hindi. Results: There were 100 patients (53 men and 47 women; 14 were bilaterally blind (vision < 10/200 in the better eye. Attitudinal barriers included: could manage daily work (71%, cataract not mature (68%, could see clearly with the other eye (64%, too busy (57%, female gender (37%, fear of surgery (34%, fear of surgery causing blindness (33% or death (13%, old age (33%, it is God′s will (29% and worry about cost of surgery (27%. The barriers relating to service delivery, cost, and affordability included: insufficient family income (76%, not knowing another person who had undergone cataract surgery (26%, no one to accompany (20%, distance from hospital (20% or from a main road (9% and lack of transport (7%. Conclusions: Attitudinal barriers were reported more often, rather than issues of accessibility or cost. Eye care providers should address the identified barriers for increasing acceptance of surgery in the study area.

  2. Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery

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    Adriana Maria Drummond Brandão

    2008-04-01

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

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

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    Majid Moshirfar

    2011-01-01

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

  4. Parinaud's oculoglandular syndrome and possibly causing cortical cataract

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    Mariana Heid Rocha Hemerly

    2014-06-01

    Full Text Available According to the World Health Organization, cataract is the leading cause of blindness and visual impairment throughout the world. However, the etiology of cataracts often remains unknown. This report describes the development of cortical cataract in a patient after Parinaud's oculoglandular syndrome caused by the fungus Sporothrix schenckii.

  5. Cataract surgery without anaesthesia: two descriptions by Arthur Jacob.

    Science.gov (United States)

    Haridas, R P

    2009-07-01

    Dr Arthur Jacob (1790-1874), of Dublin, Ireland, was one of the leading ophthalmologists of his time. He was the first to describe the membrane that contains the rods and cones in the eye (membrana Jacobi) and basal cell carcinoma (Jacob's ulcer). He made a curved needle for cataract surgery from a sewing needle (Jacob's needle). Two descriptions of cataract surgery without anaesthesia are presented. PMID:19705632

  6. Patient considerations in cataract surgery – the role of combined therapy using phenylephrine and ketorolac

    Science.gov (United States)

    Gonzalez-Salinas, Roberto; Guarnieri, Adriano; Guirao Navarro, María Concepción; Saenz-de-Viteri, Manuel

    2016-01-01

    Cataract, a degradation of the optical quality of the crystalline lens, progressive and age-related, is the leading cause of treatable blindness worldwide. Cataract surgery is the most common surgical procedure performed by ophthalmologists and is the only effective treatment for cataracts. Advances in the surgical techniques and better postoperative visual outcomes have progressively changed the primary concern of cataract surgery to become a procedure refined to yield the best possible refractive results. Sufficient mydriasis during cataract removal is critical to a successful surgical outcome. Poor pupil dilation can lead to serious sight-threatening complications that significantly increase the cost of surgery and decrease patients comfort. Mydriasis is obtained using anticholinergic and sympathomimetic drugs. Phenylephrine, an α1-adrenergic receptor agonist, can efficiently dilate the pupil when administered by intracameral injection. Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac, which inhibit the synthesis of prostaglandins, are used to decrease intraoperative miosis, control pain and inflammation associated with cataract surgery, and to prevent the development of cystoid macular edema following surgery. Recently, a new combination of phenylephrine and ketorolac (Omidria®) has been approved by United States Food and Drug Administration for use during cataract surgery to maintain intraoperative mydriasis, prevent miosis, and reduce postoperative pain and inflammation. Clinical trials have shown that this new combination is effective, combining the positive effects of both drugs with a good safety profile and patient tolerability. Moreover, recent reports suggest that this combination is also effective in patients with high risk of poor pupil dilation. In conclusion, cataract is a global problem that significantly affects patients’ quality of life. However, they can be managed with a safe and minimally invasive surgery

  7. Wound construction in manual small incision cataract surgery

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    Haldipurkar S

    2009-01-01

    Full Text Available The basis of manual small incision cataract surgery is the tunnel construction for entry to the anterior chamber. The parameters important for the structural integrity of the tunnel are the self-sealing property of the tunnel, the location of the wound on the sclera with respect to the limbus, and the shape of the wound. Cataract surgery has gone beyond just being a means to get the lens out of the eye. Postoperative astigmatism plays an important role in the evaluation of final outcome of surgery. Astigmatic consideration, hence, forms an integral part of incisional considerations prior to surgery.

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

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    Gadekar

    2013-10-01

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

  9. State of the Art in Pediatric Cataract Surgery.

    Science.gov (United States)

    Nischal, Kanwal Ken

    2016-01-01

    Pediatric cataract surgery has evolved dramatically in the past 10 years. Our understanding of the child's eye both in terms of tissue mechanics, neurobiological plasticity and physiological growth has allowed better and better surgical outcomes. The fact remains that the younger the child - infants especially - the more difficult the surgery. It is also true to say that not only is a child's eye not a small adult eye, but also that the child him- or herself is not a small adult. The importance of this statement is evident when we discuss the effects of anesthesia and fluid input in infants during infant cataract surgery. This chapter discusses the factors that should help give a child the best possible outcome after cataract surgery including timing of surgery, type of operation, biometry, the size and type of intraocular lens material , postoperative refraction, operative considerations, wound size and type, capsule management, anterior vitrectomy technique, wound closure and viscoelastic removal and perioperative medications. PMID:27043389

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

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte;

    2015-01-01

    on which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluating the outcome after cataract surgery according to preoperative visual acuity and visual complaints were included......The need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence-based recommendation for the indication of cataract surgery based...... in a meta-analysis. We identified eight observational studies comparing outcome after cataract surgery in patients with poor (20/40) preoperative visual acuity. We could not find any studies that compared outcome after cataract surgery in patients with few or many preoperative visual...

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

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    Yuan Rongdi

    2011-03-01

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

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

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    Aasuri Murali

    1999-01-01

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

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

    OpenAIRE

    Tomoichiro Ogawa; Takuya Shiba; Hiroshi Tsuneoka

    2016-01-01

    Purpose. This study retrospectively analyzed cataract surgeries to examine the usefulness of Surgical Media Center (SMC) (Abbott Medical Optics Inc.), a new cataract surgery recording device, for training of cataract surgery. Methods. We studied five hundred cataract surgeries conducted with a phacoemulsification system connected to the SMC. After surgery, the surgical procedures were reviewed, with changes in aspiration rate, vacuum level, and phaco power displayed as graphs superimposed on ...

  14. Effect of Cataract Surgery With Phacoemulsification on Diabetic Retinopathy

    OpenAIRE

    BİRİNCİ, H.; SEZGİN, S.; OGE, I.

    2009-01-01

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

  15. Lensectomy-vitrectomy indications and techniques in cataract surgery.

    Science.gov (United States)

    Sourdille, P

    1997-02-01

    Lensectomy-vitrectomy is the removal of the crystalline lens through a transscleral retrociliary incision (usually the pars plana) under clinical conditions in which the vitreous gel has to be partially or totally removed. It was designed in the early 1970s at the onset of modern vitreous surgery. The vitreous cutter was used to remove the lens and the vitreous (lensectomy as vitrectomy). With the development of small incision cataract surgery, foldable IOL, the term lensectomy-vitrectomy also applies to separate incisions in one procedure combining lens and vitreous surgery. With this in mind, it covers several very different situations from neonatal congenital cataracts to adult or senile-associated diseases. This type of surgery is widely accepted, and the main controversy is about the consequences of neonatal surgery and the age of IOL implantation in uni- or bilateral congenital cataracts. My personal work with laser flare and cellmetry demonstrates that pars plana vitrectomy alone creates very little trauma to the blood-aqueous barrier, as can be checked by the anterior chamber level of proteins (ie, flare). The postoperative flare in pars plana vitrectomy alone is very close to the preoperative level. Therefore, the association of pars plana vitrectomy and lens surgery should not be more traumatizing to the eye than lens surgery alone. This review will first report the consequences of neonatal lensectomy-vitrectomy to the eye. Subsequent indications for surgery and implantation will be discussed as well as special indications and complications in congenital cataracts, dislocated nucleus in cataract operation, cataract and associated vitreoretinal disorders in diabetes, and giant retinal tears and removal of the lens during vitrectomy. PMID:10168275

  16. Orbital cellulits following cataract surgery under peribulbar anaesthesia

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    Mukherjee, Chandoshi

    2015-01-01

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

  17. Patient considerations in cataract surgery – the role of combined therapy using phenylephrine and ketorolac

    Directory of Open Access Journals (Sweden)

    Gonzalez-Salinas R

    2016-09-01

    Full Text Available Roberto Gonzalez-Salinas,1,2 Adriano Guarnieri,3 María Concepción Guirao Navarro,3 Manuel Saenz-de-Viteri3 1Department of Biomedical Research, Universidad Autónoma de Querétaro, Querétaro, Mexico; 2Department of Research, Asociación para Evitar la Ceguera en México, Mexico City, Mexico; 3Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain Abstract: Cataract, a degradation of the optical quality of the crystalline lens, progressive and age-related, is the leading cause of treatable blindness worldwide. Cataract surgery is the most common surgical procedure performed by ophthalmologists and is the only effective treatment for cataracts. Advances in the surgical techniques and better postoperative visual outcomes have progressively changed the primary concern of cataract surgery to become a procedure refined to yield the best possible refractive results. Sufficient mydriasis during cataract removal is critical to a successful surgical outcome. Poor pupil dilation can lead to serious sight-threatening complications that significantly increase the cost of surgery and decrease patients comfort. Mydriasis is obtained using anticholinergic and sympathomimetic drugs. Phenylephrine, an α1-adrenergic receptor agonist, can efficiently dilate the pupil when administered by intracameral injection. Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs like ketorolac, which inhibit the synthesis of prostaglandins, are used to decrease intraoperative miosis, control pain and inflammation associated with cataract surgery, and to prevent the development of cystoid macular edema following surgery. Recently, a new combination of phenylephrine and ketorolac (Omidria® has been approved by United States Food and Drug Administration for use during cataract surgery to maintain intraoperative mydriasis, prevent miosis, and reduce postoperative pain and inflammation. Clinical trials have shown that this new combination is effective

  18. Long-Term Results of Cataract Surgery in Patients with Unilateral Childhood Cataract

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    Suzan Güven Yılmaz

    2012-03-01

    Full Text Available Pur po se: To evaluate the long-term visual outcome and to determine the surgical complications after cataract surgery in patients with unilateral childhood cataract. Ma te ri al and Met hod: We retrospectively reviewed the records of 18 cases with unilateral childhood cataract who had undergone cataract surgery before the age of seven. Primary intraocular lens (IOL implantation was made in children who were older than 1 year of age. Secondary IOL implantation was made after 18 months in children who were operated before the age of 1 year and were left aphakic. Occlusion therapy was performed to all children for amblyopia postoperatively. Visual acuity and complications were evaluated in a mean follow-up period of 4.8 years. Re sults: The mean age of the 18 patients (9 female/9 male at the time of surgery was 43.6±33.7(1-84 months. Eleven (61% patients had cataract surgery after 1 year of age. Secondary IOL implantation was performed at mean 28th month in 4 of 7 aphakic patients (57% who had cataract surgery before one year of age. In 3 (43% aphakic patients, secondary IOL implantation could not be performed because of ocular pathologies such as microophthalmia. Final visual acuity was 0.5 or better in 7 eyes (39%, between 0.1 and 0.5 in 6 eyes (33%, and worse than 0.1 - in 5 eyes (28%. Of 5 eyes that had visual acuity worse than 0.1, 4 (80% had at least one additional ocular pathology such as microphthalmia, strabismus and nystagmus. Nd:YAG laser posterior capsulotomy was performed at mean 8th month in 7 of 8 (87% children whose posterior capsules were left intact at surgery. Dis cus si on: Favorable visual outcomes can be achieved with surgical intervention and complementary amblyopia treatment in children with unilateral cataract. Preoperative microphthalmia, nystagmus and strabismus are not entirely an obstacle to visual development, but they are important factors leading to low visual acuity. (Turk J Ophthalmol 2012; 42: 103-10

  19. Cataract Surgery with a Refractive Corneal Inlay in Place

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    N. R. Stojanovic

    2015-01-01

    Full Text Available Purpose. To present a case of cataract surgery performed in a patient with a refractive corneal inlay in place. Methods. A 48-year-old female patient presented to our institute with bilateral cataract. The patient had undergone refractive corneal inlay implantation three years ago in her right, nondominant eye for presbyopia correction. Biometry and intraocular lens (IOL power calculation were performed without removing the inlay. Phacoemulsification and IOL insertion were carried out in both eyes in a usual manner. Results. On day one postoperatively, the patient achieved binocular uncorrected distance visual acuity 20/20 and uncorrected near visual acuity J1. The vision remained stable during the one-year follow-up period. Conclusion. Cataract surgery was performed in a standard manner in a patient with Presbia Microlens corneal inlay in place. Visual outcomes for both near and distance vision were satisfactory.

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

    Directory of Open Access Journals (Sweden)

    Armando Rafael Milanés Armengol

    2012-11-01

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

  1. Cataract Surgery for Tilted Lens in Peters' Anomaly Type 2

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    Tadayuki Nishide

    2013-09-01

    Full Text Available Background: Cases of cataract surgery without penetrating keratoplasty in patients with Peters' anomaly are very rare. We report a case of Peters' anomaly type 2 with tilted lens due to synechia between the lens and iris that was treated with cataract surgery without penetrating keratoplasty. Case Presentation: A 16-year-old girl had Peters' anomaly in both eyes. Corneal opacity was severe in the left eye due to high-grade dysgenesis of the anterior segment. In the right eye, corneal opacity had spread from the center of the cornea to the inferotemporal side, and there was synechia between the iris and corneal endothelium from the inferonasal side to the inferotemporal side. Opacity was observed in the anterior pole of the lens, and there was synechia between the anterior iris and the lens. Ultrasound biomicroscopy (UBM revealed that the lens was tilted because of synechia. The tilted lens induced astigmatism, which reduced visual acuity to 20/250, in conjunction with a cataract. Cataract surgery was performed; the synechia between the lens capsule and the iris was severed, an intraocular lens was inserted, and the tilt was repaired. UBM was used postoperatively to confirm that the lens capsule synechia had been corrected and that the intraocular lens was not tilted. As a result, visual acuity improved to 20/100; glaucoma and expansion of corneal opacity were not observed. Conclusions: Severing of the synechia between the cataract and iris, during cataract surgery, in a patient with Peters' anomaly type 2 resulted in favorable postoperative visual acuity.

  2. [Laser phacoemulsification--a method of cataract surgery].

    Science.gov (United States)

    Filip, M; Măgureanu, M; Barbu, C; Manga, C; Gregorian, F

    2001-01-01

    Today, ultrasound phacoemulsification is the most used method of cataract surgery. Because the side effects (injury of corneal endothelium and other nearly tissues), was tried to find alternative energy forms. Erbium laser was proven to be the most effective method among all of these. PMID:11519335

  3. The Effect of Cataract Surgery on Circadian Photoentrainment

    DEFF Research Database (Denmark)

    Brøndsted, Adam Elias; Sander, Birgit; Haargaard, Birgitte;

    2015-01-01

    of cataract surgery on circadian photoentrainment and to determine any difference between blue-blocking and neutral intraocular lenses (IOLs). DESIGN: The study was a single-center, investigator-driven, double-masked, block-randomized clinical trial. PARTICIPANTS: One eye in 76 patients with bilateral age...

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

    OpenAIRE

    Marseille, E.

    1996-01-01

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

  5. Maximal mydriasis evaluation in cataract surgery

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    Ho Tony

    1992-01-01

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

  6. Explicit criteria for prioritization of cataract surgery

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    Escobar Antonio

    2006-03-01

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

  7. Visco chop-a new technique for nucleus separation for soft cataracts in femtolaser assisted cataract surgery

    Institute of Scientific and Technical Information of China (English)

    Sri; Ganesh; Sheetal; Brar

    2015-01-01

    <正>INTRODUCTION Femtosecond laser technology,introduced clinically for ophthalmic surgery as a technique for creating lamellar flaps in laser in situ keratomileusis(LASIK),has recently been developed into a tool for cataract surgery.Preliminary experience for femtosecond laser-assisted cataract surgery show appropriate safety and efficacy,and possible advantage over conventional cataract surgery[1-4].The ability of the femtosecond laser to fragment the lens results in the need for less ultrasound energy to be expended inside the eye.Several studies indicate that less effective phacoemulsification time is needed to emulsify the lens

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

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    Davis Jennifer C

    2012-09-01

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

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

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    Sylvia Shirima

    2009-06-01

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

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

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Tendal, Britta;

    2016-01-01

    TOPIC: We performed a systematic review and meta-analysis to evaluate the benefit and harms associated with implantation of toric intraocular lenses (IOLs) during cataract surgery. Outcomes were postoperative uncorrected distance visual acuity (UCDVA) and distance spectacle independence. Harms were...... evaluated as surgical complications and residual astigmatism. CLINICAL RELEVANCE: Postoperative astigmatism is an important cause of suboptimal UCDVA and need for distance spectacles. Toric IOLs may correct for preexisting corneal astigmatism at the time of surgery. METHODS: We performed a systematic...

  11. αA crystallin may protect against geographic atrophy-meta-analysis of cataract vs. cataract surgery for geographic atrophy and experimental studies.

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    Peng Zhou

    Full Text Available BACKGROUND: Cataract and geographic atrophy (GA, also called advanced "dry" age-related macular degeneration are the two major causes of visual impairment in the developed world. The association between cataract surgery and the development of GA was controversial in previous studies. METHODS/PRINCIPAL FINDINGS: We performed a meta-analysis by pooling the current evidence in literature and found that cataract is associated with an increased risk of geographic atrophy with a summary odds ratio (OR of 3.75 (95% CI: 95% CI: 1.84-7.62. However, cataract surgery is not associated with the risk of geographic atrophy (polled OR=3.23, 95% CI: 0.63-16.47. Further experiments were performed to analyze how the αA-crystallin, the major component of the lens, influences the development of GA in a mouse model. We found that theαA-crystallin mRNA and protein expression increased after oxidative stress induced by NaIO(3 in immunohistochemistry of retinal section and western blot of posterior eyecups. Both functional and histopathological evidence confirmed that GA is more severe in αA-crystallin knockout mice compared to wild-type mice. CONCLUSIONS: Therefore, αA-crystallin may protect against geographic atrophy. This study provides a better understanding of the relationship between cataract, cataract surgery, and GA.

  12. Prevalence of myopic shifts among patients seeking cataract surgery

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    Rafael Iribarren

    2013-06-01

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

  13. DEPLOYMENT OF SIX SIGMA METHODOLOGY IN PHACOEMULSIFICATION CATARACT SURGERY

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    Ibrahim SAHBAZ

    2014-04-01

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

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

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    Madhu

    2014-02-01

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

  15. Impact of Cataract Surgery on the Psychological State of the Elderly

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    Bárbara Nuria Suárez Rodríguez

    2011-04-01

    Full Text Available Background: Progressively aging populations are one of the most distinctive demographic phenomena of the last decades. The elderly represent a particular risk group because typical characteristics of this stage of life, commonly associated with loss, are added to regular causes of psychopathologic disorders in today's social life. Objective: To assess the impact of cataract surgery on the psychological state of the elderly. Methods: A descriptive correlational study was conducted. The sample included 80 elder patients who attended the outpatient cataract pre-surgery consultation in the General University Hospital of Cienfuegos. They all presented some kind of affective disorder. The following psychosocial variables were analyzed: anxiety, depression, self-esteem and lifestyle. Sociodemographic variables such as age, sex, skin color, personal address, people they live with, education and occupation were also considered. Results: Predominant groups were those of females, white skinned, over 71 years old, average school level, married, living in urban residences and within a multigenerational household. Depression levels were high (30 % before surgery. After surgery they decreased in a 5 %. High levels of anxiety also decreased from 53 % to 10 %. Inadequate self-esteem before surgery (65 % decreased to 20 % after surgery. Conclusions: Cataract surgery has a favorable effect on the psychological status of the elderly.

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

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    Sonal S Khatavkar

    2009-01-01

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

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

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    Leonor Rosario Diaz Alfonso

    2010-11-01

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

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

    OpenAIRE

    Bockelbrink, A; Rasch, A; Roll, S.; Willich, SN; Greiner, W

    2006-01-01

    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 ...

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

    OpenAIRE

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

    2006-01-01

    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...

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

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    R Muralidhar

    2013-01-01

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

  1. [Progresses in antiinflamatory treatment in cataract surgery].

    Science.gov (United States)

    Stefan, C; Pop, Adina; Cojocaru, Inga

    2011-01-01

    Anti-inflamatory medication is commonly used to reduce inflammation, edema and symptoms associated with allergies, trauma and infections diseases. Topical nonsteroidial anti-inflammatory (NSAIDs) and topical corticosteroids are overview of the role of topical NSAIDs and the progress of their use in eye surgery

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

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    Heloisa Neumann Nogueira

    2015-04-01

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

  3. Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in white cataract

    Science.gov (United States)

    Titiyal, Jeewan S; Kaur, Manpreet; Singh, Archita; Arora, Tarun; Sharma, Namrata

    2016-01-01

    Purpose To compare femtosecond laser-assisted capsulotomy with conventional manual capsulorhexis in cases of white cataract. Patients and methods The prospective comparative study enrolled 80 eyes (80 patients) with white cataract that underwent either femtosecond laser-assisted cataract surgery (Group I, n=40) or conventional manual phacoemulsification (Group II, n=40) at a tertiary care ophthalmic institution. The groups were divided based on the patient’s choice and affordability of the procedure. Capsulotomy/capsulorhexis was evaluated in terms of size, circularity index (4Π [area/perimeter2]), intraocular lens coverage, and continuity. Each group was further subdivided based on the release of white milky fluid on initiation of the capsulotomy/capsulorhexis, and the “fluid” cases were compared with the “no-fluid” cases. The primary outcome measure was capsulotomy/capsulorhexis characteristics in the two groups. The secondary outcome measures were intraoperative phacoemulsification parameters, intraoperative complications, and postoperative visual acuity. Results The size of the capsulotomy/capsulorhexis was 4.9±0.1 mm in Group I and 5.3±0.4 mm in Group II (P<0.001). Mean circularity index was 0.996±0.003 and 0.909±0.047 in Groups I and II, respectively (P<0.001). In Group I, free-floating circular capsulotomies were obtained in 52.5% (21/40) eyes; 37.5% (15/40) eyes had microadhesions; and 10% (4/40) eyes had incomplete capsulotomy in 1–2 clock hours. The incidence of residual adhesions was more in cases with release of white milky fluid (P=0.003). In Group II, a multistep capsulorhexis was performed in 70% (28/40) of the eyes. There was no difference in terms of visual outcomes and intraoperative complications. Conclusion Femtosecond laser-assisted cataract surgery has the advantage of creating a circular and optimally sized capsulotomy in cases of white cataract. The release of white milky fluid during femtosecond laser delivery is the most

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

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    Bansal R

    1992-01-01

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

  5. Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery

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    Prajna N

    1998-01-01

    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.

  6. Strabismus and Nystagmus Following Cataract Surgeries in Childhood

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    Ayşe Yeşim Oral

    2012-03-01

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

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

    OpenAIRE

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

    2015-01-01

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

  8. Changes in anterior chamber flare and cells following cataract surgery.

    OpenAIRE

    Shah, S. M.; Spalton, D. J.

    1994-01-01

    The laser flare cell meter allows rapid non-invasive quantification of aqueous flare and cells. In this prospective study laser photometry was used to document the recovery of the blood-aqueous barrier in 27 normal eyes following cataract surgery. Aqueous flare and cells were highest on the first postoperative day, declining rapidly in the first week and returning to preoperative levels by 3 months. In six eyes (22.2%) there was an increase in either flare and cells or flare alone during the ...

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

    Directory of Open Access Journals (Sweden)

    Salman Amjad

    2006-01-01

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

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

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit;

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2014-01-01

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

  12. IMPROVEMENT IN VISION FOLLOWING CATARACT SURGERY: A COMPARISON OF PHACOEMULSIFICATION AND SMALL INCISION CATARACT SURGERY (SICS TECHNIQUES

    Directory of Open Access Journals (Sweden)

    Abraham

    2016-03-01

    Full Text Available INTRODUCTION Phacoemulsification is the method of choice in most of the western nations and tertiary care ophthalmology centres in India, while manual small incision cataract surgery (MSICS is the surgical technique preferred by most of the ophthalmic surgeons working in smaller centres. Many studies have indicated that the MSICS technique is preferable for smaller centres, especially in developing countries, as the duration of surgery and requirement of equipment tends to be much smaller. This study was aimed at comparing the outcomes of MSICS and phacoemulsification surgeries carried out over a period of three months at a tertiary care hospital in South India. MATERIALS AND METHODS Patients diagnosed to have age related cataract and undergoing surgery in this institution were included in the study. The choice of surgical intervention was based on the preference of the operating surgeon and choice of the patient. The patients were followed up at the end of one week on their review visit to the outpatient department of the hospital. The incidence of postoperative complications was enquired, apart from measurement of visual acuity and corneal diameters. RESULTS A total of 106 participants were included in the study. Eighty percent of the patients who underwent phacoemulsification had some improvement in vision, while 81.9% of the participants in the MSICS group showed improvement, (p-0.825, only one participant had a complication related to the surgery, and he belonged to the MSICS group. The changes in K1 (p-0.547 and K2 (p-0.698 corneal diameters during surgery was also not significantly different between the groups. CONCLUSIONS It was observed that MSICS and phacoemulsification procedures have similar outcomes when used at a tertiary care teaching hospital in South India. A large multicentric Randomised Control Trial (RCT is warranted to compare the outcomes of the two surgical procedures and the cost-effectiveness of each, before concrete

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

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2008-03-01

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

  14. Perioperative prophylaxis for endophthalmitis after cataract surgery in Iran

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    Marzieh Katibeh

    2015-01-01

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

  15. Clinical features and treatment of endophthalmitis after cataract surgery.

    Science.gov (United States)

    Zhu, J; Li, Z H

    2015-01-01

    The aim of this study was to investigate the clinical features and treatment results of endophthalmitis after cataract surgery. Five patients with endophthalmitis after phacoemulsification with intraocular lens implantation were enrolled in this study. The pathogenesis, clinical manifestation, and surgical outcomes of 5 patients were compared. Three patients were surgically treated with anterior chamber irrigation and vitrectomy with intravitreal injection. The remaining two patients were medically treated with an intravitreal injection of vancomycin and ceftazidime. Treatment results of the five patients were analyzed. Four patients had positive cultures for bacteria (two cases Staphylococcus epidermidis, one case Enterococcus faecalis, and one case head-like Staphylococcus). The culture of the fifth patient did not have bacterial growth. One year following treatment, four patients had restored visual acuity and a clear vitreous cavity. Retinal detachment and other complications were not observed. The remaining patient had a visual acuity of index at 30 cm one year following treatment. For patients with endophthalmitis after cataract surgery, a biochemical laboratory examination should be promptly performed and should include a bacterial culture and drug sensitivity test. When necessary, vitrectomy combined with an intravitreal injection of vancomycin should be performed to treat the infection early and to help retain useful vision. PMID:26125869

  16. Conjunctival sac bacterial flora isolated prior to cataract surgery

    Directory of Open Access Journals (Sweden)

    Suto C

    2012-01-01

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

  17. Update and clinical utility of the LenSx femtosecond laser in cataract surgery

    Science.gov (United States)

    Roberts, Timothy V; Lawless, Michael; Sutton, Gerard; Hodge, Chris

    2016-01-01

    The introduction of femtosecond lasers to cataract surgery has been the major disruptive technology introduced into ophthalmic surgery in the last decade. Femtosecond laser cataract surgery (FLACS) integrates high-resolution anterior segment imaging with a femtosecond laser allowing key steps of cataract surgery to be performed with computer-guided laser accuracy, precision, and reproducibility. Since the introduction of FLACS, there have been significant advances in laser software and hardware as well as surgeon experience, with over 250 articles published in the peer-reviewed literature. This review examines the published evidence relating to the LenSx platform and discusses surgical techniques, indications, safety, and clinical results.

  18. Nursing Care of the Laryngeal Mask Airway in Pediatric Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    Aihuan Chen; Ronghua Ye; Yanchan Liu; Weici Liu; Jingyi Lin

    2014-01-01

    Purpose:To investigate the important experience of nursing care of the laryngeal mask airway (LMA) in children under-going cataract surgery. Methods: Fifty-five children undergoing cataract surgery were anesthetized by inhaling sevoflurane through a LMA and re-ceived perioperative nursing care. The safety of perioperative nursing for these children was also evaluated. Results:Through perioperative nursing care and psychological counseling for children with LMA,.all patients were anes-thetized without complications and underwent successful surgeries..No severe postoperative complications were ob-served. Conclusion: Nursing care specific for LMA is a vital part of the success of anesthesia and pediatric cataract surgery.

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

    OpenAIRE

    Juan C. Medina Perdomo; Idalia Triana Casado; Leydi E. Jacomino Hernández

    2010-01-01

    Background: Cataract is the leading cause of blindness in the world. Its only effective treatment is surgery, with a high rate of efficiency, but it is not always practiced due to several reasons that limit access to health services. Objective: To identify clinical and epidemiological behaviour of patients after cataract surgery. Methods: An observational, descriptive and cross-sectional study conducted in ...

  20. Development of cataract caused by diabetes mellitus: Raman study

    Science.gov (United States)

    Furić, Krešimir; Mohaček-Grošev, Vlasta; Hadžija, Mirko

    2005-06-01

    originate in nonenzimatically glycated proteins. The maximum of possible binding ends after approximately 4 months (cataract degree 4), but the water continues to enter the tissue and resides in water agglomerates. The lens impairing caused by fluorescent light scattering on aberrant glycoproteins and other fluorescent centers appears first and is usually associated with the ageing cataract, while deterioration of lens properties caused by increased binding of water steadily rises with glucose and is characteristic of diabetic cataract. This interpretation is in agreement with electron microscopy results of other groups and with our preliminary findings obtained with light microscopy.

  1. Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation

    Science.gov (United States)

    Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

    2016-01-01

    Abstract The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement. This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China. Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I—capsule with mild opacification but no invasion into the capsule opening; Type II—capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III—capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed. The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I—120 eyes (38.1%); Type II—157 eyes (49.8%); Type III—38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = −0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = −0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type

  2. Congenital cataract

    Science.gov (United States)

    ... both eyes. Moderate to severe cataracts that affect vision, or a cataract that is in only 1 eye, will need to be treated with cataract removal surgery. In most (noncongenital) cataract surgeries, an artificial intraocular lens (IOL) is inserted into the eye. ...

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

    OpenAIRE

    Monestam, E.; Wachtmeister, L.

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ravindra M

    2009-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

    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

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

    LENUS (Irish Health Repository)

    Saeed, Ayman

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Ruchi Goel

    2012-01-01

    Full Text Available 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, requirement of additional procedure and complications, if any. Results. Capsular bag retention in subluxated lenses is possible in 90% cases in phacoemulsification versus 76.67% cases in MSICS (=0.16. Both groups, achieved similar best corrected visual acuity (=0.73, although additional procedures, intraoperative, and postoperative complications were more common in MSICS. Conclusions. Achieving intact capsulorhexis and nuclear rotation in MSICS may be difficult in cases with large nucleus size and severe subluxation, but subluxated cataracts can be effectively managed by both phacoemuslification and MSICS.

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

    Science.gov (United States)

    Venkatesh, Rengaraj; Veena, Kannusamy; Ravindran, Ravilla D

    2009-01-01

    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. PMID:19075402

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

    Directory of Open Access Journals (Sweden)

    Venkatesh Rengaraj

    2009-01-01

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

  10. Dealings between Cataract and Retinal Reattachment Surgery in PVR

    Directory of Open Access Journals (Sweden)

    Svenja Deuchler

    2016-01-01

    Full Text Available Introduction. To evaluate the impact of the eye lens status and oil side effects on the outcome of vitreoretinal surgery in retinal detachment with proliferative vitreoretinopathy (PVR and a temporary silicone oil tamponade (SOT. Methods. 101 eyes were analyzed retrospectively and 103 eyes prospectively in regard to their retinal reattachment success rate and key factors for the outcome. Subgroup analysis of 27 eyes with Scheimpflug lens photography (SLP before and after retinal reattachment service with SOT was performed. For SLP (65% phakic eyes a Pentacam densitometry reference body with 3 mm diameter was chosen and 3 segments (anterior/mid/posterior were evaluated separately after a quality check. Results. The retinal reattachment rate was highest in the prospective pseudophakic group (p=0.039. Lens transparency loss occurred earlier in middle aged patients than in younger patients. Besides the nucleus, layers posterior and anterior to it showed specific transparency changes. The emulsification rate was higher when eyes had been operated on in the anterior chamber before retinal reattachment service. Conclusions. Retinal reattachment surgery seems to benefit from preoperative cataract removal. We found significant lens changes in the nucleus as well as in the layers anterior and posterior to it. This corresponds to the histology of the lens epithelium published before.

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

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    Vasantha Kumar

    2015-05-01

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

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

    OpenAIRE

    Venkatesh Rengaraj; Veena Kannusamy; Ravindran Ravilla

    2009-01-01

    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...

  13. Profitability analysis of a femtosecond laser system for cataract surgery using a fuzzy logic approach

    Science.gov (United States)

    Trigueros, José Antonio; Piñero, David P; Ismail, Mahmoud M

    2016-01-01

    AIM To define the financial and management conditions required to introduce a femtosecond laser system for cataract surgery in a clinic using a fuzzy logic approach. METHODS In the simulation performed in the current study, the costs associated to the acquisition and use of a commercially available femtosecond laser platform for cataract surgery (VICTUS, TECHNOLAS Perfect Vision GmbH, Bausch & Lomb, Munich, Germany) during a period of 5y were considered. A sensitivity analysis was performed considering such costs and the countable amortization of the system during this 5y period. Furthermore, a fuzzy logic analysis was used to obtain an estimation of the money income associated to each femtosecond laser-assisted cataract surgery (G). RESULTS According to the sensitivity analysis, the femtosecond laser system under evaluation can be profitable if 1400 cataract surgeries are performed per year and if each surgery can be invoiced more than $500. In contrast, the fuzzy logic analysis confirmed that the patient had to pay more per surgery, between $661.8 and $667.4 per surgery, without considering the cost of the intraocular lens (IOL). CONCLUSION A profitability of femtosecond laser systems for cataract surgery can be obtained after a detailed financial analysis, especially in those centers with large volumes of patients. The cost of the surgery for patients should be adapted to the real flow of patients with the ability of paying a reasonable range of cost. PMID:27500115

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

    Directory of Open Access Journals (Sweden)

    Rohit C Khanna

    2013-01-01

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

  15. Willingness to Pay for Cataract Surgery Provided by a Senior Surgeon in Urban Southern China.

    Directory of Open Access Journals (Sweden)

    Mei Wang

    Full Text Available To study willingness to pay for cataract surgery and surgical service provided by a senior cataract surgeon in urban Southern China.This study was a cross-sectional willingness-to-pay (WTP interview using bidding formats. Two-hundred eleven persons with presenting visual impairment in either eye due to cataract were enrolled at a tertiary eye hospital. Participants underwent a comprehensive eye examination and a WTP interview for both surgery and service provided by a senior surgeon. Demographic information, socioeconomic status and clinical data were recorded.Among 211 (98% response rate persons completing the interview, 53.6% were women and 80.6% were retired. About 72.2% had a monthly income lower than 1000 renminbi (US $161. A total of 189 (89.6% were willing to pay for cataract and the median amount of WTP was 6000 renminbi (US$968. And 102 (50.7% were willing to pay additional fees for surgery performed by a senior surgeon, and the median amount of WTP was 500 renminbi (US$81. In regression models adjusting for age and gender, persons with preexisting eye diseases other than cataract, were more likely to pay for cataract surgery and service provided by a senior surgeon (P = 0.04 for both.In urban China, cataract patients, especially those with preexisting eye conditions, are willing to pay additional fees for a senior surgeon. Moving to a system where the price of cataract surgery is proportional to the consultant' skill and expertise is possible and may have a potential impact on waiting list and quality of eye care. Further studies are needed to examine the impact of such pricing system on attitudes and choices of cataract patients.

  16. Cataracts

    Science.gov (United States)

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

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

    DEFF Research Database (Denmark)

    Lou, Astrid R.; Madsen, Kristoffer Hougaard; Julian, Hanne O.;

    2013-01-01

    . 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......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...

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

    DEFF Research Database (Denmark)

    Kessel, Line; Erngaard, Ditte; Flesner, Per;

    2015-01-01

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

  19. A VidEo-Based Intelligent Recognition and Decision System for the Phacoemulsification Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Shu Tian

    2015-01-01

    Full Text Available The phacoemulsification surgery is one of the most advanced surgeries to treat cataract. However, the conventional surgeries are always with low automatic level of operation and over reliance on the ability of surgeons. Alternatively, one imaginative scene is to use video processing and pattern recognition technologies to automatically detect the cataract grade and intelligently control the release of the ultrasonic energy while operating. Unlike cataract grading in the diagnosis system with static images, complicated background, unexpected noise, and varied information are always introduced in dynamic videos of the surgery. Here we develop a VidEo-Based Intelligent Recognitionand Decision (VEBIRD system, which breaks new ground by providing a generic framework for automatically tracking the operation process and classifying the cataract grade in microscope videos of the phacoemulsification cataract surgery. VEBIRD comprises a robust eye (iris detector with randomized Hough transform to precisely locate the eye in the noise background, an effective probe tracker with Tracking-Learning-Detection to thereafter track the operation probe in the dynamic process, and an intelligent decider with discriminative learning to finally recognize the cataract grade in the complicated video. Experiments with a variety of real microscope videos of phacoemulsification verify VEBIRD’s effectiveness.

  20. The impact of cataract surgery on activities and time-use: results from a longitudinal study in Kenya, Bangladesh and the Philippines.

    Directory of Open Access Journals (Sweden)

    Sarah Polack

    Full Text Available BACKGROUND: Cataract is the leading cause of blindness in the world, and blindness from cataract is particularly common in low-income countries. The aim of this study is to explore the impact of cataract surgery on daily activities and time-use in Kenya, Bangladesh and the Philippines. METHODS/PRINCIPAL FINDINGS: A multi-centre intervention study was conducted in three countries. Time-use data were collected through interview from cases aged >or=50 years with visually impairing cataract (VA or=6/18. Cases were offered free/subsidized cataract surgery. Approximately one year later participants were re-interviewed about time-use. At baseline across the three countries there were 651 cases and 571 controls. Fifty-five percent of cases accepted surgery. Response rate at follow up was 84% (303 out of 361 for operated cases, and 80% (459 out of 571 for controls. At baseline, cases were less likely to carry out and spent less time on productive activities (paid and non-paid work and spent more time in "inactivity" compared to controls. Approximately one year after cataract surgery, operated cases were more likely to undertake productive activities compared to baseline (Kenya from 55% to 88%; Bangladesh 60% to 95% and Philippines 81% to 94%, p<0.001 and mean time spent on productive activities increased by one-two hours in each setting (p<0.001. Time spent in "inactivity" in Kenya and Bangladesh decreased by approximately two hours (p<0.001. Frequency of reported assistance with activities was more than halved in each setting (p<0.001. CONCLUSIONS/SIGNIFICANCE: The empirical evidence provided by this study of increased time spent on productive activities, reduced time in inactivity and reduced assistance following cataract surgery among older adults in low-income settings has positive implications for well-being and inclusion, and supports arguments of economic benefit at the household level from cataract surgery.

  1. Cataract

    Science.gov (United States)

    ... eye to the other. Common symptoms are Blurry vision Colors that seem faded Glare - headlights, lamps or sunlight may seem too bright. You may also see a halo around lights. Not being able to see well at night Double vision Frequent prescription changes in your eye wear Cataracts ...

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

    Directory of Open Access Journals (Sweden)

    Rahul

    2015-08-01

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

  3. Optical coherence tomography in patients undergoing cataract surgery

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    Carlos Augusto Moreira Neto

    2015-08-01

    Full Text Available ABSTRACTPurpose:To assess the ability of spectral domain optical coherence tomography (SD-OCT to diagnose macular changes pre- and post-cataract surgery and to identify changes in central foveal thickness (CFT relative to age, sex, and presence of concomitant ophthalmic pathologies, for a period of 6 months post-surgery.Methods:A prospective study of patients evaluated by SD-OCT within 5 h before surgery at 7, 30, 60, 90, and 180 days post-op, with respect to CFT and presence of maculopathy.Results:Ninety-eight eyes of 98 patients were evaluated, with the following mean results: age = 71.4 years, pre-op VA = 0.27 logMAR, and final VA = 0.73 logMAR. There were 21 eyes in patients with diabetes mellitus (DM and 10 eyes with age-related macular degeneration (AMD, three with epiretinal membrane, and four with glaucoma. Sixty eyes had no other ophthalmic-related pathologies (NOO, and had a mean pre-op CFT of 222 μm, which progressively increased up to the 60thday post-op, reaching a mean of 227.2 μm. No pseudophakic cystoid macular edema was observed. The mean CFT was statistically significantly different (p<0.001 between NOO and diabetic patients from 30 days post-op. Four eyes presented with preoperative diagnosis of AMD as measured by ophthalmoscopy. After completion of the OCT, which was performed within 5 h before surgery, six additional patients were found to have AMD. Of the 98 total eyes, 10 were diagnosed with maculopathy only by OCT exam. Binocular indirect ophthalmoscopy (BIO was unable to detect such changes.Conclusion:OCT diagnosed preoperative maculopathies in 21.4% of the patients, and was more effective than BIO (11.2%. OCT showed a progressive increase in CFT in diabetics up to 180 days post-operatively, as well as greater CFT in male patients and patients older than 70 years.

  4. Favorable Long-term Prognosis of Cataract Surgery in Herpes Zoster Ophthalmicus

    Science.gov (United States)

    Chaudhary, Kulbhushan Prakash; Mahajan, Deepti; Panwar, Praveen

    2016-01-01

    Purpose: Scleritis is a rare presentation of herpes zoster ophthalmicus, complicated most commonly by iridocyclitis and raised intraocular pressure. These complications can recur in subsequent years, therefore they should be managed well. Case Report: We describe a female patient who developed scleritis, complicated cataract and secondary glaucoma 2 years after being diagnosed by HZO. Secondary glaucoma was managed medically, and the patient underwent extracapsular cataract extraction for the complicated cataract. Final visual acuity was 6/6 and IOP was 22.4 mm Hg. This is a rare report describing favorable long-term (>20 years) prognosis for surgical management of cataract associated with HZO together with scleritis, secondary glaucoma and post-herpetic neuralgia. Conclusion: A favorable outcome may be attained with surgery for complicated cataract associated with HZO if the condition is managed optimally and intraocular inflammation is well controlled. PMID:27413505

  5. Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops

    DEFF Research Database (Denmark)

    Kessel, Line; Tendal, Britta; Jørgensen, Karsten Juhl;

    2014-01-01

    PURPOSE: Favorable outcome after cataract surgery depends on proper control of the inflammatory response induced by cataract surgery. Pseudophakic cystoid macular edema is an important cause of visual decline after uncomplicated cataract surgery. DESIGN: We compared the efficacy of topical steroids...... with topical nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling inflammation and preventing pseudophakic cystoid macular edema (PCME) after uncomplicated cataract surgery. PARTICIPANTS: Patients undergoing uncomplicated surgery for age-related cataract. METHODS: We performed a systematic literature...

  6. Factors Influencing Efficacy of Peripheral Corneal Relaxing Incisions during Cataract Surgery

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    Nino Hirnschall

    2015-01-01

    Full Text Available Purpose. To evaluate influencing factors on the residual astigmatism after performing peripheral corneal relaxing incisions (PCRIs during cataract surgery. Methods. This prospective study included patients who were scheduled for cataract surgery with PCRIs. Optical biometry (IOLMaster 500, Carl Zeiss Meditec AG, Germany was taken preoperatively, 1 week, 4 months, and 1 year postoperatively. Additionally, corneal topography (Atlas model 9000, Carl Zeiss Meditec AG, Germany, ORA (Ocular Response Analyzer, Reichert Ophthalmic Instruments, USA, and autorefraction (Autorefractometer RM 8800 Topcon were performed postoperatively. Results. Mean age of the study population n=74 was 73.5 years (±9.3; range: 53 to 90 and mean corneal astigmatism preoperatively was −1.82 D (±0.59; 1.00 to 4.50. Mean corneal astigmatism was reduced to 1.14 D (±0.67; 0.11 to 3.89 4 months postoperatively. A partial least squares regression showed that a high eccentricity of the cornea, a large deviation between keratometry and topography, and a high preoperative astigmatism resulted in a larger postoperative error concerning astigmatism. Conclusions. PCRI causes a reduction of preoperative astigmatism, though the prediction is difficult but several factors were found to be a relevant source of error.

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

    LENUS (Irish Health Repository)

    Dooley, I

    2012-02-01

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

  8. Comparison between Subjective Sensations during First and Second Phacoemulsification Eye Surgeries in Patients with Bilateral Cataract

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    Ji-guo Yu

    2016-01-01

    Full Text Available Purpose. To evaluate and compare the subjective sensations reported by patients during first and second cataract extractions. Methods. Consecutive patients undergoing bilateral sequential cataract extraction using phacoemulsification were recruited. Following cataract surgery, patients completed questionnaires designed to evaluate subjective sensations, including anxiety, eye bulges, pain, and light sensitivity. Changes in painful sensations experienced by patients between the two surgeries were also recorded. Comparisons were also performed for each subjective sensation between different age groups (79 years. Results. A total of 127 patients were included in the final evaluation. Statistical comparison of the results showed that there were significant differences in perception of anxiety, eye bulges, and pain scores between the first and second cataract surgeries (P0.05 for all. Conclusions. Our research confirms the common observation that patients with bilateral cataracts often report more ocular discomfort during the second surgery. There are, therefore, additional factors that should be considered upon treating patients with bilateral cataracts, and the provision of preoperative counseling could play an important role in providing adequate patient care.

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

    LENUS (Irish Health Repository)

    Barry, Peter

    2014-01-01

    To determine the use of intracameral cefuroxime at the end of cataract surgery since the beneficial results were first reported by the European Society of Cataract and Refractive Surgeons Endophthalmitis Study Group in 2006, 250 ophthalmic surgeons affiliated with both public and private hospitals and clinics across Europe were surveyed. The questions regarded their awareness of the results of the ESCRS endophthalmitis study and their current use or non-use of intracameral antibiotics in their cataract procedures. Seventy-four percent of respondents said they always or usually use intracameral antibiotics in their cataract surgery procedures. The most frequently cited reasons for not using cefuroxime or other intracameral antibiotics was the lack of an approved commercial preparation and related anxieties regarding the risk of dilution errors and contamination. More than 90% of respondents said they would use cefuroxime if an approved single-unit dose product were commercially available.

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

    Science.gov (United States)

    Bjerrum, Søren Solborg

    2015-03-01

    The main purpose of this thesis was to examine whether the Danish National Patient Registry (NPR) could be used to monitor and assess the quality of cataract surgery in Denmark by studying the risks of two serious postoperative complications following cataract surgery - retinal detachment (RD) and postoperative endophthalmitis (PE). The thesis consists of four retrospective studies. In the first study (paper I), we used data from the NPR in the calendar period 2000-2010 to investigate the risk of pseudophakic retinal detachment (PRD) using the fellow non-operated eyes of the patients as reference. The study showed that over a 10-year study period, the risk of PRD was increased by a factor of 4.2 irrespective of sex and age. The risk of PRD was highest in the first part of the postoperative period and then gradually decreased but remained statistically significantly higher than the risk of RD in non-operated fellow eyes up to 10 years after cataract surgery. The epidemiology of RD in the non-operated fellow eyes was different from the epidemiology of RD in the background population as young men had the highest risk of RD in the non-operated fellow eyes. This means that the absolute risk of PRD was highest for young men because they had a higher risk of RD before they underwent cataract surgery. In the second study (paper II), we used data from the NPR and reviewed patient charts to assess the risk of PE after cataract surgery performed in public eye departments and private hospitals/clinics in the study period 2002-2010. The overall risk of PE among the seven public eye departments was 0.36 per 1000 registered cataract operations, and the PE risk among the departments was homogeneous. The overall risk of PE among the 28 private hospitals/clinics was 0.73 per 1000 registered cataract operations, and the risk among the private hospitals/clinics was heterogeneous. Most private hospitals/clinics had a risk of PE that was lower than or similar to the risk of PE after

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

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

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

  12. Exploration of Management Workflow of Cataract Surgery in an Impoverished Population in Urban China

    Institute of Scientific and Technical Information of China (English)

    Haofeng Jiang; Haotian Lin; Bo Qu; Weirong Chen

    2014-01-01

    Purpose:To explore and establish a rational management workflow for a free cataract surgery program for the poor pop-ulation in urban China, aiming to improve surgical efficiency. Methods:.Establishment of a management workflow mainly includes system design and an auxiliary facility. System design procedures consist of outpatient screening, outpatient physical examination,.surgical procedures,.and postoperative clinic visits. After establishing the management workflow of cataract surgery, a free cataract surgery program was conducted for 15 months. Results:Based upon the established management mode, 9003 patients received preoperative screening and 2358 underwent cataract surgery..During the 15-month investigation,.each pro-cedure was successfully conducted,.the efficiency of screening and operation attained the highest standards in China,.and no surgical malpractice occurred intraoperatively. Conclusion:.In this study,.a management workflow for cataract surgery was designed for a poverty relief project in urban China. During the 15-month project, the degree of pa-tient satisfaction was enhanced without disrupting the normal practice and safety of the sponsor hospital.

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

    Directory of Open Access Journals (Sweden)

    Yazici Ahmet

    2010-01-01

    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.

  14. Contributions of public and private sectors to the Iranian cataract surgery output.

    Science.gov (United States)

    Hashemi, H; Rezvan, F; Fotouhi, A; Khabazkhoob, M; Gilasi, H; Etemad, K; Mahdavi, A; Asgari, S

    2015-08-01

    This study determined trends in the contributions of the public and private sectors to the cataract surgery output in the Islamic Republic of Iran. Data about cataract surgeries performed at surgical centres throughout the nation were extracted from patient charts for a 5-year period from 2006 to 2010. Of the total 516 273 surgeries performed in 2010, more were done in public sector centres (61.7%) than private ones (38.3%). The total number of surgeries increased by 59.1% between 2006 and 2010. Analysis of the relative contributions of the public and private sectors showed a 41.0% increase in surgeries in public centres and 100.5% in private centres over the 5-year period. Thus the rate of growth of cataract surgery in the private sector was 2.7 times greater than that in the public sector. Despite a smaller contribution to the total number of cataract surgeries, the private sector has experienced a substantial rate of growth. PMID:26446533

  15. Cataract, ocular surgery, aphakia, and the chromatic expression of the painter Jovan Bijelić

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    Nikolić Ljubiša

    2016-01-01

    Full Text Available Background/Aim. Approaching art from the standpoint of optics and the artist’s eye pathology can sometimes explain the shift of the spectral colors in the work of some artists with cataract and aphakia. This may not be obvious in the paintings of other artists with the same eye pathology. The aim of this study was to create a timeline from the recently obtained details of the cataract surgery, his best corrected aphakic visual acuity, and the last paintings of the artist Jovan Bijelić. Methods. The research included primary and secondary source material: Bijelić’s paintings from all stages of his career, interviews with Bijelić and his eye surgeon, art criticism, sources with the description of Bijelić’s symptoms, hospital archives, discussion with art historians, comparison of his palette from different periods. Results. Jovan Bijelić was nearly blind from cataract in 1957. He underwent an unsuccessful cataract surgery in 1956, followed by enucleation of the operated eye. In 1958, 20/25–20/20 vision was regained, after the extracapsular cataract extraction and sector iridectomy in his right eye, with the posterior lens capsule discision afterwards. Xanthopsia and cyanopsia are not present in his art, which is not a representation of visualized objects. Conclusion. The response of Jovan Bijelić to cataract and aphakia was predominantly a change of his style.

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

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    Malagola R

    2013-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Rajiv D. Sha

    2011-06-01

    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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Science.gov (United States)

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

  20. Comparative evaluation of aqueous and plasma concentration of topical moxifloxacin alone and with flurbiprofen in patients of cataract surgery

    OpenAIRE

    Sujash Halder; Kanchan Kumar Mondal; Supreeti Biswas; Tapan Kumar Mandal; Bakul Kumar Dutta; Mithilesh Haldar

    2013-01-01

    Objectives: To determine the aqueous and plasma concentrations of moxifloxacin administered topically alone and with flurbiprofen in patients undergoing cataract surgery. Materials and Methods: A total of 50 subjects scheduled for routine cataract surgery were randomly allocated to two groups (n = 25 each). Group-1 patients were treated with topical moxifloxacin alone: One drop 6 times/day for 3 days before surgery and one drop 4 times on the day of surgery: Group-2 patients were treated ...

  1. Early clinical experience with a new preloaded one-piece intraocular lens in paediatric cataract surgery.

    Science.gov (United States)

    Gosling, D B; Chan, T K J

    2016-09-01

    PurposeTo report the clinical experience of using the Tecnis PCB00 (Abbott Medical Optics, Santa Ana, CA, USA) preloaded one-piece intraocular lens (IOL) in the setting of a tertiary referral centre for paediatric cataract.MethodsA retrospective case note review of all paediatric cataract surgeries using the Tecnis PCB00 IOL, at a single UK paediatric ophthalmology department.ResultsNine eyes in seven patients received the IOL between December 2014 and January 2016. All patients underwent lens aspiration and insertion of the IOL 'in the bag.' The indications for surgery included developmental cataract (8/9) and traumatic cataract (1/9). Mean age at the time of surgery was 7 years (range 2-14). The median improvement in logMAR best-corrected visual acuity was 0.475 (range 0.250-1.500). The mean follow-up duration was 5 months (range 1-13). No operative or post-operative complications occurred as a result of using the device.ConclusionThe Tecnis PCB00 preloaded IOL appears to be a safe and effective device in treating paediatric cataract.

  2. Visual and Refractive Outcomes after Cataract Surgery with Implantation of a New Toric Intraocular Lens

    Directory of Open Access Journals (Sweden)

    Cinzia Mazzini

    2013-06-01

    Full Text Available Purpose: The aim of this study was to evaluate and report the visual, refractive and aberrometric outcomes of cataract surgery with implantation of the new aspheric Tecnis ZCT toric intraocular lens (IOL in eyes with low to moderate corneal astigmatism. Methods: We conducted a prospective study of 19 consecutive eyes of 17 patients (mean age: 78 years with a visually significant cataract and moderate corneal astigmatism [higher than 1 diopter (D] undergoing cataract surgery with implantation of the aspheric Tecnis ZCT toric IOL (Abbott Medical Optics. Visual, refractive and aberrometric changes were evaluated during a 6-month follow-up. Ocular aberrations as well as IOL rotation were evaluated by means of the OPD-Station II (Nidek. Results: The six-month postoperative spherical equivalent and power vector components of the refractive cylinder were within ±0.50 D in all eyes (100%. Postoperative logMAR uncorrected and corrected distance visual acuities (UDVA/CDVA were 0.1 (about 20/25 or better in almost all eyes (94.74%. The mean logMAR CDVA improved significantly from 0.41 ± 0.23 to 0.02 ± 0.05 (p Conclusion: Cataract surgery with implantation of the aspheric Tecnis ZCT IOL is a predictable and effective procedure for visual rehabilitation in eyes with cataract and low to moderate corneal astigmatism, providing an excellent postoperative ocular optical quality.

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

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    Prasanna T

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    B. M. Wu

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Variation of cataract surgery costs in four different graded providers of China

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    Fang Jiahua

    2010-09-01

    Full Text Available Abstract Background China has the largest population of cataract patients in the world. However, the cataract surgery rate per million remains low in China. We carried out a survey on costs of cataract surgery from four different graded providers in China and analyzed differences in cost among these clinics. Methods 1,189 patients were recruited for the study in four eye clinics, located in two provinces, Guangdong province in southern China and Hubei province in central China. The average cost of each cataract surgery episode was calculated including cost of intraocular lens, cost of drugs and facility cost. We also collected information on reimbursement and disposable annual income of local residents. Results Mean total cost per cataract intervention of four different providers varied considerably, ranging from US$ 1,293 in Union Hospital to US$ 536 in Jingshan County Hospital. In all providers, except for Jingshan County Hospital, the cost exceeded annual disposable income of local rural residents. As to the proportion of patients with reimbursement, the figure for Union Hospital was only 36%, while for other three clinics it was more than 60%. There was a significant difference between mean reimbursement ratios, with the highest ratio in Zhongshan Ophthalmic Center being 71%. Conclusions Significant differences in costs of cataract surgery were found among the 4 different graded providers. A part of the cost was borne by patients. Proportion of patients with reimbursement and mean reimbursement ratios were higher in economically developed regions than in economically developing regions. Much more financial support should be directed into the rural New Cooperative Medical Scheme to raise the reimbursement ratio in rural China.

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

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    Umesh

    2014-03-01

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

  9. Causes, epidemiology, and long-term outcome of traumatic cataracts in children in rural India

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    Parikshit Gogate

    2012-01-01

    Full Text Available Purpose : To describe preoperative factors, long-term (>3 years postoperative outcome and cost of traumatic cataracts in children in predominantly rural districts of western India. Subjects : Eighty-two traumatic cataracts in 81 children in a pediatric ophthalmology department of a tertiary eye-care center. Materials and Methods : Traumatic cataracts operated in 2004-2008 were reexamined prospectively in 2010-2011 using standardized technique. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Statistical Analysis : Data analysis done by using SPSS (Statistical package for social sciences version 17.0 We have used Chi-square test, Fisher′s exact test, paired t-test to find the association between the final vision and various parameters at 5% level of significance; binary logistic regression was performed for visual outcome ≥6/18 and ≥6/60. Results : The children were examined in a 3-7 year follow-up (4.35 ± 1.54. Average age at time of surgery was 10.4 ± 4.43 years (1.03 to 18. Fifty (61.7% were boys. Forty (48.8% were blunt and 32 (39% were sharp trauma. The most common cause was wooden stick 23 (28.0% and sharp thorn 14 (17.1%. Delay between trauma and presentation to hospital ranged from same day to 12 years after the injury with median of 4 days. The mean preoperative visual acuity by decimal notation was 0.059 ± 0.073 and mean postoperative visual acuity was 0.483 ± 0.417 (P < 0.001. Thirty-eight (46.3% had best corrected visual acuity (BCVA ≥6/18 and 51 (62.2% had BCVA ≥ 6/60. In univariable analysis, visual outcome (≥6/18 depended on type of surgery (P = 0.002, gender (P = 0.028, and type of injury (P = 0.07-sharp trauma and open globe injury had poorer outcomes; but not on age of child, preoperative vision, and type of surgeon. On multivariable binary logistic regression, only gender was significant variable. Of the 82 eyes, 18 (22% needed more than one

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

    DEFF Research Database (Denmark)

    Munk, Sofie J; Heegaard, Steffen; Mosbech, Holger;

    2013-01-01

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

  11. Comparing different fentanyl concentrations added to local anesthetic mixture in peribulbar block for cataract surgery

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    Inas Kamel

    2016-04-01

    Conclusion: Adding Fentanyl at concentrations ⩾ 2–3 μg/ml to the local anesthetic mixture (Lidocaine and Hyaluronidase for regional peribulbar block provides safe and effective method in improving postoperative analgesia in patients undergoing cataract surgery.

  12. Addition of hyaluronidase to lignocaine with adrenaline for retrobulbar anaesthesia in the surgery of senile cataract.

    OpenAIRE

    Thomson, I.

    1988-01-01

    A double-blind trial demonstrates the effectiveness of adding hyaluronidase to lignocaine with adrenaline in producing ocular akinesia and anaesthesia in retrobulbar nerve blocks. 92% of the blocks in which hyaluronidase was used for intracapsular cataract surgery were judged successful compared with 56% of those without added hyaluronidase (p less than 0.01).

  13. Cataract surgery and the risk of aging macula disorder: The Rotterdam study

    NARCIS (Netherlands)

    L. Ho (Lintje); S. Boekhoorn (Sharmila); A. Liana (Alin); P. Tikka-Kleemola (Päivi); A.G. Uitterlinden (André); A. Hofman (Albert); P.T.V.M. de Jong (Paulus); Th. Stijnen (Theo); J.R. Vingerling (Hans)

    2008-01-01

    textabstractPURPOSE. To investigate still-controversial associations between prior cataract surgery and aging macula disorder (AMD) in a general population. METHODS. Baseline lens status and risk of incident AMD (iAMD) were examined in participants of the prospective population-based Rotterdam Study

  14. Prevalence, causes of blindness, visual impairment and cataract surgical services in Sindhudurg district on the western coastal strip of India

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    Shailbala Patil

    2014-01-01

    Full Text Available Background : Konkan coast of India is geographically distinct and its pattern of blindness has never been mapped. Aim : To study the prevalence and causes of blindness and cataract surgical services in Sindhudurg district of West Coast. Subjects : Individual aged > 50 years. Materials and Methods: Rapid assessment of avoidable blindness used to map blindness pattern in the district. Statistical analysis: SPSS version 19. Results: Amongst those examined 1415 (51.7% had visual acuity (VA >20/60, 924 (33.8%, confidence interval (C.I 30.5%-36.8% had VA 20/200-<20/60(visual impairment, 266 (9.7%, C.I. 6.1%-13.3% had VA < 20/200-20/400 (severe visual impairment and 132 (4.8%, C. I. 1.1%-8.5% had VA < 20/400 (blindness by WHO standards. There was no significant gender difference in prevalence of blindness, but blindness and visual impairment was more in older and rural residing individuals. Amongst those with presenting vision < 20/200 in better eye, 309 (82.4% had cataract, 36 (9.7% had corneal scars, 13 (3.5% had diabetic retinopathyand 3 (0.8% had glaucoma. Cataract surgical coverage for the district was only 30.5%; 32% for males and 28.4% for females. Unable to afford, lack of knowledge and lack of access to services were the commonest barriers responsible for cataract patients not seeking care. Amongst those who had undergone cataract surgery, only 50% had visual acuity ≥ 20/60.46.9% of the population had spectacles for near, but only 53.3% of the population had presenting near vision < N10. Conclusion : Cataract, refractive errors and diabetes were significant causes of visual impairment and blindness.

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

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    Bhattacharya Debasish

    2009-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

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

    DEFF Research Database (Denmark)

    Ostri, Christoffer; Lux, Anja; Lund-Andersen, Henrik;

    2014-01-01

    PURPOSE: To report long-term results, prognostic factors and cataract surgery after diabetic vitrectomy. METHODS: Retrospective review of patient files from a large diabetes centre between 1996 and 2010. Surgical history was obtained from the Danish National Patient Register. Follow-up intervals...... were 3 months and 1, 3, 5 and 10 years after surgery. RESULTS: In total, 167 patients had diabetic vitrectomy indicated for non-clearing vitreous haemorrhage (47%) and tractional retinal detachment (53%). The proportion of patients with visual acuity ≥0.3 increased from 29% before surgery to 60% after...... 3 months (p surgery to 0.3 after 3 months (p

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

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    Yunis Muhammad H

    2011-04-01

    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.

  19. Safety and Efficacy of Propranolol in Comparison With Combination of Fentanyl and Ketamine as Premedication in Cataract Surgery Under the Topical Anesthesia.

    Science.gov (United States)

    Fazel, Farhad; Saryazdi, Hamidhajigholam; Rezaei, Leila; Mahboubi, Mohammad

    2015-01-01

    This study evaluated the safety and effects of propranolol as a premedication before cataract surgery and compared them with the usual combination doses of fentanyl and ketamine. Among all reffered patients to Feiz Hospital of Esfahan for cataract surgery, 122 patients between Mar to Sep 2010 were enrolled in this study and randomly allocated into one of the following equal groups: 40 mg propranolol, 2 hours before surgery and combination of 15 mg ketamine and 50 µg fentanyl l. 5 min before surgery. The ability to control of hemodynamic instabilities caused by stress and to gain patients satisfaction was compared between two groups. Also, the efficacy of each premedication to control of hemodynamic changes during surgery were evaluated and compared. No significant differences were seen in the patients satisfaction and controlling of stress induced hemodynamic changes between two groups (P>0.05). However, patients in ketamine + fentanyl group showed more nausea and less pain during and after surgery. Moreover, no significant adverse effects were reported during and after the surgery. Our results demonstrated that propranolol can be used safely as a premedication in cataract surgery in the comparable efficacy to ketamine plus fentanyl premedication. PMID:26153173

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

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    Md Shafiqul Alam

    2014-01-01

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

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

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    Willich, Stefan N.

    2006-12-01

    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

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

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    MR Safavi

    2007-11-01

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

  3. Characterization of molecular mechanisms of in vivo UVR induced cataract.

    Science.gov (United States)

    Galichanin, Konstantin; Talebizadeh, Nooshin; Söderberg, Per

    2012-01-01

    Cataract is the leading cause of blindness in the world (1). The World Health Organization defines cataract as a clouding of the lens of the eye which impedes the transfer of light. Cataract is a multi-factorial disease associated with diabetes, smoking, ultraviolet radiation (UVR), alcohol, ionizing radiation, steroids and hypertension. There is strong experimental (2-4) and epidemiological evidence (5,6) that UVR causes cataract. We developed an animal model for UVR B induced cataract in both anesthetized (7) and non-anesthetized animals (8). The only cure for cataract is surgery but this treatment is not accessible to all. It has been estimated that a delay of onset of cataract for 10 years could reduce the need for cataract surgery by 50% (9). To delay the incidence of cataract, it is needed to understand the mechanisms of cataract formation and find effective prevention strategies. Among the mechanisms for cataract development, apoptosis plays a crucial role in initiation of cataract in humans and animals (10). Our focus has recently been apoptosis in the lens as the mechanism for cataract development (8,11,12). It is anticipated that a better understanding of the effect of UVR on the apoptosis pathway will provide possibilities for discovery of new pharmaceuticals to prevent cataract. In this article, we describe how cataract can be experimentally induced by in vivo exposure to UVR-B. Further RT-PCR and immunohistochemistry are presented as tools to study molecular mechanisms of UVR-B induced cataract. PMID:23222480

  4. 23-gauge Transconjunctival Sutureless Vitrectomy in Eyes with Posteriorly Dislocated Intraocular Lens after Cataract Surgery

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    Fatih Horozo¤lu

    2011-08-01

    Full Text Available Purpose: To evaluate the outcomes of 23-gauge (23-G transconjunctival sutureless vitrectomy (TSV in eyes with posteriorly dislocated intraocular lens (IOL after cataract surgery. Material and Method: In this retrospective study, we evaluated 6 eyes of 6 consecutive cases with posteriorly dislocated intraocular lens after cataract surgery between April 2007 and November 2010. Visual acuity, intraocular pressure, detailed fundus examination and details of surgery were recorded. Results: The mean age of the patients was 64.7 years and the mean follow-up was 5.5 months (3-12 months. All eyes received 23-G TSV. Dislocated IOL was removed from the vitreous and implanted into ciliary sulcus in 2 eyes (33.3% with polymethylmetacrilate IOL and in 4 eyes (66.7% with 3-piece hydrophilic acrylic IOL. In 5 of the 6 eyes (83.7%, visual acuity improved postoperatively. In one eye (16.7%, elevation of intraocular pressure was observed postoperatively and controlled by topical treatment. Discussion: 23-G TSV surgery may be used in eyes with posteriorly IOLs after cataract surgery. Studies with a larger number of patients would better demonstrate the efficacy of this method. (Turk J Ophthalmol 2011; 41: 213-6

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

    Science.gov (United States)

    Marseille, E; Brand, R

    1997-11-01

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

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

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D;

    2011-01-01

    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...

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

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    Line Kessel

    2015-01-01

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

  8. Safety of undiluted intracameral moxifloxacin without postoperative topical antibiotics in cataract surgery.

    Science.gov (United States)

    Zhou, Andrew Xingyu; Messenger, Wyatt Boyer; Sargent, Steven; Ambati, Balamurali Krishna

    2016-08-01

    The objective of this study is to evaluate the safety of undiluted 0.5 % intracameral moxifloxacin for postoperative endophthalmitis prophylaxis in cataract surgery patients without the use of additional postoperative topical antibiotics. All phacoemulsification cataract surgeries performed by a single surgeon (B.A.) at the John A. Moran Eye Center from June 2012 to May 2015 were reviewed retrospectively. From June 2012 to April 2014, patients were given topical 0.5 % moxifloxacin postoperatively. From May 2014 to May 2015, all patients were given moxifloxacin intracamerally with no antibiotics postoperatively. The follow-up period was 1 month after surgery. Preoperative visual acuity and postoperative visual acuity, corneal edema, and anterior chamber reaction were recorded and compared between the two groups. 384 cataract surgeries were performed during the study period. None of the 384 eyes in the study developed endophthalmitis. Of those 384 eyes, 222 were included in the study for analysis based on the inclusion and exclusion criteria. 131 were part of the topical antibiotic group and 91 were part of the intracameral group. The differences in uncorrected visual acuity at 1 day postoperatively (p = 0.595) and best corrected visual acuity at 1 month postoperatively (p = 0.099) were not statistically significant. Differences in corneal edema (p = 0.370) and anterior chamber reaction (p = 0.069) at 1 day postoperatively and corneal edema (p = 0.512) and anterior chamber reaction (p = 0.512) at 1 month postoperatively were also not statistically significant. Undiluted 0.5 % moxifloxacin can be safely injected intracamerally following cataract surgery without additional postoperative antibiotic prophylaxis to prevent endophthalmitis without adverse effects on patient outcomes. PMID:26577588

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

    Directory of Open Access Journals (Sweden)

    Berdeaux Gilles

    2008-07-01

    Full Text Available Abstract Background To compare the lifetime costs of liberating patients from spectacles after cataract surgery by implanting the multifocal intraocular lens (IOL 'ReSTOR®' versus monofocal IOLs in France, Italy, Germany and Spain. Methods A Markov model was created to follow patient cohorts from cataract surgery until death. Prevalence rates of patients not needing spectacles after cataract surgery were obtained from clinical trials. Resource utilisation included implant surgery, IOLs, spectacles, visits to ophthalmologists and eye centres, transport, and time lost by patients. Economic perspectives were those of Society and Sickness Funds (SFs. Results The mean number of spectacles purchased after ReSTOR® was 1.34–1.61 and after monofocal IOLs 6.05–7.27. From the societal perspective, total cost estimates discounted by 3% were between €3,551 and €4,052 with ReSTOR® compared to €3,989 and €5,548 with monofocal IOLs. Undiscounted savings related to ReSTOR® ranged from €815 to €2,164. From the SFs' perspective total cost estimates discounted by 3% were between €2,150 and €2,524 with ReSTOR® compared to €2,324 and €2,610 with monofocal IOLs. Savings related to ReSTOR®, once costs discounted, ranged from €61 to €219. Discount and spectacle freedom prevalence rates were the most sensitive parameters. Conclusion The bulk of the savings related to ReSTOR® were realized outside the SF. From both a societal and SF perspective, savings, after a 3% discounting, achieved by liberating patients from spectacles counterbalanced the initially higher cost of ReSTOR®. ReSTOR® is a cost saving alternative to spectacles for patients requiring cataract surgery.

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

    OpenAIRE

    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

    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...

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

    DEFF Research Database (Denmark)

    Bjerrum, Søren Solborg

    2015-01-01

    The main purpose of this thesis was to examine whether the Danish National Patient Registry (NPR) could be used to monitor and assess the quality of cataract surgery in Denmark by studying the risks of two serious postoperative complications following cataract surgery - retinal detachment (RD......) and postoperative endophthalmitis (PE). The thesis consists of four retrospective studies. In the first study (paper I), we used data from the NPR in the calendar period 2000-2010 to investigate the risk of pseudophakic retinal detachment (PRD) using the fellow non-operated eyes of the patients as reference....... The study showed that over a 10-year study period, the risk of PRD was increased by a factor of 4.2 irrespective of sex and age. The risk of PRD was highest in the first part of the postoperative period and then gradually decreased but remained statistically significantly higher than the risk of RD in non...

  12. Clinical Outcomes after Uncomplicated Cataract Surgery with Implantation of the Tecnis Toric Intraocular Lens

    Science.gov (United States)

    Lubiński, Wojciech; Kaźmierczak, Beata; Gronkowska-Serafin, Jolanta; Podborączyńska-Jodko, Karolina

    2016-01-01

    Purpose. To evaluate the clinical outcomes after uncomplicated cataract surgery with implantation of an aspheric toric intraocular lens (IOL) during a 6-month follow-up. Methods. Prospective study including 27 consecutive eyes of 18 patients (mean age: 66.1 ± 11.4 years) with a visually significant cataract and corneal astigmatism ≥ 0.75 D and undergoing uncomplicated cataract surgery with implantation of the Tecnis ZCT toric IOL (Abbott Medical Optics). Visual, refractive, and keratometric outcomes as well as IOL rotation were evaluated during a 6-month follow-up. At the end of the follow-up, patient satisfaction and perception of optical/visual disturbances were also evaluated using a subjective questionnaire. Results. At 6 months after surgery, mean LogMAR uncorrected (UDVA) and corrected distance visual acuity (CDVA) were 0.19 ± 0.12 and 0.14 ± 0.10, respectively. Postoperative UDVA of 20/40 or better was achieved in 92.6% of eyes. Mean refractive cylinder decreased significantly from −3.73 ± 1.96 to −1.42 ± 0.88 D (p < 0.001), while keratometric cylinder did not change significantly (p = 0.44). Mean absolute IOL rotation was 1.1 ± 2.4°, with values of more than 5° in only 2 eyes (6.9%). Mean patient satisfaction score was 9.70 ± 0.46, using a scale from 0 (not at all satisfied) to 10 (very satisfied). No postoperative optical/visual disturbances were reported. Conclusion. Cataract surgery with implantation of the Tecnis toric IOL is an effective method of refractive correction in eyes with corneal astigmatism due to the good IOL positional stability, providing high levels of patient's satisfaction. PMID:27022478

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

    OpenAIRE

    Saedon H

    2013-01-01

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

  14. Influence of Biometric Variables on Refractive Outcomes after Cataract Surgery in Angle-closure Glaucoma Patients

    Science.gov (United States)

    Kim, Kyoung Nam; Lim, Hyung Bin; Lee, Jong Joo

    2016-01-01

    Purpose To evaluate the influence of biometric variables on refractive outcomes after cataract surgery in angle-closure glaucoma (ACG) patients. Methods In this case-control study, 42 ACG patients, 40 open-angle glaucoma (OAG) patients, and 35 controls without glaucoma who had undergone conventional cataract surgery were enrolled consecutively. Electronic medical records, including preoperative biometric variables (keratometric diopter, axial length, anterior chamber depth, and lens thickness), the refractive change (RC), and the absolute value of refractive change (ARC) were reviewed. Results In the control and OAG patients, the anterior chamber depth was negatively correlated with the ARC (r = -0.344, p = 0.043 and r = -0.431, p = 0.006, respectively), whereas there was no correlation in the ACG patients. Lens thickness was positively correlated with the RC, but not with the ARC, in the control and OAG groups (r = 0.391, p = 0.020 and r = 0.501, p = 0.001, respectively). In contrast, lens thickness in the ACG group was not correlated with the RC but was positively correlated with the ARC (r = 0.331, p = 0.032). Conclusions In contrast with the anterior chamber depth, preoperatively measured lens thickness may be a useful predictor of the direction of the RC after cataract surgery in control and OAG patients. However, in ACG patients, a thicker lens was correlated with a larger RC, regardless of the direction of the shift (hyperopic or myopic). PMID:27478355

  15. Non-Irritant Baby Shampoos May Cause Cataract Development

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    Omer Faruk Tekbas

    2008-02-01

    Full Text Available BACKGROUND: The effect of different shampoo formulations as a risk factor for cataract formation was investigated in Sprague Dawley rats in the present study. METHODS: Study was performed by using 20 rats. Two different shampoos used by adult subjects and two different baby shampoos were used in the study. Different shampoos were used in different groups for 14 days, and they were followed for changes. RESULTS: Different degree of opacities were observed in 4 (40%, 4 (40%, 5 (50%, and 6 (60% eyes in Groups A, B, C, and D, respectively. There was no statistically significant difference for formation of cataract between the groups (p>0.05. The number of irritated eyes was significantly lower (p<0.05 in groups C (10% and D (20% compared to groups A (90% and B (80%. CONCLUSION: The use of non-irritant baby shampoos does not seem to eliminate the risk of cataract formation and these should even be used more carefully as the non-irritant shampoo will have more contact with the eye. [TAF Prev Med Bull. 2008; 7(1: 1-6

  16. Non-Irritant Baby Shampoos May Cause Cataract Development

    Directory of Open Access Journals (Sweden)

    Omer Faruk Tekbas

    2008-02-01

    Full Text Available BACKGROUND: The effect of different shampoo formulations as a risk factor for cataract formation was investigated in Sprague Dawley rats in the present study. METHODS: Study was performed by using 20 rats. Two different shampoos used by adult subjects and two different baby shampoos were used in the study. Different shampoos were used in different groups for 14 days, and they were followed for changes. RESULTS: Different degree of opacities were observed in 4 (40%, 4 (40%, 5 (50%, and 6 (60% eyes in Groups A, B, C, and D, respectively. There was no statistically significant difference for formation of cataract between the groups (p>0.05. The number of irritated eyes was significantly lower (p<0.05 in groups C (10% and D (20% compared to groups A (90% and B (80%. CONCLUSION: The use of non-irritant baby shampoos does not seem to eliminate the risk of cataract formation and these should even be used more carefully as the non-irritant shampoo will have more contact with the eye. [TAF Prev Med Bull 2008; 7(1.000: 1-6

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

    AIM:To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty(PKP).METHODS:In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin0.5% ophthalmic solution(0.5 mg/0.1 mL). The main outcome measures were anterior chamber reaction, best corrected visual acuity(BCVA), corneal endothelial cell count(ECC), and central corneal thickness(CCT).RESULTS:Fifty-five patients were recruited(26 males,29 females). The mean age was 54.36±4.97y(range 45-64y).All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively,which was statistically significant(P <0.001). One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33 ±1.01 s. The mean ECC was 2340.20 cells/mm2 preoperatively and 1948.75 cells/mm21 mo postoperatively(P <0.001). The increase of21.09 μm in postoperative pachymetry 1mo after surgery was statistically significant(P <0.001).CONCLUSION:Nountowardeffectswereobservedafter intracameral injection of moxifloxacin(0.5 mg/0.1 mL) in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP.

  18. A PROSPECTIVE OBSERVATIONAL STUDY TO ANALYZE THE CAUSES AND TYPES OF PRE SENILE CATARACT IN SOUTH INDIAN PATIENTS

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    Manoj

    2014-10-01

    Full Text Available Cataract is the opacification of the crystalline lens and or its capsule. Senile cataract is the cataract occurring commonly in the elderly who are above 50 years of age. It is one of the major causes of blindness in both the developing and the developed countries. Cataracts which develop prior to age of 50 are defined as pre senile cataract. There may be several reasons for an individual to develop such pre senile cataract. Some of the major identified risk factors are ocular trauma, uncontrolled diabetes, nutritional deficiencies, environmental factors like chronic exposure to sunlight as in tropics, cigarette smoking, refractive errors like high myopia, chronic intake of certain drugs for some systemic illness and certain ocular inflammatory diseases. AIM AND OBJECTIVES: To determine the various types of pre senile cataract and to determine the common causes of pre senile cataract. DESIGN: Prospective Observational study. METHODS & MATERIALS: The patients attending the out-patient clinics of the ophthalmology department who are found to have pre senile cataract and who give consent to participate in the observational study are requested to fill the questionnaire and undergo a complete ocular examination. The type of cataract and any cause of the cataract formation identified from the questionnaire, examination or investigations done are documented and analyzed using frequency distribution. RESULTS: 100 eyes of 54 patients were included in the study. Most common type of cataract was found to be posterior sub capsular cataract. The common causes identified were sunlight exposure, chronic steroid use, diabetes, uveitis and smoking. CONCLUSION: Protection from sunlight, avoidance of chronic steroid usage, screening and adequate control of diabetes, meticulous management of uveitis and avoiding cigarette smoking helps to prevent early development of cataracts.

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

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    Grob SR

    2014-07-01

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

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

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    H SOLTANI NEZHAD

    2003-03-01

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

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

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    Singh R

    2012-08-01

    Full Text Available Rishi Singh,1 Louis Alpern,2 Glenn J Jaffe,3 Robert P Lehmann,4 John Lim,5 Harvey J Reiser,6 Kenneth Sall,7 Thomas Walters,8 Dana Sager91Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2The Cataract, Glaucoma, and Refractive Surgery Center, El Paso, TX, 3Duke Eye Center, Duke Reading Center, Duke University, Durham, NC, 4Lehmann Eye Center, Nacogdoches, TX, 5Houston Eye Associates, Houston, TX, 6Eye Care Specialists, Kingston, PA, 7Sall Research Medical Center, Artesia, CA, 8Texan Eye, Austin, TX, 9Alcon Research Ltd, Fort Worth, TX, USABackground: The purpose of this study was to evaluate nepafenac ophthalmic suspension 0.1% (Nevanac®; Alcon Research Ltd in the prevention of macular edema following cataract surgery in diabetic retinopathy patients.Methods: This was a multicenter, randomized, double-masked, vehicle-controlled study of 263 adult diabetic patients with nonproliferative diabetic retinopathy requiring cataract surgery. Patients were randomized (1:1 to instill nepafenac or vehicle three times daily beginning 1 day prior to surgery through day 90. Efficacy included the percentage of patients who developed macular edema (≥30% increase in central subfield macular thickness from baseline and the percentage of patients with decreases of more than five letters in best-corrected visual acuity from day 7 to 90.Results: A significantly lower percentage of patients in the nepafenac group developed macular edema relative to patients in the vehicle group (3.2% versus 16.7%; P < 0.001. A significantly lower percentage of patients in the nepafenac group had best-corrected visual acuity decreases of more than five letters relative to patients in the vehicle group on day 30 (P < 0.001, day 60 (P = 0.002, and day 90 (P = 0.006. The mean central subfield macular thickness and mean percent change from baseline in macular volume were also significantly lower in the nepafenac group versus the vehicle group at days 14 through 90 (P

  2. Ectopic intraocular lens: An unusual complication of cataract surgery

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    Mehul A Shah

    2014-01-01

    Full Text Available We wish to report an unusual complication of intraocular lens (IOL insertion following uneventful phacoemulsification. After successful phacoemulsification surgery, a hydrophobic acrylic IOL was loaded in the injector for insertion into the capsular bag. During insertion, the IOL inadvertently extended into the corneal stromal lamella. The complication was recognized at a late stage, and the foldable acrylic lens was retrieved and reinserted correctly in the bag. The anterior chamber was made viscoelastically taut and was maintained in this state for 10 min, followed by a routine viscoelastic wash and air bubble injection. Cornea was slightly edematous with stromal haze, and the corneal thickness was 908 μm. At the 1-month follow-up visit, the patient′s vision was 20/40, the stromal haze had subsided, the corneal thickness was 572 μm, and the patient was comfortable. Though it was unknown complication, following proper management patient recovered satisfactorily.

  3. 白内障的疾病与手术分类%The Disease and Surgery Classification of Cataract

    Institute of Scientific and Technical Information of China (English)

    尹劲峰; 岳月英; 陈彩霞; 刘波苑; 方宝珍; 俞长荣

    2011-01-01

    Objectives This article discusses disease and surgery code of cataract and code also problems . Methods Through learning about the related references of cataract disease and surgery and careful medical records reading , it has correct ICD code according to classification principle . Results the disease code axis of cataract has many , we should correctly classify according to disease time. the cause of disease and the shape and position of lens opacity . The code classification axis of cataract enucleation also has many , we should correctly classify to subdivisions from 13 .1 to 13 .6 according to types of cataract. different enucleation and different approach : the code of intraocular lens implantation is 13 .71 ; the code of vitrectomy is 14 .73 or 14 .74 ; the code of anti-glaucom a surgery is 12 .64 ; the code of keratoplasty is 11 .6 ; The code of secondary im bedding operation after cataract enucleation is 13 .72 . Conclusions The coder not only should master ICD code know ledge , but also need to learn related m edical know ledge and carefulm edical records read ing for correct coding .%目的 探讨白内障疾病与手术编码及另编码问题.方法 通过学习白内障疾病与手术的相关文献,仔细阅读病历,按照分类原则进行准确的ICD编码.结果 白内障疾病编码分类轴心有多重,应按发病时间、病因以及晶状体混浊的形态和部位准确分类.白内障摘除术编码分类轴心也有多重,根据不同的白内障类型、不同的摘除方法及入路等准确分类到13.1-13.6的各个具体细目,伴有人工晶体植入术应另编码13.71,伴有玻璃体切除术应另编码14.73或14.74,伴有抗青光眼手术应另编码12.64,伴有角膜移植术应另编码11.6,白内障摘出术后人工晶体的二期置入手术只需编码13.72.结论 编码员不但要掌握ICD编码知识,还要学习相关的医学知识和仔细阅读病历,才能做到准确编码.

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

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    Micheli Patrícia de Fátima Magri

    2012-10-01

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

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

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    Arantes Tiago Eugênio Faria e

    2006-01-01

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

  6. The Safety and Efficacy of Routine Administration of Intracameral Vancomycin during Cataract Surgery

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    Sloan W. Rush

    2015-01-01

    Full Text Available Purpose. To evaluate the safety and efficacy of intracameral vancomycin during cataract surgery using a standardized dosage and delivery technique. Methods. The charts of 20,719 consecutive eyes that underwent phacoemulsification with intraocular lens implantation in a single ambulatory surgery center were retrospectively reviewed over a 5-year period. Results. The first 11,333 consecutive cases did not receive intracameral vancomycin, whereas the next 9,386 consecutive cases all received intracameral vancomycin. There were no significant differences in the baseline characteristics between the cohort of subjects who received intracameral vancomycin and the cohort of subjects that did not. There were a total of 11 subjects (0.97 cases per 1,000 that developed postoperative endophthalmitis in the group that did not receive intracameral vancomycin, whereas there were no cases of postoperative endophthalmitis in the group that received intracameral vancomycin (p = 0.0015. The overall rate of intraoperative and postoperative complications and the final postoperative visual acuities were similar among cohorts. There were no cases of toxic anterior segment syndrome occurring in either group during the study period. Conclusions. Routine administration of intracameral vancomycin during cataract surgery significantly decreased the incidence of postoperative endophthalmitis and was not associated with an increased incidence of postoperative adverse events.

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

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    Manuela Bezerril Cipião Fernandes

    2013-12-01

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

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

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    Yelda B Özkurt

    2009-06-01

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

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

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    Aileen Walsh

    2012-10-01

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

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

    Science.gov (United States)

    Hjelmstad, David P.; Sayegh, Samir I.

    2013-03-01

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

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

    DEFF Research Database (Denmark)

    Rasmussen, Line D; Kessel, Line; Molander, Laleh D;

    2011-01-01

    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...... 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...

  12. Higher Cognitive Function in Elderly Individuals with Previous Cataract Surgery: Cross-Sectional Association Independent of Visual Acuity in the HEIJO-KYO Cohort.

    Science.gov (United States)

    Miyata, Kimie; Obayashi, Kenji; Saeki, Keigo; Tone, Nobuhiro; Tanaka, Kunihiko; Nishi, Tomo; Morikawa, Masayuki; Kurumatani, Norio; Ogata, Nahoko

    2016-06-01

    Cataract surgery improves visual acuity and drastically increases the capacity for light reception to the retina. Although previous studies suggested that both light exposure and visual acuity were associated with cognitive function, the relationships between cataract surgery, visual acuity, and cognitive function have not been evaluated in large populations. In this cross-sectional study, we measured cognitive function using the Mini-Mental State Examination and best-corrected visual acuity in pseudophakic (previous cataract surgery) and phakic (no previous cataract surgery) elderly individuals. Of 945 participants (mean age 71.7 years), 166 (17.6%) had pseudophakia and 317 (33.5%) had impaired cognitive function (score ≤26). The pseudophakic group showed significantly better visual acuity than the phakic group (p = 0.003) and lower age-adjusted odds ratio (ORs) for cognitive impairment (OR 0.66; p = 0.038). Consistently, in multivariate logistic regression models, after adjusting for confounding factors, including visual acuity and socioeconomic status, ORs for cognitive impairment were significantly lower in the pseudophakic group than in the phakic group (OR 0.64; 95% confidence interval 0.43-0.96; p = 0.031). This association remained significant in sensitivity analysis, excluding participants with low cognitive score ≤23 (n = 36). In conclusion, in a general elderly population, prevalence of cognitive impairment was significantly lower in pseudophakic individuals independently of visual acuity. The association was also independent of several major causes of cognitive impairment such as aging, gender, obesity, socioeconomic status, hypertension, diabetes, sleep disturbances, depressive symptoms, and physical inactivity.

  13. Risk factors for acute endophthalmitis following cataract surgery: a systematic review and meta-analysis.

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    He Cao

    Full Text Available BACKGROUND: Acute endophthalmitis is one of the most serious complications of cataract surgery and often results in severe visual impairment. Several risk factors for acute postoperative endophthalmitis (POE following cataract surgery have been reported but the level of evidence and strength of association is varied. The purpose of this study was to critically appraise published reports on and to summarize clinical risk factors associated with acute POE which could be easily assessed by ophthalmologists for the introduction and implementation of preventive measure. METHODS: A systematic review and meta-analysis of observational studies was performed. Six databases were searched with no limits on the year or language of publication. Study-specific odds ratios (Ors or relative risk (RR of each risk factor were pooled using a random effect model. RESULTS: A total of 6 686 169 participants with 8 963 endophthalmitis in 42 studies were analyzed. Of the nine risk factors identified in our systematic review and meta-analysis, extra- or intracapsular cataract extraction, a clear corneal incision, without intracameral cefazolin (1 mg in 0.1 ml solution, without intracameral cefuroxime (1 mg in 0.1 ml solution, post capsular rupture, silicone intraocular lenses and intraoperative complications were found strongly associated with acute endophthalmitis. Other significant factors with a lower strength of association (risk estimates generally 1.5 or less were male gender and old age (85 years and older. CONCLUSIONS: Our study provides summary data on the risk factors for acute POE. Identifying patients at high risk of this sight-threatening eye disease is important from both the public health and clinical perspectives as this would facilitate detection of disease before the onset of irreversible visual loss enabling earlier intervention.

  14. Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes.

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    Wood, K S; Tadros, D; Trivedi, R H; Wilson, M E

    2016-09-01

    PurposeThe purpose of this study was to determine the long-term complications and outcomes of secondary intraocular lens (IOL) implantation in patients with congenital cataracts.Patients and MethodsThe medical records of children operated for secondary IOL implantation surgery between 2000 and 2014 were retrospectively reviewed. Those who had undergone their initial congenital cataract surgery before 7 months of age were included and were analyzed for intra- and postoperative factors and postoperative refractive outcomes. We focused on three complications: visual axis opacification (VAO), glaucoma, and IOL exchange after at least 1 year of follow-up.ResultsA total of 49 eyes of 49 patients were analyzed for intraoperative indications. Of those, 37 eyes of 37 patients had at least 1 year of follow-up and were analyzed for postoperative outcomes. The mean age at secondary implantation was 55.2±21.6 months. At secondary implantation, 69.4% of eyes were implanted in the capsular bag, 28.6% in the sulcus, and 2.0% that were angle-supported. There was no significant correlation between the site of secondary IOL implantation and age at implantation (P=0.216). The mean follow-up after implantation was 57.6±33.6 months. The rate of VAO was 5.4%, the rate of glaucoma occurring after secondary implantation was 16.2%, and the rate of IOL exchange was 2.7%. The median visual acuity at final follow-up was 20/40. For patients with unilateral cataracts it was 20/60 and for bilateral patients it was 20/30.ConclusionsThe secondary IOL implantation in children is a relatively safe procedure associated with low rates of postoperative complications. Visual outcomes are acceptable and are better for bilateral patients than for unilateral patients.

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

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    Saedon H

    2013-12-01

    Full Text Available Habiba Saedon Birmingham Midland Eye Centre, Birmingham, West Midlands, UK Objectives: To determine whether feedback for cataract surgery is perceived to be given to trainee ophthalmologists, the way in which any feedback is given, and what the trainee perceives to be the effect of feedback on their performance. Design: Cross-sectional qualitative study. Participants: Twelve trainee ophthalmologists at various levels of specialty training in the UK. Methods: Semi-structured interviews were conducted via telephone or face to face. Interviews were transcribed and underwent thematic analysis using a qualitative software data package. Main outcome measures: The importance of feedback to the trainee and methods to improve the giving of feedback. Results: Feedback was thought to be a useful tool for improving performance in cataract surgery by all participants. Emergent themes were the importance of specificity of feedback and having confidence in the supervisor. Participants suggested ways that the feedback given can be improved upon. An insight was gained into how the feedback has an effect on their performance. Conclusion: This study showed that trainees perceive the feedback they receive to be of high quality. Feedback enables the trainees to self-reflect and improve their surgical techniques. Keywords: postgraduate training, education, phacoemulsification, microsurgical skills, cognitive learning, reflection

  16. Combined cataract surgery on a Marfan-syndrome patient (case report).

    Science.gov (United States)

    Biró, Zsolt; Szabó, Ilona; Pámer, Zsuzsanna

    2014-01-01

    Combined cataract surgery of an ectopic lens was performed on a 10 years old girl with Marfan-syndrome. A Cionni capsular tension ring was implanted into the capsular bag, and the bag was pulled to its place and fixed with a scleral suture. Because of the young age of the patient a primary posterior capsulorhexis was performed, through which anterior vitrectomy was carried out and the artificial lens was implanted into the capsular bag. In the literature several surgical solutions are advised for the treatment of the ectopic lens in patients with Marfan-syndrome. We have performed a successful surgery combined with posterior capsulorhexis in our case. Because of its rarity and special surgical solution, we think this case report is interesting and can be helpful in such cases to be published.

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

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    Simon S. M. Fung

    2015-01-01

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

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

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

    2014-12-01

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

  19. The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery

    Science.gov (United States)

    Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

    2016-01-01

    Purpose The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Methods Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. Results The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%–12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France). Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Conclusion Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity. PMID:27382245

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

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    Godrat Akhavanakbari

    2013-01-01

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

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

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    Hamid Fesharaki

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

    Purpose The purpose of this study was to evaluate the visual and refractive outcomes and rotational stability of the new aspheric Precizon® toric intraocular lens (IOL) for the correction of corneal astigmatism in cataract surgery. Setting Department of Ophthalmology, Hospital Geral de Santo António – Centro Hospitalar do Porto, EPE and Hospital de Pedro Hispano, Matosinhos, Portugal. Design This was a prospective clinical study. Patients and methods A total of 40 eyes of 27 patients with corneal astigmatism greater than 1.0 diopter (D) underwent cataract surgery with implantation of Precizon® toric IOL. IOL power calculation was performed using optical coherence biometry (IOLMaster®). Outcomes of uncorrected (UDVA) and best-spectacle corrected distance visual acuities (BCDVA), refraction, and IOL rotation were analyzed at the 1st week, 1st, 3rd, and 6th month’s evaluations. Results The median postoperative UDVA was better than preoperative best-spectacle corrected distance visual acuity (0.02 [0.06] logMAR vs 0.19 [0.20] logMAR, P<0.001). At 6 months, postoperative UDVA was 0.1 logMAR or better in 95% of the eyes. At last follow-up, the mean spherical equivalent was reduced from −3.35±3.10 D to −0.02±0.30 D (P<0.001) with 97.5% of the eyes within ±0.50 D of emmetropia. The mean preoperative keratometric cylinder was 2.34±0.95 D and the mean postoperative refractive cylinder was 0.24±0.27 D (P<0.001). The mean IOL rotation was 2.43°±1.55°. None of the IOLs required realignment. Conclusion Precizon® toric IOL revealed very good rotational stability and performance regarding predictability, efficacy, and safety in the correction of preexisting regular corneal astigmatism associated with cataract surgery. PMID:26855559

  3. Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation: Qualitative Classification and Quantitative Measurement.

    Science.gov (United States)

    Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

    2016-03-01

    The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement.This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China.Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I-capsule with mild opacification but no invasion into the capsule opening; Type II-capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III-capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed.The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I-120 eyes (38.1%); Type II-157 eyes (49.8%); Type III-38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = -0.572, P < 0.001), but no significant correlation with intraoperative posterior capsulorhexis size (R = -0.16, P = 0.122) was observed. The ACOA significantly decreased from Type I to Type II to Type III, the PCOA increased in size from Type I to Type II, and the PCOO increased

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

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    Monali S Malvankar-Mehta

    Full Text Available Immediately sequential bilateral cataract surgery (ISBCS, the cataract surgery that is performed in both eyes simultaneously, is gaining popularity worldwide compared to the traditional treatment paradigm: delayed sequential bilateral cataract surgery (DSBCS, the surgery that is performed in each eye on a different day as a completely separate operation. ISBCS provides advantages to patients and patients' families in the form of fewer hospital visits. Additionally, patients enjoy rapid rehabilitation, lack of anisometropia - potentially reducing accidents and falls, and avoid suboptimal visual function in daily life. The hospital may benefit due to lower cost.To perform a systematic review and meta-analysis to evaluate ISBCS and DSBCS.Databases including MEDLINE, EMBASE, BIOSIS, CINAHL, Health Economic Evaluations Database (HEED, ISI Web of Science (Thomson-Reuters and the Cochrane Library were searched.Not applicable.Literature was systematically reviewed using EPPI-Reviewer 4 gateway. Meta-analysis was conducted using STATA v. 13.0. Standardized mean difference (SMD and 95% confidence intervals (CI were calculated and heterogeneity was assessed using I2 statistics. Fixed-effect and random-effect models were computed based on heterogeneity. Meta-analysis was done by instrument used to calculate utility score.In total, 9,133 records were retrieved from multiple databases and an additional 128 records were identified through grey literature search. Eleven articles with 3,657 subjects were included for analysis. Our meta-analysis results indicated significant improvement in post-operative utility score using TTO, EQ5D, HUI3, VF-7, and VF-14 and a non-significant improvement using Catquest questionnaire for both surgeries. For ISBCS versus DSBCS, utility-specific fixed-effect model provided an overall SMD of the utility score using the TTO method as 0.12 (95% CI: -0.15, 0.40, EQ5D as 0.14 (95% CI: -0.14, 0.41, HUI3 as 0.12 (95% CI: -0.15, 0.40, VF

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

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    Mohammad Ali Zare

    2011-01-01

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

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

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    Wei Ching-Kuo

    2012-10-01

    Full Text Available Abstract Background The implementation of capitated payment has driven medical institutions through developing balance billing for medical services. By exploring the patients’ decision-making factors on different self-pay items, a reference for the pricing and sales strategy for the related products can be formed. The major purposes of this study were to analyze the determinants of preoperative selection and postoperative satisfaction with implantation of different types of intraocular lenses in cataract surgery. Methods This cross-sectional study consisted of 127 patients that were 50 years of age and older, and who had phacoemulsification with intraocular lens implantation in both eyes. Data were collected by using a structured questionnaire. The following parameters were measured: access to medical care, attitude towards receiving medical products at one’s own expense, overall patient satisfaction and postoperative visual clarity. Results The results showed that the patient’s gender, educational level and economic status influenced the type of intraocular lens chosen. Patients in the insurance group cared about access to medical care, and patients in the balance billing group cared about product differentiation. ANOVA results showed no statistically significant differences in the overall satisfaction of the patients among the groups with different types of intraocular lenses. Patients that received cataract surgery with implantation of multifocal intraocular lenses had better vision when trying to view smaller objects and when looking at objects under strong light. Conclusions Manufacturers should increase the number of differences between their products, and health care providers can then recommend the appropriate intraocular lens in accordance with the needs or demands of their patients, and also by keeping in mind the financial constraints of their patients.

  7. A case of perforating injury of eyeball and traumatic cataract caused by acupuncture

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    Han Shuang

    2016-01-01

    Full Text Available Perforating globe injury is the leading cause of monocular blindness and vision loss. A 58-year-old male was injured by acupuncture needle during acupuncture treatment for his cerebral infarction. To the best of our knowledge, this is the first case report of perforating injury of the eyeball and traumatic cataract caused by acupuncture. The patient was hospitalized due to diagnosis of perforating ocular injury, traumatic cataract, and corneal and iris perforating injury. Moreover, he had to accept treatments of phacoemulsification, anterior vitrectomy along with intraocular lens implantation in the sulcus to improve his visual acuity. As acupuncture therapy has been widely performed for various diseases and achieved highly approval, the aim of this report is to remind acupuncturists operating accurately to avoid unnecessary injury during the treatment process, or the cure can also become the weapon.

  8. Effect of Co-Implantation of a Capsular Tension Ring on Clinical Outcomes after Cataract Surgery with Monofocal Intraocular Lens Implantation

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    Park, Hyun Ju; Lee, Hun; Kim, Do Wook; Kim, Eung Kweon; Seo, Kyoung Yul

    2016-01-01

    Purpose The objective was to evaluate the effect of co-implantation of a preloaded capsular tension ring (CTR) and aberration-free monofocal intraocular lens (IOL) on clinical outcomes and visual quality after cataract surgery. Materials and Methods Patients who underwent cataract surgery were randomized into two groups that were implanted with a CTR and IOL (group 1, 26 eyes) or an IOL only (group 2, 26 eyes). At 1 and 3 months after surgery, visual acuity, refractive errors, refractive prediction errors, ocular aberrations, and modulation transfer function (MTF) were analyzed. At 3 months postoperatively, anterior chamber depth (ACD) and contrast sensitivity were evaluated. Results Group 1 showed greater hyperopic shift, which caused the refractive prediction error at 3 months after surgery to be significantly different between the two groups (p=0.049). Differences in ACD between the preoperative and postoperative periods tended to be greater in group 1 than in group 2. At 3 months postoperatively, internal MTF values at 20, 25, and 30 cycles per degree were significantly better in group 1 than in group 2 (p=0.034, 0.017, and 0.017, respectively). Contrast sensitivity showed comparable results at almost all spatial frequencies between the groups. Conclusion Regarding visual acuity and quality, both groups showed comparable results. Co-implantation of a CTR and aberration-free monofocal IOL was associated with hyperopic refractive outcomes. Surgeons should consider the position of the IOL when planning co-implantation of a CTR and IOL. PMID:27401657

  9. Medical Malpractice Claims Related to Cataract Surgery Complicated by Retained Lens Fragments (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Kim, Judy E.; Weber, Paul; Szabo, Aniko

    2012-01-01

    Purpose: To review malpractice claims associated with retained lens fragments during cataract surgery to identify ways to improve patient outcomes. Methods: Retrospective, noncomparative, consecutive case series. Closed claims data related to cataract surgeries complicated by retained lens fragments (1989 through 2009) from an ophthalmic insurance carrier were reviewed. Factors associated with these claims and claims outcomes were analyzed. Results: During the 21-year period, 117 (12.5%) of 937 closed claims associated with cataract surgery were related to retained lens fragments with 108 unique cataract surgeries, 97% against cataract surgeon and 3% against retinal surgeon. Twelve (11%) of 108 claims were resolved by a trial, 30 (28%) were settled, and 66 (61%) were dismissed. The defendant prevailed in 83% of trials. Indemnity payments totaling more than $3,586,000 were made in 32 (30%) of the claims (median payment, $90,000). The difference between the preoperative visual acuity and the final visual acuity was predictive of an indemnity payment (odds ratio [OR], 2.28; P=.001) and going to a trial (OR, 2.93; P=.000). Development of corneal edema was associated with an indemnity payment (OR, 3.50; P=.037). Timing of referral and elevated intraocular pressure (IOP) were statistically significant in univariate analyses but not in multivariate analyses for a trial. Conclusions: Whereas the majority of claims were dismissed, claims associated with greater visual acuity decline, corneal edema, or elevated IOP were more likely to result in a trial or payment. Ways to reduce significant vision loss, including improved management of corneal edema and IOP, and timely referral to a subspecialist should be considered. PMID:23818737

  10. The impact of successful cataract surgery on quality of life, household income and social status in South India.

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    Robert P Finger

    Full Text Available BACKGROUND: To explore the hypothesis that sight restoring cataract surgery provided to impoverished rural communities will improve not only visual acuity and vision-related quality of life (VRQoL but also poverty and social status. METHODS: Participants were recruited at outreach camps in Tamil Nadu, South India, and underwent free routine manual small incision cataract surgery (SICS with intra-ocular lens (IOL implantation, and were followed up one year later. Poverty was measured as monthly household income, being engaged in income generating activities and number of working household members. Social status was measured as rates of re-marriage amongst widowed participants. VRQoL was measured using the IND-VFQ-33. Associations were explored using logistic regression (SPSS 19. RESULTS: Of the 294 participants, mean age ± standard deviation (SD 60 ± 8 years, 54% men, only 11% remained vision impaired at follow up (67% at baseline; p<0.001. At one year, more participants were engaged in income generating activities (44.7% to 77.7%; p<0.001 and the proportion of households with a monthly income <1000 Rps. decreased from 50.5% to 20.5% (p<0.05. Overall VRQoL improved (p<0.001. Participants who had successful cataract surgery were less likely to remain in the lower categories of monthly household income (OR 0.05-0.22; p<0.02 and more likely to be engaged in income earning activities one year after surgery (OR 3.28; p = 0.006. Participants widowed at baseline who had successful cataract surgery were less likely to remain widowed at one year (OR 0.02; p = 0.008. CONCLUSION: These findings indicate the broad positive impact of sight restoring cataract surgery on the recipients' as well as their families' lives. Providing free high quality cataract surgery to marginalized rural communities will not only alleviate avoidable blindness but also - to some extent - poverty in the long run.

  11. A novel GJA8 mutation (p.V44A causing autosomal dominant congenital cataract.

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    Yanan Zhu

    Full Text Available To examine the mechanism by which a novel connexin 50 (Cx50 mutation, Cx50 V44A, in a Chinese family causes suture-sparing autosomal dominant congenital nuclear cataracts.Family history and clinical data were recorded and direct gene sequencing was used to identify the disease-causing mutation. The Cx50 gene was cloned from a human lens cDNA library. Connexin protein distributions were assessed by fluorescence microscopy. Hemichannel functions were analyzed by dye uptake assay. Formation of functional channels was assessed by dye transfer experiments.Direct sequencing of the candidate GJA8 gene revealed a novel c.131T>C transition in exon 2, which cosegregated with the disease in the family and resulted in the substitution of a valine residue with alanine at codon 44 (p. V44A in the extracellular loop 1 of the Cx50 protein. Both Cx50 and Cx50V44A formed functional gap junctions, as shown by the neurobiotin transfer assay. However, unlike wild-type Cx50, Cx50V44A was unable to form open hemichannels in dye uptake experiments.This work identified a unique congenital cataract in the Chinese population, caused by the novel mutation Cx50V44A, and it showed that the V44A mutation specifically impairs the gating of the hemichannels but not the gap junction channels. The dysfunctional hemichannels resulted in the development of human congenital cataracts.

  12. Cataracts and microphthalmia caused by a Gja8 mutation in extracellular loop 2.

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    Chun-Hong Xia

    Full Text Available The mouse semi-dominant Nm2249 mutation displays variable cataracts in heterozygous mice and smaller lenses with severe cataracts in homozygous mice. This mutation is caused by a Gja8(R205G point mutation in the second extracellular loop of the Cx50 (or α8 connexin protein. Immunohistological data reveal that Cx50-R205G mutant proteins and endogenous wild-type Cx46 (or α3 connexin proteins form diffuse tiny spots rather than typical punctate signals of normal gap junctions in the lens. The level of phosphorylated Cx46 proteins is decreased in Gja8(R205G/R205G mutant lenses. Genetic analysis reveals that the Cx50-R205G mutation needs the presence of wild-type Cx46 to disrupt lens peripheral fibers and epithelial cells. Electrophysiological data in Xenopus oocytes reveal that Cx50-R205G mutant proteins block channel function of gap junctions composed of wild-type Cx50, but only affect the gating of wild-type Cx46 channels. Both genetic and electrophysiological results suggest that Cx50-R205G mutant proteins alone are unable to form functional channels. These findings imply that the Gja8(R205G mutation differentially impairs the functions of Cx50 and Cx46 to cause cataracts, small lenses and microphthalmia. The Gja8(R205G mutation occurs at the same conserved residue as the human GJA8(R198W mutation. This work provides molecular insights to understand the cataract and microphthalmia/microcornea phenotype caused by Gja8 mutations in mice and humans.

  13. Cataracts and microphthalmia caused by a Gja8 mutation in extracellular loop 2.

    Science.gov (United States)

    Xia, Chun-Hong; Chang, Bo; Derosa, Adam M; Cheng, Catherine; White, Thomas W; Gong, Xiaohua

    2012-01-01

    The mouse semi-dominant Nm2249 mutation displays variable cataracts in heterozygous mice and smaller lenses with severe cataracts in homozygous mice. This mutation is caused by a Gja8(R205G) point mutation in the second extracellular loop of the Cx50 (or α8 connexin) protein. Immunohistological data reveal that Cx50-R205G mutant proteins and endogenous wild-type Cx46 (or α3 connexin) proteins form diffuse tiny spots rather than typical punctate signals of normal gap junctions in the lens. The level of phosphorylated Cx46 proteins is decreased in Gja8(R205G/R205G) mutant lenses. Genetic analysis reveals that the Cx50-R205G mutation needs the presence of wild-type Cx46 to disrupt lens peripheral fibers and epithelial cells. Electrophysiological data in Xenopus oocytes reveal that Cx50-R205G mutant proteins block channel function of gap junctions composed of wild-type Cx50, but only affect the gating of wild-type Cx46 channels. Both genetic and electrophysiological results suggest that Cx50-R205G mutant proteins alone are unable to form functional channels. These findings imply that the Gja8(R205G) mutation differentially impairs the functions of Cx50 and Cx46 to cause cataracts, small lenses and microphthalmia. The Gja8(R205G) mutation occurs at the same conserved residue as the human GJA8(R198W) mutation. This work provides molecular insights to understand the cataract and microphthalmia/microcornea phenotype caused by Gja8 mutations in mice and humans.

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

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    Sniatecki JJ

    2015-09-01

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

  15. Identification of a Novel GJA8 (Cx50) Point Mutation Causes Human Dominant Congenital Cataracts

    Science.gov (United States)

    Ge, Xiang-Lian; Zhang, Yilan; Wu, Yaming; Lv, Jineng; Zhang, Wei; Jin, Zi-Bing; Qu, Jia; Gu, Feng

    2014-02-01

    Hereditary cataracts are clinically and genetically heterogeneous lens diseases that cause a significant proportion of visual impairment and blindness in children. Human cataracts have been linked with mutations in two genes, GJA3 and GJA8, respectively. To identify the causative mutation in a family with hereditary cataracts, family members were screened for mutations by PCR for both genes. Sequencing the coding regions of GJA8, coding for connexin 50, revealed a C > A transversion at nucleotide 264, which caused p.P88T mutation. To dissect the molecular consequences of this mutation, plasmids carrying wild-type and mutant mouse ORFs of Gja8 were generated and ectopically expressed in HEK293 cells and human lens epithelial cells, respectively. The recombinant proteins were assessed by confocal microscopy and Western blotting. The results demonstrate that the molecular consequences of the p.P88T mutation in GJA8 include changes in connexin 50 protein localization patterns, accumulation of mutant protein, and increased cell growth.

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

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    Taraprasad Das

    2012-01-01

    Full Text Available 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 after care. In addition, we analyzed systemic diseases, surgeon factor, habitat, and socioeconomic status. Results. Clinical and culture positive endophthalmitis incidence were 0.13% and 0.07%, respectively. Differential incidence of 0.10% and 0.17% for in- and ambulatory care surgeries, respectively, was close to statistical significance (=0.054. Lower economy category ambulatory patients had higher risk of infection. Conclusion. Ambulatory cataract surgery carried additional risk for post-operative infection in lower socioeconomic group. Improved health education could ensure greater safety.

  17. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery

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    Je Hwan Yoon

    2013-01-01

    Full Text Available Aims: To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery. Materials and Methods: This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes. The outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA 1 and 3 months, post-operatively. Results: At 1 month, the mean SIA was 0.81 diopter (D for the temporal incisions and 0.92 D for nasal incisions (P = 0.139. At 3 months, the mean SIA were 0.53 D for temporal incisions and 0.62 D for nasal incisions (P = 0.309. The UCVA was similar in the 2 incision groups before surgery, and at 1 and 3 months post-operatively. Conclusion: After bilateral cataract surgery using 3.0 mm temporal and nasal horizontal corneal incisions, the induced corneal astigmatic change was similar in both incision groups. Especially in Asian eyes, both temporal and nasal incisions (3.0 mm or less would be favorable for astigmatism-neutral cataract surgery.

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

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    Rodrigo Pessoa Cavalcanti Lira

    2001-10-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

  20. Cataract Surgery Visual Outcomes and Associated Risk Factors in Secondary Level Eye Care Centers of L V Prasad Eye Institute, India

    OpenAIRE

    Sumathi Matta; Jiwon Park; Ghanshyam Palamaner Subash Shantha; Rohit C Khanna; Gullapalli N Rao

    2016-01-01

    Purpose To evaluate cataract surgery visual outcomes and associated risk factors in rural secondary level eye care centers of L V Prasad Eye Institute (LVPEI), India. Methods The Eye Health pyramid of LVPEI has a network of rural secondary care centres (SCs) and attached vision centres (VCs) that provide high quality comprehensive eye care with permanent infrastructure to the most disadvantaged sections of society. The most common procedure performed at SCs is cataract surgery. We au...

  1. Cataract blindness, surgical coverage, outcome, and barriers to uptake of cataract services in Plateau State, Nigeria

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    Ojo P Odugbo

    2012-01-01

    Full Text Available Purpose: The purpose was to estimate the prevalence of blindness due to cataract, assess visual outcomes of cataract surgery, and determine the cataract surgical coverage rate and barriers to uptake of services among individuals aged 50 years or older in Plateau State, Nigeria. Materials and Methods: A population-based, cross-sectional survey of 4200 adults 50 years or older was performed. Multistage stratified random sampling, with probability proportional to size was used to select a representative sample. The Rapid Assessment of Cataract Surgical Services protocol was used. Statistical significance was indicated by (P 0.05. The prevalence of monocular blindness due to cataract was 5.9% (95% CI: 5.2-6.6%. The cataract surgical coverage for subjects with visual acuity (VA less 3/60 was 53.8% in the entire cohort; 60.5% for males and 48% for females (χ2 = 2.49, P > 0.05. The couching coverage for subjects who were blind was 12%. A total of 180 eyes underwent surgical intervention (surgery or couching for cataract, of which, 48 (26.7% eyes underwent couching. The prevalence of bilateral (pseudo aphakia was 1.5%, (95% CI: 1.2-1.9% and 2.7% (95% CI: 2.2-3.2% for unilateral (pseudo aphakia. Visual outcomes of the 180 eyes that underwent surgical intervention were good (VA ≥ 6/18 in 46 (25.6% eyes and poor (VA < 6/60 in 105 (58.3% eyes. Uncorrected aphakia was the most common cause of poor outcome (65.1%. Most subjects who underwent cataract surgery were not using spectacles 74 (71.2%. Cost and lack of awareness were the main barriers to uptake of cataract surgery services. Conclusion: Couching remains a significant challenge in Nigeria. The outcomes of cataract surgery are poor with the lack of aphakic correction being the main cause of the poor outcomes.

  2. Etiopathogenesis of cataract: An appraisal

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    Varun B Gupta

    2014-01-01

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

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

    LENUS (Irish Health Repository)

    Goto, Y

    2012-02-03

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

  4. Theater for Development Methodology in Childhood Cataract Case Finding

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    Roseline Ekanem Duke

    2016-03-01

    Full Text Available The key informant methodology for case finding for childhood cataract  was utilized  in a rural population in Nigeria to identify suitable children who would benefit surgically from intervene for cataract and restore vision such children. It was however noticed that some parents who had children with cataract did not bring their children to the primary health center for examination and recommendation. The purpose of this study is to investigate the benefits of using the theatre for development approach in childhood cataract case finding. The delay in identification and referral of children with cataract at an appropriate age for surgical intervention and optical rehabilitation is the main cause of poor vision following surgery for the condition as amblyopia results. Therefore early presentation, identification, referral and surgical intervention as well as appropriate optical rehabilitation is the key to successful surgical outcome of childhood cataract and good visual prognosis. The theater for development (TfD approach methodology was implemented in a community in Akpabuyo local government are of Cross River state, Nigeria as a means to enhance community participation, health promotion and education and to complement the key informant methodology in case finding for childhood cataract. Three children with cataracts were referred by the community following the TfD intervention, for cataract surgery and uptake of follow up care after surgery. The TfD approach appears to be a useful method for encouraging community participation in the case finding of childhood cataract.

  5. Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report

    OpenAIRE

    Yoshino Hideaki; Seki Masaaki; Ueda Jun; Yoshino Takaiko; Fukuchi Takeo; Abe Haruki

    2012-01-01

    Abstract Background Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure. Case presentation A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a sha...

  6. A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery

    OpenAIRE

    Hosoda, Yoshikatsu

    2016-01-01

    Yoshikatsu Hosoda, Shoji Kuriyama, Yoko Jingami, Hidetsugu Hattori, Hisako Hayashi, Miho Matsumoto Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan Purpose: The purpose of this study was to compare the level of patient pain during the phacoemulsification and implantation of foldable intraocular lenses while under topical, intracameral, or sub-Tenon lidocaine.Patients and methods: This was a retrospective study. Three hundred and one eyes subjected to cataract surgery were i...

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

    OpenAIRE

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

    2014-01-01

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

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

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    Edison Ferreira e Silva

    2007-08-01

    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.

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

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    Edward F Hall

    2008-03-01

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

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

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    Monaco G

    2015-08-01

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

  11. Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report

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    Yoshino Hideaki

    2012-03-01

    Full Text Available Abstract Background Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure. Case presentation A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block. Conclusion This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.

  12. Impact of Laser Capsulotomy in the Quality of Life of the Elderly with Posterior Capsule Opacity after Cataract Surgery

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    Armando Rafael Milanés Armengol

    2013-04-01

    Full Text Available Background: the opacity of the posterior lens capsule after cataract surgery has decreased in recent years but its incidence remains high.Objective: To assess the impact of the opacification of the posterior lens capsule and its treatment with laser capsulotomy on visual function and life quality of patients after cataract surgery. Methods: A case series study of elderly patients with diagnose of opacity in the posterior lens capsule after cataract surgery who were treated with laser capsulotomy from January 2010 to January 2011 in the General University Hospital of Cienfuegos was conducted. A survey and a battery of assessment tools to measure functional status were applied as well as the VF-14 test for the assessment of life quality. Results: We observed an improvement in the average value of the visual acuity (0, 326 by 0, 726 practiced capsulotomy to later, with an average range of efficiency improvement of a binocular visual 6.96%, likewise improved functional visual capacity from 57, 728 to 96, 223; exploration by VF-14 showed a higher life quality. The degree of overall validism was recovered in 86, 56 % of patients and only one patient was totally dependent for the realization of daily life activities. Conclusions: Patients who underwent laser capsulotomy showed evidence of improvement in visual acuity, functionality and life quality.

  13. Comparative evaluation of aqueous and plasma concentration of topical moxifloxacin alone and with flurbiprofen in patients of cataract surgery

    Science.gov (United States)

    Halder, Sujash; Mondal, Kanchan Kumar; Biswas, Supreeti; Mandal, Tapan Kumar; Dutta, Bakul Kumar; Haldar, Mithilesh

    2013-01-01

    Objectives: To determine the aqueous and plasma concentrations of moxifloxacin administered topically alone and with flurbiprofen in patients undergoing cataract surgery. Materials and Methods: A total of 50 subjects scheduled for routine cataract surgery were randomly allocated to two groups (n = 25 each). Group-1 patients were treated with topical moxifloxacin alone: One drop 6 times/day for 3 days before surgery and one drop 4 times on the day of surgery: Group-2 patients were treated with topical moxifloxacin as in Group-1 and with topical flurbiprofen: One drop 4 times/day for 3 days before and on the day of surgery. The interval between two drugs was 30 min for last 3 days and 15 min on the day of surgery. Last dose was administered 1 h before aqueous humor and blood sampling for both the groups. The antibiotic concentration in aqueous humor and plasma were determined by using high performance liquid chromatography. Results: The mean concentration of moxifloxacin in aqueous humor was 1.71 ± 0.82 mg/ml in Group-1 and 2.39 ± 1.34 mg/ml in Group-2. Concentrations of moxifloxacin in aqueous humor were significantly higher in Group-2 than that of Group-1. Conclusion: Flurbiprofen may increase the concentration of moxifloxacin in aqueous humor. PMID:23833362

  14. Comparative evaluation of aqueous and plasma concentration of topical moxifloxacin alone and with flurbiprofen in patients of cataract surgery

    Directory of Open Access Journals (Sweden)

    Sujash Halder

    2013-01-01

    Full Text Available Objectives: To determine the aqueous and plasma concentrations of moxifloxacin administered topically alone and with flurbiprofen in patients undergoing cataract surgery. Materials and Methods: A total of 50 subjects scheduled for routine cataract surgery were randomly allocated to two groups (n = 25 each. Group-1 patients were treated with topical moxifloxacin alone: One drop 6 times/day for 3 days before surgery and one drop 4 times on the day of surgery: Group-2 patients were treated with topical moxifloxacin as in Group-1 and with topical flurbiprofen: One drop 4 times/day for 3 days before and on the day of surgery. The interval between two drugs was 30 min for last 3 days and 15 min on the day of surgery. Last dose was administered 1 h before aqueous humor and blood sampling for both the groups. The antibiotic concentration in aqueous humor and plasma were determined by using high performance liquid chromatography. Results: The mean concentration of moxifloxacin in aqueous humor was 1.71 ± 0.82 mg/ml in Group-1 and 2.39 ± 1.34 mg/ml in Group-2. Concentrations of moxifloxacin in aqueous humor were significantly higher in Group-2 than that of Group-1. Conclusion: Flurbiprofen may increase the concentration of moxifloxacin in aqueous humor.

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

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    R Muralidhar

    2012-01-01

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

  16. Pediatric cataract: challenges and future directions.

    Science.gov (United States)

    Medsinge, Anagha; Nischal, Ken K

    2015-01-01

    Cataract is a significant cause of visual disability in the pediatric population worldwide and can significantly impact the neurobiological development of a child. Early diagnosis and prompt surgical intervention is critical to prevent irreversible amblyopia. Thorough ocular evaluation, including the onset, duration, and morphology of a cataract, is essential to determine the timing for surgical intervention. Detailed assessment of the general health of the child, preferably in conjunction with a pediatrician, is helpful to rule out any associated systemic condition. Although pediatric cataracts have a diverse etiology, with the majority being idiopathic, genetic counseling and molecular testing should be undertaken with the help of a genetic counselor and/or geneticist in cases of hereditary cataracts. Advancement in surgical techniques and methods of optical rehabilitation has substantially improved the functional and anatomic outcomes of pediatric cataract surgeries in recent years. However, the phenomenon of refractive growth and the process of emmetropization have continued to puzzle pediatric ophthalmologists and highlight the need for future prospective studies. Posterior capsule opacification and secondary glaucoma are still the major postoperative complications necessitating long-term surveillance in children undergoing cataract surgery early in life. Successful management of pediatric cataracts depends on individualized care and experienced teamwork. We reviewed the etiology, preoperative evaluation including biometry, choice of intraocular lens, surgical techniques, and recent developments in the field of childhood cataract. PMID:25609909

  17. The refractive outcome of Toric Lentis Mplus implant in cataract surgery

    Science.gov (United States)

    Chiam, Patrick J; Quah, Say A

    2016-01-01

    AIM To evaluate the refractive outcome of Toric Lentis Mplus intraocular lens (IOL) implant. METHODS This is a retrospective case series. Consecutive patients with corneal astigmatism of at least 1.5 D had Toric Lentis Mplus IOL implant during cataract surgery. The exclusion criteria included irregular astigmatism on corneal topography, large scotopic pupil diameter (>6 mm), poor visual potential and significant ocular comorbidity. Postoperative manifest refraction, uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA), uncorrected intermediate visual acuity (UIVA) at 3/4 m and uncorrected near visual acuity (UNVA) were obtained. RESULTS There were 70 eyes from 49 patients in this study. Patients were refracted at a median of 8.9wk (range 4.0 to 15.5) from the operation date. Sixty-five percent of eyes had 6/7.5 (0.10 logMAR) or better, and 99% 6/12 (0.30 logMAR) or better postoperative UDVA. Eighty-nine percent could read Jaeger (J) 3 (0.28 logMAR) and 95% J5 (0.37 logMAR) at 40 cm. The median magnitude of astigmatism decreased from 1.91 D to 0.49 D (Wilcoxon, PLentis Mplus IOL has good predictability in reducing preexisting corneal astigmatism. PMID:27275424

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

    Science.gov (United States)

    Ozcan, Halil; Yucel, Atakan; Ates, Orhan

    2016-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Amedo AO

    2016-04-01

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

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

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    Li X-R

    2011-06-01

    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

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

    Directory of Open Access Journals (Sweden)

    Moharra Montse

    2008-04-01

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

  2. Development of senile cataract surgery database%老年性白内障手术资料数据库的建立

    Institute of Scientific and Technical Information of China (English)

    张鲲; 李晓陵; 王炜; 王宁; 崔霞

    2011-01-01

    Objective To develop the cataract surgery database for clinical case management and scientific research. Methods A senile cataract surgery database and its management system were developed by reviewing the cataract surgery data using the Microsoft Access 2003 Software and linked to a related network system. Results The database could run quite well on the related network system. Conclusion Development of cataract surgery database in a hospital contributes to the scientific and systematic collection of clinical cataract surgery data and lays a foundation for further analysis of cataract surgery data, thus providing evidence for the research on cataract surgery.%目的 开发较为详细的白内障手术资料数据库,便于病例管理和科研.方法 复习文献制定白内障手术资料登记表,应用Microsoft Access 2003数据库软件建立老年白内障患者手术资料数据库及其管理系统,并联网测试使用.结果 我院干部病房老年白内障手术资料数据库初步建立,相关网络通道运行良好.结论 医院白内障手术资料数据库的建立有利于科学和系统地收集白内障手术资料数据,为进一步统计分析奠定基础,并为白内障手术治疗研究提供依据.

  3. Training a cataract surgeon

    Directory of Open Access Journals (Sweden)

    M Babar Qureshi

    2014-07-01

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

  4. Surgical and Functional Results of Hybrid 25-27-Gauge Vitrectomy Combined with Coaxial 2.2 mm Small Incision Cataract Surgery

    OpenAIRE

    Fabian Höhn; Florian Kretz; Mitrofanis Pavlidis

    2016-01-01

    Purpose. To investigate outcomes after coaxial 2.2 mm small incision cataract surgery combined with hybrid 25-27-gauge vitrectomy in eyes with vitreoretinal disease and age-related cataract. Methods. A single-center, retrospective case series study of 55 subjects (55 eyes) with a mean age of 70 years who underwent combined small incision phacoemulsification, intraocular lens (IOL) implantation, and hybrid 25-27-gauge vitrectomy during the 12-month period to December 2014. Intraoperative and p...

  5. Cataract Surgery Visual Outcomes and Associated Risk Factors in Secondary Level Eye Care Centers of L V Prasad Eye Institute, India.

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    Sumathi Matta

    Full Text Available To evaluate cataract surgery visual outcomes and associated risk factors in rural secondary level eye care centers of L V Prasad Eye Institute (LVPEI, India.The Eye Health pyramid of LVPEI has a network of rural secondary care centres (SCs and attached vision centres (VCs that provide high quality comprehensive eye care with permanent infrastructure to the most disadvantaged sections of society. The most common procedure performed at SCs is cataract surgery. We audited the outcome of a random sample of 2,049 cataract surgeries done from October 2009-March 2010 at eight rural SCs. All patients received a comprehensive ophthalmic examination, both before and after surgery. The World Health Organization recommended cataract surgical record was used for data entry. Visual outcomes were measured at discharge, 1-3 weeks and 4-11 weeks follow up visits. Poor outcome was defined as best corrected visual acuity <6/18.Mean age was 61.8 years (SD: 8.9 years and 1,133 (55.3% surgeries were performed on female patients. Pre-existing ocular co-morbidity was present in 165 patients (8.1%. The most common procedure was small incision cataract surgery (SICS with intraocular lens (IOL implantation (91.8%. Intraoperative complications were seen in 29 eyes (1.4%. At the 4-11 weeks follow-up visit, based on presenting visual acuity (PVA, 61.8% had a good outcome and based on best-corrected visual acuity (BCVA, 91.7% had a good outcome. Based on PVA and BCVA, those with less than 6/60 were only 2.9% and 1.6% respectively. Using multivariable analysis, poor visual outcomes were significantly higher in patients aged ≥70 (OR 4.63; 95% CI 1.61, 13.30, in females (OR 1.58; 95% CI 1.04, 2.41, those with preoperative comorbidities (odds ratio 4.68; 95% CI 2.90, 7.57, with intraoperative complications (OR 8.01; 95% CI 2.91, 22.04, eyes that underwent no IOL or anterior chamber-IOL (OR 12.63; 95% CI 2.65, 60.25 and those undergoing extracapsular cataract extraction (OR 9

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

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    H Zahedi

    2004-10-01

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

  7. Perceptions of patients about cataract

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    Oliveira Regina de Souza Carvalho de Salles

    2005-01-01

    Full Text Available OBJECTIVE: To identify in adult patients suffering from cataract the perceptions regarding the disease and its surgical treatment. MATERIALS AND METHODS: An exploratory survey was conducted among adult patients suffering from cataract and participating in a large-scale cataract management program at the University of São Paulo General Hospital in 2004. The interviews were conducted by research assistants previously trained to pose questions and record answers. RESULTS: The sample consisted of 170 men and women (43.5% and 56.5%, respectively, aged between 40 and 88 years. Of the 170 participants, 43.5% were from the State of São Paulo, 14.7% from the State of Bahia, 12.4% from the State of Minas Gerais, 5.9% from the State of Pernambuco, 1.8% from other countries, and the remaining 21.7% were from other Brazilian states. Of those who were actively working (n = 87, 43.7% had an occupational level corresponding to nonspecialized manual labor, 27.6% were in specialized manual labor jobs, 25.3% had routine nonmanual occupations, 1.1% supervised manual labor, and 2.3% had low-ranking supervision or inspection jobs over nonmanual occupations. Of those who were not actively working (n = 82, 53.6% were retired, 45.2% were housewives, and 1.2% were unemployed. Concerning conceptions about cataract, 79.0% referred to it as "a small skin fold that gradually covers the eye" and 32.4% mentioned, in addition, other conceptions. Concerning the cause, of the alternatives presented to them, 80% reported aging, 47.1% blamed "overusing the eyes in the workplace or at home", 7.1% believed they had cataract due to some kind of "spell." Of the associated answers, 94.1% referred to "blurred vision" in people suffering from cataract, 72.4% thought the person may become blind, and 66.5% believed that the patients suffering from cataract are depressed because they cannot see. Regarding surgery, 28.8% were afraid of undergoing surgery; of those, 16.3% cited with the fear

  8. Pediatric cataract: challenges and future directions

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    Medsinge A

    2015-01-01

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

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

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    Joao Crispim

    2015-10-01

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

  10. A study on visual outcomes after cataract surgery with intraocular lens implants at the rural health training center, Paithan, Maharashtra

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    Vijay K Domple

    2011-01-01

    Full Text Available A study was conducted to assess the visual outcomes of patients after cataract surgery with intraocular lens implants with reference to visual acuity (VA and visual function (VF and to assess patient satisfaction with surgical outcome. The retrospective study was carried out using operation theatre records at the Rural Health Training Centre (RHTC, Paithan, during 2007. Out of 819 cataract surgery patients operated in 2007 a total of 50 were selected randomly. Door-to-door visits were paid by investigator and multipurpose worker to previously operated patients for VA examination and to fill predesigned questionnaire. Statistical analysis was done by using SPSS 17.0 Version; 50% patients had VA in fair vision range of <6/18-6/60 and 52% showed the VF in the range of 76-100. Of the 32 satisfied patients, majority were in the age group 70-79 years. The patients with good visual outcomes achieved after surgery would act as pamphlets for the community.

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

    OpenAIRE

    Li X-R; Sun G-L; Zhou X-X; Liu A-H; Wei R-H; Wu J-G

    2011-01-01

    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...

  12. Influence of age-related cataract and cataract-surgery on dominance eye%年龄相关性白内障及手术对老年人优势眼的影响

    Institute of Scientific and Technical Information of China (English)

    邢潇英; 祝雪宁; 喻芳; 李瑾; 赵云娥

    2014-01-01

    altered form the left eyes to the right eyes in 3 patients and form the right eyes to the left eyes in 1 patient,and unstable change occurred in 5 patients.There were no significant differences in the frequency of dominant eyes between before and after operation both the two groups (group A:P =0.092 ; group B:P =0.727).Conclusions Age-related cataract impact on eye dominance.Dominance eye may occur alteration binocularly following cataract surgery,which is one of causes of visual discomfort.

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

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    Huseynova T

    2015-11-01

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

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

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    Gutiérrez-Moreno Santiago

    2008-02-01

    Full Text Available Abstract Background In Spain, there are substantial variations in the utilization of health resources among regions. Because the need for surgery differs in patients with appropriate surgical indication, introducing a prioritization system might be beneficial. Our objective was to assess geographical variations in the impact of applying a prioritization system in patients on the waiting list for cataract surgery in different regions of Spain by using a discrete-event simulation model. Methods A discrete-event simulation model to evaluate demand and waiting time for cataract surgery was constructed. The model was reproduced and validated in five regions of Spain and was fed administrative data (population census, surgery rates, waiting list information and data from research studies (incidence of cataract. The benefit of introducing a prioritization system was contrasted with the usual first-in, first-out (FIFO discipline. The prioritization system included clinical, functional and social criteria. Priority scores ranged between 0 and 100, with greater values indicating higher priority. The measure of results was the waiting time weighted by the priority score of each patient who had passed through the waiting list. Benefit was calculated as the difference in time weighted by priority score between operating according to waiting time or to priority. Results The mean waiting time for patients undergoing surgery according to the FIFO discipline varied from 1.97 months (95% CI 1.85; 2.09 in the Basque Country to 10.02 months (95% CI 9.91; 10.12 in the Canary Islands. When the prioritization system was applied, the mean waiting time was reduced to a minimum of 0.73 months weighted by priority score (95% CI 0.68; 0.78 in the Basque Country and a maximum of 5.63 months (95% CI 5.57; 5.69 in the Canary Islands. The waiting time weighted by priority score saved by the prioritization system varied from 1.12 months (95% CI 1.07; 1.16 in Andalusia to 2

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

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    Modi SS

    2011-09-01

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

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

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    Xuefei Song

    2014-01-01

    Full Text Available 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. Changes (Δ were calculated as preoperative value versus postoperative value. Biometrical data were extracted from TMS-5 (CSI and SAI, IOLMaster (AL, and EM-3000 (CCT and ECC preoperatively. Results. The average values of the changes were ΔCH=-0.45±1.27 mmHg, ΔCRF=-0.88±1.1 mmHg, ΔIOPg=-1.58±3.15 mmHg, and ΔIOPcc=-1.45±3.93 mmHg. The higher the CSI the smaller the decrease in CH (r=0.302, P=0.028. The higher the CCT the larger the decrease in CRF (r=-0.371, P=0.013. The higher the AL the smaller the decrease in IOPg (r=0.417, P=0.005. The higher the AL, SAI, and EEC the smaller the decrease in IOPcc (r=0.351, P=0.001; r=-0.478, P<0.001; r=0.339, P=0.013. Conclusions. Corneal biomechanical properties were affected by comprehensive factors after cataract surgery, including corneal endothelium properties, biometry, and geometrical characteristics.

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

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    Linertová R

    2014-08-01

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

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

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    V. N. Trubilin

    2013-01-01

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

  19. Nursing care of patients with cataract

    OpenAIRE

    VESELÁ, Markéta

    2012-01-01

    This Bachelor´s thesis focuses on caring for cataract patients. Cataract is one of the leading causes of blindness in the world and the surgery for its correction is the most common surgery in the developed countries. 80 % of all that people perceive comes to them through their eyes; that´s why deteorating vision may mean limited self-sufficiency or even a complete loss of thereof; patients may then find it difficult to look after themselves. This Bachelor´s thesis consists of both theoretica...

  20. Congenital Cataract Screening.

    Science.gov (United States)

    Rajavi, Zhale; Sabbaghi, Hamideh

    2016-01-01

    Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year) is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender. PMID:27621790

  1. Congenital cataract screening

    Directory of Open Access Journals (Sweden)

    Zhale Rajavi

    2016-01-01

    Full Text Available Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender.

  2. Congenital Cataract Screening

    Science.gov (United States)

    Rajavi, Zhale; Sabbaghi, Hamideh

    2016-01-01

    Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year) is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender. PMID:27621790

  3. Short-term influence of cataract surgery on circadian biological rhythm and related health outcomes (CLOCK-IOL trial): study protocol for a randomized controlled trial

    OpenAIRE

    Saeki, Keigo; Obayashi, Kenji; Nishi, Tomo; Miyata, Kimie; Maruoka, Shinji; Ueda, Tetsuo; OKAMOTO, Masahiro; Hasegawa, Taiji; Matsuura, Toyoaki; Tone, Nobuhiro; Ogata, Nahoko; Kurumatani, Norio

    2014-01-01

    Background Light information is the most important cue of circadian rhythm which synchronizes biological rhythm with external environment. Circadian misalignment of biological rhythm and external environment is associated with increased risk of depression, insomnia, obesity, diabetes, cardiovascular disease, and cancer. Increased light transmission by cataract surgery may improve circadian misalignment and related health outcomes. Although some observational studies have shown improvement of ...

  4. Local Anesthesia in Cataract Surgery-A Comparison of Different Methods

    Institute of Scientific and Technical Information of China (English)

    Nolan; J; Aziz; M; Ahmad; M; Shehata; M; Iqbal; F

    1993-01-01

    Seven groups of thirty patients undergoing cataract extraction under local anesthesia were each given different combinations of local anesthesia. These varied from a maximum approach using supra-orbital, infra-orbital and facial blocks with Hyalase, orbital compression and pre-operative Acetazolamide down to a minimum group receiving purely an infra- orbital and supra-orbital block with a Ugnocaine/Bupivacaine mixture. There was no significant difference in local analgesia or in the complication rates b...

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

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    Jackson Barreto Junior

    2010-10-01

    Full Text Available OBJETIVO: Avaliar a frequência de complicações nas cirurgias de catarata realizada por residentes de um hospital universitário (segundo e terceiro anos, comparado com as realizadas por cirurgiões experientes (assistentes. MÉTODOS: Análise retrospectiva dos prontuários de todos pacientes submetidos à cirurgia de catarata realizadas nas primeiras quinzenas de março (época do início do aprendizado da técnica cirúrgica e de novembro (meados do aprendizado da técnica. Foram analisados a época da realização da cirurgia; graduação do cirurgião (residente ou médico assistente; técnica cirúrgica empregada (extração extracapsular ou facoemulsificação e a ocorrência de complicações per-operatórias e pós-operatórias. RESULTADOS: Foram analisadas 481 cirurgias, destas, 194 (40% foram realizadas pelos residentes do terceiro ano, 165 (34% pelos residentes do segundo ano e 116 (26% pelos assistentes. A complicação mais frequentemente encontrada em todas as cirurgias foi a rotura de cápsula posterior (4,8%. Não houve diferença estatisticamente significativa de complicações entre as cirurgias realizadas em março e novembro (p=0,97, bem como entre os residentes sob supervisão e os assistentes (p=0,08. CONCLUSÃO: A rotura de cápsula posterior continua sendo a complicação mais frequentemente encontrada nas cirurgias de residentes em treinamento. Não houve diferença estatisticamente significativa entre as taxas de complicação destes residentes e os assistentes, o que demonstra o importante papel de uma supervisão adequada.PURPOSE: To evaluate the complication's rate of cataract surgery performed by ophthalmology residents (second and third-year and experienced surgeons at a public teaching hospital. METHODS: A retrospective chart review of all patients who had cataract surgery between March (begin of the technique practice and November (end of the technique practice was conducted. RESULTS: In 481 cataracts surgeries

  6. A missense mutation S228P in the CRYBB1 gene causes autosomal dominant congenital cataract

    Institute of Scientific and Technical Information of China (English)

    WANG Jun; MA Xu; GU Feng; LIU Ning-pu; HAO Xiao-lin; WANG Kai-jie; WANG Ning-li; ZHU Si-quan

    2007-01-01

    Background Congenital cataract is a highly heterogeneous disorder at both the genetic and phenotypic levels. This study was conducted to identify disease locus for autosomal dominant congenital cataracts in a four generation Chinese family.Methods Family history and clinical data were recorded. All the members were genotyped with microsatellite markers which are close to the known genetic loci for autosomal congenital cataracts. Two-point Lod scores were obtained using the MLINK of the LINKAGE program package (ver 5.1). Candidate genes were amplified by polymerase chain reaction (PCR) and direct cycle sequencing.Results The maximum Lod score of Zmax=2.11 was obtained with three microsatellite markers D22S258, D22S315,and D22S1163 at recombination fraction θ= 0. Haplotype analysis showed that the disease gene was localized to a 18.5 Mbp region on chromosome 22 flanked by markers D22S1174 and D22S270, spanning the β-crystallin gene cluster. A c.752T-->C mutation in exon 6 of CRYBB1 gene, which resulted in a heterozygous S228P mutation in predicted protein,was found to cosegregate with cataract in the family.Conclusions This study identified a novel mutation in CRYBB1 gene in a Chinese family with autosomal dominant congenital cataract. These results provide strong evidence that CRYBB1 is a pathogenic gene for congenital cataract.

  7. Severe prelenticular membrane formation on the surface of a hydrophilic acrylic intraocular lens after cataract surgery in an eye with an Ahmed valve implant

    Institute of Scientific and Technical Information of China (English)

    Yong-Sun; Ahn; Jin; A; Choi

    2015-01-01

    <正>Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the

  8. A RANDOMIZED CLINICAL TRIAL ON THE ANTI - INFLAMATORY EFFECT OF INTRACAMERAL LOW MOLECULAR WE HEPARIN (ENOXAPAIN IN DIABETIC CATARACT SURGERY

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    Shivanand

    2015-08-01

    Full Text Available AIM: To study the effect intracameral low molecular weight on postoperative inflammation after cataract surgery in diabetic patients. SETTING: Department of Ophtha lmology J. N. Medical College. Belgaum. DESIGN: Randomized control trial . MATERIAL AND METHODS: Forty patients with diabetes undergoing small incision cataract surgery with posterior chamber intraocular lens (IOL implantation were randomly assigned to two groups, group A and group B. All patients in g roup A received low molecular weight heparin (enoxaparin in the concentration of 40 IU in 500ml in the irrigating solution and patients in group B received irrigating solution without low molecular weight heparin. In all patients polymethyl methacrylate ( PMMA IOLs were implanted. The patients were examined postoperatively on day 1, day 7, day 30 and day 60 for anterior chamber cells and flare and iris pigments on cell by slit lamp biomicroscopy. RESULTS: A statistically significant reduction in postoperat ive cells, flare and intraocular lens surface pigments was noted in group with addition of low molecular weight heparin (enoxaparin at day 1(p0.001 and 1 week (p<0.001. At 4 weeks and 8 weeks no statistically significant reduction in post - operative cell s and flare was seen between the two groups but there was a significant reduction in the intraocular lens pigments in the group with addition of low molecular weight heparin (enoxaparin. CONCLUSION: Intraoperative use of low molecular weight heparin (enox aparin reduced disturbance in the blood - aq ueous barrier in the early post - operative period evidenced by lower postoperative anterior chamber cells and flare, and also reduced iris pigments on the intraocular lens. At 8 weeks cells and flare in both the gr oups did not show significant difference.

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

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    Madge Simon

    2006-11-01

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

  10. Long-term visual outcome of dense bilateral congenital cataract

    Institute of Scientific and Technical Information of China (English)

    YE He-hua; DENG Da-ming; QIAN Yi-yong; LIN Zhi; CHEN Wei-rong

    2007-01-01

    Background Dense congenital cataracts often cause severe visual impairment. The results of long-term follow-up of dense bilateral congenital cataract in China have not been well documented. The purpose of this study was to evaluate the long-term visual function in children who underwent cataract extraction for dense bilateral congenital cataract in southern part of China.Methods Medical records of children who underwent surgery of dense bilateral congenital cataract between January 1992 and December 2000 at Zhongshan Ophthalmic Center of Sun Yat-sen University were retroactively reviewed. In 38 children available for current follow-up, best corrected visual acuity (BCVA) and stereoscopic vision, as well as nystagmus, strabismus, and other complications, were evaluated. The mean follow-up period was 107.6 months (range 60 to 167 months).Results The mean age of cataract extraction and secondary intraocular lens implantation were 5.6 months (range 3 to 12 months) and 4.2 years (range 2.4 to 15 years), respectively. The mean BCVA was 0.25 in the better eye and 0.16 in the fellow eye. Stereoscopic vision was absent in all patients, and 3 children had simultaneous perception. Nystagmus was detected in all cases and strabismus in 35 cases. A high correlation was found between timing of cataract extraction and final BCVA of the better eye (r=-0.55, P=0.00). A statistically significant difference was found in BCVA between postand pre-treatment of amblyopia (t=5.65, P=0.00).Conclusions Long-term visual function in children with dense bilateral congenital cataract was poor when cataract surgery was performed at age of 3 months or later. Earlier cataract surgery with adequate optical rehabilitation contributed to better visual outcome.

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

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    Vikas

    2015-01-01

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

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

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    Juan C. Medina Perdomo

    2010-12-01

    Full Text Available Background: Cataract is the leading cause of blindness in the world. Its only effective treatment is surgery, with a high rate of efficiency, but it is not always practiced due to several reasons that limit access to health services. Objective: To identify clinical and epidemiological behaviour of patients after cataract surgery. Methods: An observational, descriptive and cross-sectional study conducted in the "José Joaquín Palma" Ophthalmology Center in the town of San Cristóbal, Guatemala. We included all patients over 18 years old meeting the inclusion criteria who had had a cataract surgery between July and December 2007. The following variables were analyzed: age, sex, skin color, place of origin, ocular and systemic personal medical history, etiologic type of cataract and intra and immediate postoperative complications. Results: 63.3% of the patients are in the 60 years on age group, with a slight predominance of females (51.89% and most of them come from the rural areas (66.66%. Among personal medical histories myopia was detected (14.17% and among systemic medical histories there were arterial hypertension (25.98% and diabetes mellitus (22.04%. Senile cataract was more frequent (52.75%. The most frequent intraoperative complications were posterior capsule ruptures with or without vitreous loss (29.548% and 3.37% respectively and corneal edema in the immediate postoperative (5.48%. Conclusions: The results of clinical and epidemiological characterization of patients after cataract surgery included in this series do not differ from those of similar studies, except for the personal glaucoma history.Fundamento: la catarata es la primera causa de ceguera en el mundo; su único tratamiento efectivo es la cirugía, que tiene un alto índice de eficiencia, y que no siempre se practica debido a diversas razones que limitan el acceso a

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

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    Wang BZ

    2013-03-01

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

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

    Science.gov (United States)

    Bagnis, Alessandro; Saccà, Sergio Claudio; Iester, Michele; Traverso, Carlo Enrico

    2011-01-01

    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. PMID:21573094

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

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    Pajic B

    2014-12-01

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

  16. A 76-bp deletion in the Mip gene causes autosomal dominant cataract in Hfi mice.

    NARCIS (Netherlands)

    Sidjanin, D.J.; Parker-Wilson, D.M.; Neuhauser-Klaus, A.; Pretsch, W.; Favor, J.; Deen, P.M.T.; Ohtaka-Maruyama, C.; Lu, Y.; Bragin, A.; Skach, W.R.; Chepelinsky, A.B.; Grimes, P.A.; Stambolian, D.E.

    2001-01-01

    Hfi is a dominant cataract mutation where heterozygotes show hydropic lens fibers and homozygotes show total lens opacity. The Hfi locus was mapped to the distal part of mouse chromosome 10 close to the major intrinsic protein (Mip), which is expressed only in cell membranes of lens fibers. Molecula

  17. Patients' satisfaction and spectacle independence after cataract surgery with multifocal intraocular lens implantation in a tertiary care hospital.

    Science.gov (United States)

    Baig, Rashid; A Chaudhry, Tanveer; Kukreja, Saajan; Shakil, Sidra; Ahmad, Khabir

    2016-06-01

    This single group cohort study, undertaken at Aga Khan University Hospital, Karachi, from Jan 2012 to September 2013, assessed patients' satisfaction, spectacle independence and visual disturbance after implantation of multifocal IOLs. A total of 39 patients who underwent bilateral cataract surgery with multifocal IOL implantation were included for telephonic interviews. The mean age of participants was 55.5 ± 8.1 years. The mean follow up time was 9.60 ± 3.19 months. The overall satisfaction rate after surgery was found to be 84.6% and there was no statistically significant association of satisfaction with gender, age or education. In all 84.6%, 94.9% and 84.6% people had spectacle independence for far, intermediate and near, respectively. More than half of participants (59%) had some degree of visual disturbance. In this study, multifocal IOL implantation provided high levels of satisfaction and spectacle independence despite notable risk of halo or glare symptoms at night. Therefore, careful patient selection and preoperative counselling regarding possible risks and benefits is recommended. PMID:27339580

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

    Institute of Scientific and Technical Information of China (English)

    Florian; T; A; Kretz; Tamer; Tandogan; Ramin; Khoramnia; Gerd; U; Auffarth

    2015-01-01

    ·AIM: To evaluate the quality of vision in respect to high order aberrations and straylight perception after implantation of an aspheric, aberration correcting,monofocal intraocular lens(IOL).·METHODS: Twenty-one patients(34 eyes) aged 50 to83 y underwent cataract surgery with implantation of an aspheric, aberration correcting IOL(Tecnis ZCB00,Abbott Medical Optics). Three months after surgery they were examined for uncorrected(UDVA) and corrected distance visual acuity(CDVA), contrast sensitivity(CS)under photopic and mesopic conditions with and without glare source, ocular high order aberrations(HOA, Zywave II) and retinal straylight(C-Quant).· RESULTS: Postoperatively, patients achieved a postoperative CDVA of 0.0 log MAR or better in 97.1% of eyes. Mean values of high order abberations were +0.02±0.27(primary coma components) and-0.04 ±0.16(spherical aberration term). Straylight values of the C-Quant were 1.35±0.44 log which is within normal range of age matched phakic patients. The CS measurements under mesopic and photopic conditions in combination with and without glare did not show any statistical significance in the patient group observed(P ≥0.28).· CONCLUSION: The implantation of an aspherical aberration correcting monofocal IOL after cataractsurgery resulted in very low residual higher order aberration(HOA) and normal straylight.

  19. 儿童白内障手术的研究进展%Progress on pediatric cataract surgery

    Institute of Scientific and Technical Information of China (English)

    田芳; 张红

    2013-01-01

    Cataract surgery is the most commonly performed intraocular surgery in the pediatric population.Although the basic surgical techniques have not significantly changed over the last several years,there are many related issues under continual debate and research.These include use of local perioperative anesthesia,capsular management,type and power of intraocular lenses (IOLs),sutured IOLs,and risk of subsequent glaucoma.Besides,the Infant Aphakia Treatment Study has published the early report.%白内障手术是儿童内眼手术中最常见的手术,虽然近年来基本手术技术未见更多进展,但仍有许多研究着眼于争论性问题,如围手术期的局部麻醉、囊膜的处理、人工晶状体的类型和度数选择、人工晶状体缝合术、继发性青光眼的风险等.另外,多中心“婴儿无晶状体眼治疗研究”也有了早期的研究结果.

  20. Can drugs or micronutrients prevent cataract?

    Science.gov (United States)

    Harding, J J

    2001-01-01

    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

  1. [The use of OVD' for enhancement of their use in cataract surgery and complications of surger].

    Science.gov (United States)

    Marc, T; Pop, Doina; Horvath, Karin

    2014-01-01

    OVD's are pseudoplastic fluids used in anterior segment surgery, their correct use decrease the incidence of complications. Arshinoff classified OVD's according to their properties and described optimal techniques for their use. The three classes are represented by viscoadaptive, cohesinve and dispersive OVD's, used in different steps of the surgery and their behavior is influenced by operating parameters.

  2. Cataract and latitude.

    Science.gov (United States)

    Javitt, J C; Taylor, H R

    For many years, it has been suggested that exposure to sunlight, particularly its ultraviolet component, may be associated with an increased risk of senile cataract. This paper addresses 1) the physical and geographic variables that affect the entry of ultraviolet light in the eye; 2) the epidemiologic evidence that associates cataract with ultraviolet light exposure; and 3) the effectiveness of personal barrier protection (i.e. sunglasses and hats) in reducing ocular exposure to ultraviolet light. The epidemiologic evidence is drawn from studies in Australia, China, Tibet, and the United States. The U.S. evidence consists of data from the Maryland Watermen study and analyses of cataract surgery under the Medicare program which provides health insurance for nearly all Americans age 65 and over (30 million) and pays for 85% of the 1.3 million cataract extractions performed annually in the U.S. Analysis of the Medicard data shown that, after controlling for age, sex, and race, and income of the population and also controlling for supply of ophthalmologists, optometrists, price of surgery and local practice costs, the strongest predictor of cataract surgery likelihood in a Medicare beneficiary is the person's latitude of residence. Latitude correlates directly with the UV-B content of sunlight, because the incident angle of the sun determines the atmospheric penetration of ultraviolet radiation. Data suggest that the probability of cataract surgery in the U.S. increases by 3% for each 1 degree decrease (i.e. more Southerly) in latitude. PMID:7634999

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

    Directory of Open Access Journals (Sweden)

    Kongsap P

    2012-11-01

    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

  4. Associação entre aspectos depressivos e déficit visual causado por catarata em pacientes idosos Association of depressive aspects with visual impairment caused by cataract in the elderly

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    João Eduardo Caixeta Ribeiro

    2004-10-01

    Full Text Available OBJETIVO: Investigar a associação entre a presença de sintomas depressivos e a deficiência visual causada por catarata no paciente idoso. MÉTODOS: Vinte e três pacientes com catarata e acuidade visual inferior a 20/200 no melhor olho foram avaliados. As idades variavam de 60 a 93 anos. Antes da cirurgia de catarata e um mês após, os sintomas depressivos foram avaliados pela Escala de Depressão Geriátrica (EDG. RESULTADOS: A cirurgia melhorou a visão para 20/50, ou melhor, em todos os pacientes. Antes e após a cirurgia de catarata foram encontrados 11 (47,82% e 10 (43,47% indivíduos com escores indicativos de depressão respectivamente (p=1,0; teste de McNemar. Antes da cirurgia observamos o valor mediano da EDG de 5,0 e após a cirurgia a EDG apresentou o valor mediano de 4,0 (p = 0,012; Wilcoxon pareado. Neste período os sintomas indicativos de depressão diminuíram significativamente, de valores entre 3 a 8 pontos para valores entre 3 a 6 pontos. CONCLUSÕES: Sintomas depressivos são prevalentes e persistentes entre pacientes idosos, entretanto os níveis dos sintomas indicativos de depressão diminuem significativamente com a melhora da visão.PURPOSE: To investigate the association of depressive symptoms with visual impairment caused by cataract in the elderly. METHODS: Twenty-three patients with cataract and visual acuity less than 20/200 were studied. Ages ranged from 60 to 93 years. Before the cataract operation and one month there after the patient's depression was tested using the Geriatric Depression Scale-GDS. RESULTS: The cataract surgery restored visual acuity to 20/50 or better in all patients. Before and after the surgery, 11 (47.82% and 10 (43.47% patients had scores indicative of depression, respectively (p=l.0; McNemar test. The average GDS score for all subjects before operation was 5.0 and after the cataract surgery it was 4.0 (p=0.012; paired Wilcoxon. After the operation the subjects' depression symptoms had

  5. Loteprednol etabonate gel 0.5% for postoperative pain and inflammation after cataract surgery: results of a multicenter trial

    Directory of Open Access Journals (Sweden)

    Fong R

    2012-07-01

    Full Text Available Raymond Fong,1 Martin Leitritz,2 Raphaele Siou-Mermet,3 Tara Erb41Manhattan Eye, Ear and Throat Hospital, Lenox Hill Hospital, New York, NY, USA; 2Department of Ophthalmology, University Eye Hospital Tübingen, University of Tübingen, Tübingen, Germany; 3Bausch and Lomb, Montpellier, France; 4Bausch and Lomb, Rochester, NY, USAPurpose: Loteprednol etabonate (LE is approved by the US FDA in a suspension and ointment form (0.5% for the treatment of postoperative ocular inflammation. This study examined the gel formulation of LE, an improved, nonsettling formulation with a lower preservative level and a more physiologic pH.Patients and methods: This multicenter, double-masked, parallel-group, vehicle-controlled study randomized patients aged ≥18 years with postoperative anterior chamber cell (ACC ≥ grade 2 following uncomplicated cataract surgery to either LE gel or vehicle four times a day for 14 days. Primary efficacy end points included the proportion of patients with complete resolution of ACC and grade 0 (no pain by postoperative day 8. Secondary efficacy end points included complete resolution and change from baseline in ACC and flare (individual and combined, and grade 0 pain at each visit. Safety end points included treatment-emergent adverse events, ocular symptoms, changes in intraocular pressure (IOP and visual acuity, and biomicroscopy and funduscopy findings.Results: A total of 407 patients were randomized to treatment (n = 206, LE gel; n = 201, vehicle. At day 8, 31.1% (64 of LE-treated patients and 13.9% (28 of vehicle-treated patients had complete resolution of ACC (P < 0.001, and 75.7% (156 of LE-treated patients and 45.8% (92 of vehicle-treated patients had grade 0 pain (P < 0.001. Secondary efficacy end points also favored LE gel. Fewer patients treated with LE gel required rescue medication (10.7% versus 42.3% prior to day 15, and fewer had an ocular adverse event (16.0% versus 28.9%, P = 0.002. No drug-related adverse

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

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    Preeti

    2015-04-01

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

  7. The effect of lens aging and cataract surgery on circadian rhythm.

    Science.gov (United States)

    Yan, Shen-Shen; Wang, Wei

    2016-01-01

    Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment. Suprachiasmatic nucleus (SCN) is the central pacemaker of circadian rhythm, and its activity is entrained to the external light-dark cycle. The SCN controls circadian rhythm through regulating the synthesis of melatonin by pineal gland via a multisynaptic pathway. Light, especially short-wavelength blue light, is the most potent environmental time cue in circadian photoentrainment. Recently, the discovery of a novel type of retinal photoreceptors, intrinsically photosensitive retinal ganglion cells, sheds light on the mechanism of circadian photoentrainment and raises concerns about the effect of ocular diseases on circadian system. With age, light transmittance is significantly decreased due to the aging of crystalline lens, thus possibly resulting in progressive loss of circadian photoreception. In the current review, we summarize the circadian physiology, highlight the important role of light in circadian rhythm regulation, discuss about the correlation between age-related cataract and sleep disorders, and compare the effect of blue light- filtering intraocular lenses (IOLs) and ultraviolet only filtering IOLs on circadian rhythm. PMID:27500118

  8. Gendered Disparities in Quality of Cataract Surgery in a Marginalised Population in Pakistan: The Karachi Marine Fishing Communities Eye and General Health Survey.

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    Khabir Ahmad

    Full Text Available Marine fishing communities are among the most marginalised and hard-to-reach groups and have been largely neglected in health research. We examined the quality of cataract surgery and its determinants, with an emphasis on gender, in marine fishing communities in Karachi, Pakistan, using multiple indicators of performance.The Karachi Marine Fishing Communities Eye and General Health Survey was a door-to-door, cross-sectional study conducted between March 2009 and April 2010 in fishing communities living on 7 islands and in coastal areas in Keamari, Karachi, located on the Arabian Sea. A population-based sample of 638 adults, aged ≥ 50 years, was studied. A total of 145 eyes (of 97 persons had undergone cataract surgery in this sample. Cataract surgical outcomes assessed included vision (presenting and best-corrected with a reduced logMAR chart, satisfaction with surgery, astigmatism, and pupil shape. Overall, 65.5% of the operated eyes had some form of visual loss (presenting visual acuity [PVA] < 6/12. 55.2%, 29.0%, and 15.9% of these had good, borderline, and poor visual outcomes based on presenting vision; with best correction, these values were: 68.3 %, 18.6%, and 13.1%, respectively. Of 7 covariates evaluated in the multivariable generalized estimating equations (GEE analyses, gender was the only significant independent predictor of visual outcome. Women's eyes were nearly 4.38 times more likely to have suboptimal visual outcome (PVA<6/18 compared with men's eyes (adjusted odds ratio 4.38, 95% CI 1.96-9.79; P<0.001 after adjusting for the effect of household financial status. A higher proportion of women's than men's eyes had an irregular pupil (26.5% vs. 14.8% or severe/very severe astigmatism (27.5% vs. 18.2%. However, these differences did not reach statistical significance. Overall, more than one fourth (44/144 of cataract surgeries resulted in dissatisfaction. The only significant predictor of satisfaction was visual outcome (P <0

  9. Three cases of extracapsular cataract extraction for radiation cataract

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-02-01

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

  10. Pattern of Refractive Correction and Timing of Stage II IOL Implantation after Congenital Cataract Extraction

    Institute of Scientific and Technical Information of China (English)

    Yan Li; Haotian Lin

    2014-01-01

    Congenital cataract occurs during infancy when the axial length and corneal and visual function are in the sensitive stages of rapid development..Inappropriate surgical interven-tion not only fails to restore visual function,.but also causes irreversible serious influences upon eyeball development in children diagnosed with congenital cataract. At present, the uncertainty of selection of intraocular lens (IOL) degrees dur-ing the eyeball development period is averted by using a main treatment of congenital cataract that includes two -stage surgery:.stage I cataract extraction and stage II IOL implanta-tion. However, the accurate selection of a refractive correction method and the timing of IOL implantation during stage II surgery for aphakic eyes remains controversial following stage I cataract extraction..This review retrospectively summarizes the current progress and existing problems indicated by related recent studies focusing on refractive correction pattern and IOL implantation timing.

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

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    Astor Grumann Junior

    2015-02-01

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

  12. Toric Intraocular Lens vs. Peripheral Corneal Relaxing Inci-sions to Correct Astigmatism in Eyes Undergoing Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    Zhiping Liu; Xiangyin Sha; Xuanwei Liang; Zhonghao Wang; Jingbo Liu; Danping Huang

    2014-01-01

    Purpose:.To compare toric intraocular lens implantation (Toric-IOL).with peripheral corneal relaxing incisions (PCRIs) for astigmatism correction in patients undergoing cataract surgery. Methods: 54 patients (54 eyes) with more than 0.75 diopter (D).of preexisting corneal astigmatism were classified as group A (0.75-1.50D) or group B (1.75-2.50D). The patients were randomized to undergo Toric-IOL or PCRIs in the steep axis with spherical IOL implantation..LogMAR uncorrected visual acuity (LogMAR UCVA), LogMAR best corrected vi sual acuity.(LogMAR BCVA),.error of vector (|EV|), surgery induced refraction correction. (|SIRC|),.and correction rates (CR) were measured 1 month and 6 months postoperatively. Results: At 6 months postoperatively, all 54 eyes had Log-MAR BCVA≤0.2. Patients who underwent PCRIs and Toric-IOL with LogMAR BCVA≤0.1 showed no significant differ-ences in group A (P=1.00) or in group B (P=0.59). Group A showed no significant differences in LogMAR UCVA (P=0.70), |EV| (P=0.13), |SIRC| (P=0.71), and CR (P=0.56) in patients underwent PCRIs and Toric-IOL. However, group B showed significant differences in LogMAR UCVA (P Conclusion:.The efficacy and stability of Toric-IOL and PCRIs were equal in low astigmatic patients..Toric-IOL achieved an enhanced effect over PCRIs in higher astigmatic patients. PCRIs had the more refractive regression than Toric-IOL in 6 months.

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

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    Arnould Benoit

    2010-05-01

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

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

    DEFF Research Database (Denmark)

    Solborg Bjerrum, Søren; Kiilgaard, Jens Folke; Dornonville de la Cour, Morten

    2015-01-01

    (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...

  15. Application of intraocular lens in infant cataract surgery%IOL在婴幼儿白内障手术中的应用

    Institute of Scientific and Technical Information of China (English)

    祁锦艳; 肖伟; 王明玥; 濮伟

    2015-01-01

    Cataract extraction and the intraocular lens ( IOL ) implantation are the first choice to cure children cataract both domestic and overseas so far. However, IOL implantation in the eyes of children, especially in infant, has always been cared by ophthalmologists. Timely implanting IOL after the cataract extraction has played a significant role in terms of the refractive correction, the establishment of visual function, the prevention of amblyopia and the reconstruction of binocular vision. However, on the issue of IOL implantation after cataract extraction, there is always controversy on cataract treatment programs for children, and the focus of the controversy is when the IOL should be implanted. Theoretically, the principle of pediatric cataract surgery is the sooner the better, aiming to remove deprivation factor, open the visual pathway, implant IOL timely, and promote the visual development. How to find both“early” and safe IOL implantation time point is undoubtedly helpful for the rehabilitation of visual function of these children. The issues on the IOL implantation after children cataract extraction both at home and abroad are summarized below.%目前,国内外已将白内障摘除和人工晶状体( intraocularlens, IOL)植入作为治疗儿童白内障的首要选择。但是,儿童眼特别是婴幼儿眼的IOL植入一直是眼科界关注的问题。适时的白内障摘除术后IOL植入对于屈光矫正、视功能建立、预防弱视和双眼视功能重建都有极大的作用。然而,有关婴幼儿白内障摘除术后IOL植入问题,在儿童白内障治疗方案上始终存在争议,争议的焦点主要集中在IOL植入的时机问题上。理论上讲,儿童白内障的手术治疗原则是越早越好,目的是去形觉剥夺因素,打开视觉通路,及时植入IOL,促进视觉发育。但如何找到既“早”又安全的IOL植入时间点无疑对患儿视功能的康复是大有益处的,本文就国内外儿童

  16. The effects of melatonin on anxiety and pain scores of patients, intraocular pressure, and operating conditions during cataract surgery under topical anesthesia

    Directory of Open Access Journals (Sweden)

    Marzieh Beigom Khezri

    2013-01-01

    Full Text Available Aims: To evaluate the effects of melatonin premedication on anxiety and pain scores of patients, operating conditions, and intraocular pressure during cataract surgery under topical anesthesia. Materials and Methods: Sixty patients were randomly assigned to receive either sublingual melatonin 3 mg or placebo 60 min before surgery. Verbal anxiety scores and verbal pain scores, heart rate, systolic and diastolic blood pressure, intraocular pressure, and quality of operating conditions were recorded. Results: Melatonin significantly reduced the anxiety scores (median, interquartile range from 5 and 5-3 to 3 and 2-4 after premedication and to 3 and 2-3 during surgery and to 0 and 0-1 postoperatively before discharge from the recovery room. There were significant differences between two groups in anxiety scores after premedication (95% CI 3-3.5; P = 0.023, intraoperatively (95% CI 2.5-3.5; P = 0.007, and postoperatively (95% CI 0.5-1; P = 0.007. The surgeon reported better quality of operating conditions in the melatonin group (P = 0.001. No significant difference in intraoperative and postoperative pain scores, intraocular pressure, heart rate, and systolic and diastolic blood pressure between two groups was recorded. Conclusion: Sublingual melatonin premedication for patients undergoing cataract surgery under topical anesthesia reduced the anxiety scores in patients and provided excellent operating conditions.

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

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    Rajesh Sinha

    2013-01-01

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

  18. A 5-bp insertion in Mip causes recessive congenital cataract in KFRS4/Kyo rats.

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    Kei Watanabe

    Full Text Available We discovered a new cataract mutation, kfrs4, in the Kyoto Fancy Rat Stock (KFRS background. Within 1 month of birth, all kfrs4/kfrs4 homozygotes developed cataracts, with severe opacity in the nuclei of the lens. In contrast, no opacity was observed in the kfrs4/+ heterozygotes. We continued to observe these rats until they reached 1 year of age and found that cataractogenesis did not occur in kfrs4/+ rats. To define the histological defects in the lenses of kfrs4 rats, sections of the eyes of these rats were prepared. Although the lenses of kfrs4/kfrs4 homozygotes showed severely disorganised fibres and vacuolation, the lenses of kfrs4/+ heterozygotes appeared normal and similar to those of wild-type rats. We used positional cloning to identify the kfrs4 mutation. The mutation was mapped to an approximately 9.7-Mb region on chromosome 7, which contains the Mip gene. This gene is responsible for a dominant form of cataract in humans and mice. Sequence analysis of the mutant-derived Mip gene identified a 5-bp insertion. This insertion is predicted to inactivate the MIP protein, as it produces a frameshift that results in the synthesis of 6 novel amino acid residues and a truncated protein that lacks 136 amino acids in the C-terminal region, and no MIP immunoreactivity was observed in the lens fibre cells of kfrs4/kfrs4 homozygous rats using an antibody that recognises the C- and N-terminus of MIP. In addition, the kfrs4/+ heterozygotes showed reduced expression of Mip mRNA and MIP protein and the kfrs4/kfrs4 homozygotes showed no expression in the lens. These results indicate that the kfrs4 mutation conveys a loss-of-function, which leads to functional inactivation though the degradation of Mip mRNA by an mRNA decay mechanism. Therefore, the kfrs4 rat represents the first characterised rat model with a recessive mutation in the Mip gene.

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

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    Jaichandran Venkatakrishnan

    2010-01-01

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

  20. Morphological Findings of Intraocular Lens with Haptics Detached from Optics Following Cataract Surgery.

    Science.gov (United States)

    Suzuki, Yukihiko; Suzuki, Kaori; Metok, Tomomi; Nakazawai, Mitsuru

    2010-03-09

    A 55-year-old woman was treated using phacoemulsification, aspiration, and intraocular lens (IOL) implantation. Three months after surgery, the optical zone of the anterior capsule was completely closed due to strong capsular contractions. As the two haptics were found to be completely detached from the optics, the IOL was subsequently extracted and morphologically examined. Although the optics and haptics of the IOL when viewed with a stereomicroscope appeared to have no marked damage on their surfaces, an ultra-structural examination showed that a portion of the acrylic optics on the detached surface was defective. We considered that the IOL haptics might have become detached from the optics due to continuous force from postoperative capsular contractions.

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

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte;

    2015-01-01

    UNLABELLED: We conducted a systematic review and metaanalysis to provide evidence-based recommendations on the value of early postoperative review. We identified 3 randomized controlled trials (RCTs) that compared patients seen on the first postoperative day with those reviewed at 2 weeks; the 3...... studies comprised 886 patients. The risk for postoperative complications was lower when review was deferred 2 weeks because of early transient pressure spikes. There was no difference in the number of unscheduled visits during the first 2 weeks postoperatively or the visual acuity at follow-up. No safety...... was gained by reviewing patients on the first postoperative day, and we recommend that routine early postoperative control can be omitted in nonglaucomatous patients after uneventful surgery if symptomatic patients are seen by an ophthalmologist as needed. FINANCIAL DISCLOSURE: No author has a financial...

  2. Use of a Toric Intraocular Lens and a Limbal-Relaxing Incision for the Management of Astigmatism in Combined Glaucoma and Cataract Surgery

    Science.gov (United States)

    Gibbons, Allister

    2016-01-01

    Purpose We report the surgical management of a patient with glaucoma undergoing cataract surgery with high preexisting astigmatism. A combination of techniques was employed for her astigmatism management. Methods A 76-year-old female with 5.5 dpt of corneal astigmatism underwent surgery in her left eye consisting of one-site trabeculectomy, phacoemulsification, toric intraocular lens implantation and a single inferior limbal-relaxing incision. Results Intraocular pressure control was achieved with no medication at 11 mm Hg; before the filtering procedure, the pressure was 16 mm Hg on two topical drugs. Astigmatism was reduced to 0.75 dpt, and both corrected and uncorrected visual acuity improved. Conclusions Astigmatism management can have a good outcome in combined procedures. We encourage surgeons to address astigmatism in the preoperative planning of patients undergoing glaucoma surgery associated with phacoemulsification. PMID:27293408

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

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    McDonnell Peter J

    2011-02-01

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

  4. Surgical and Functional Results of Hybrid 25-27-Gauge Vitrectomy Combined with Coaxial 2.2 mm Small Incision Cataract Surgery.

    Science.gov (United States)

    Höhn, Fabian; Kretz, Florian; Pavlidis, Mitrofanis

    2016-01-01

    Purpose. To investigate outcomes after coaxial 2.2 mm small incision cataract surgery combined with hybrid 25-27-gauge vitrectomy in eyes with vitreoretinal disease and age-related cataract. Methods. A single-center, retrospective case series study of 55 subjects (55 eyes) with a mean age of 70 years who underwent combined small incision phacoemulsification, intraocular lens (IOL) implantation, and hybrid 25-27-gauge vitrectomy during the 12-month period to December 2014. Intraoperative and postoperative complications and visual results were the main outcome measures. Results. The mean follow-up period was 6 months (range: 2-18 months). Intraoperative findings were 3 retinal breaks (5.5%). No cases required corneal or scleral suture or conversion to larger-gauge vitrectomy. Postoperative complications consisted of posterior capsule opacification (12.7%), elevated intraocular pressure >30 mmHg (1.8%), and fibrin reaction (5.5%). There were no cases of hypotony (25-27-gauge vitrectomy combined with small incision phacoemulsification and IOL implantation is feasible, safe, and effective as a one-step surgical procedure for the management of vitreoretinal pathologies and concurrent cataract. PMID:26966558

  5. Surgical and Functional Results of Hybrid 25-27-Gauge Vitrectomy Combined with Coaxial 2.2 mm Small Incision Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Fabian Höhn

    2016-01-01

    Full Text Available Purpose. To investigate outcomes after coaxial 2.2 mm small incision cataract surgery combined with hybrid 25-27-gauge vitrectomy in eyes with vitreoretinal disease and age-related cataract. Methods. A single-center, retrospective case series study of 55 subjects (55 eyes with a mean age of 70 years who underwent combined small incision phacoemulsification, intraocular lens (IOL implantation, and hybrid 25-27-gauge vitrectomy during the 12-month period to December 2014. Intraoperative and postoperative complications and visual results were the main outcome measures. Results. The mean follow-up period was 6 months (range: 2–18 months. Intraoperative findings were 3 retinal breaks (5.5%. No cases required corneal or scleral suture or conversion to larger-gauge vitrectomy. Postoperative complications consisted of posterior capsule opacification (12.7%, elevated intraocular pressure >30 mmHg (1.8%, and fibrin reaction (5.5%. There were no cases of hypotony (<7 mmHg, IOL decentration, or postoperative endophthalmitis. Visual acuity (mean ± SD improved from 0.52±0.6 logMAR preoperatively to 0.22±0.46 logMAR at final postoperative visit (P<0.0001. Conclusion. Surgical and visual outcomes suggest hybrid 25-27-gauge vitrectomy combined with small incision phacoemulsification and IOL implantation is feasible, safe, and effective as a one-step surgical procedure for the management of vitreoretinal pathologies and concurrent cataract.

  6. Comparison of different techniques of cataract surgery in bacterial contamination of the anterior chamber in diabetic and non-diabetic population

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    M Ashok Kumar

    2012-01-01

    Full Text Available Aim : To compare the bacterial contamination of the anterior chamber (AC between manual small incision cataract surgery (SICS and phacoemulsification (Phaco. To study the conjunctival flora and bacterial contamination of AC between well-controlled diabetics and non-diabetics. Materials and Methods : Three hundred and sixty-eight patients were randomized to manual SICS and Phaco. Sixty-eight patients were excluded for not completing follow-up or for intraoperative complications like posterior capsule rupture. One hundred and fifty patients in each group were finally analyzed. Conjunctival swabs were taken on admission, after one day of topical ofloxacin and 15 min after 5% Povidone Iodine (PI instillation. AC aspirate at the end of the surgery was also cultured. Results : Fifty-six (18.66% patients had positive conjunctival swab on admission which was reduced to 19 (6.33% with topical ofloxacin and to five (1.66% with instillation of 5% PI. AC contamination in both manual SICS and Phaco was 0.66%. The conjunctival flora in diabetics was similar to non-diabetics. None of the diabetics had AC contamination. Statistical analysis was performed by Chi-Square test (with Yates′ correction. Conclusion : Statistically significant reduction in conjunctival flora was achieved with topical ofloxacin and 5% PI instillation and AC contamination in both manual SICS and Phaco was minimal (0.66%. Well-controlled diabetics who underwent cataract surgery in this study had similar conjunctival flora and AC contamination as non-diabetics.

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

    Directory of Open Access Journals (Sweden)

    Viala Muriel

    2008-01-01

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

  8. Lens Epithelial Cell Proliferation and Cell Density in Human Age-related Cataract

    Institute of Scientific and Technical Information of China (English)

    Xialin Liu; Yizhi Liu; Jianliang Zheng; Qiang Huang; Huling Zheng

    2000-01-01

    Purpose: To discuss the potential effect of the lens epithelial cell proliferation in age-related cataract.Methods: In vitro cell proliferation was assayed by MTT method to evaluate the lens epithelial cell density, index, and proliferation capacity in normal lens and all kinds of age-related cataract. Capsulotomy specimens from all kinds of patients who underwent cataract phacoemulsification extraction surgery were compared with the lens epithelial specimens from non-cataract lenses of Eye Bank eyes.Results: Lens epithelial cell density of central anterior capsule (LECD) in female normal lens was higher than that in male, LECD in nuclear cataract( > NⅢ ) was higher than that in normal lens, but in the mature cortical cataract, LF CD was lower. Mitotic index of three kinds of age-related cataracts in vivo had no statistical difference, neither did cell proliferation capacity of cultivated cells in vitro.Conclusion: The individual difference of lens epithelial cell density and proliferation capacity in vivo may be an important underlying cause for senile cataract in the cellular level, especially for nuclear cataract.

  9. 白内障手术致角膜后弹力层脱离的诊断与处理%Diagnosis and Management of Descemet membrane detachment after cataract surgery

    Institute of Scientific and Technical Information of China (English)

    侯艳宏; 崔红平

    2015-01-01

    Descemet membrane detachment (DMD) is an uncommon but potentially serious complication of intraocular surgeries such as cataract surgery.The high risk factors of DMD includes particularity of anatomical structures,surgical stimulation,irrigation/ aspiration and viscoelastic material factors,suboptimal instruments,and poor skilled surgeon.Management options for this surgical complication include conservative treatment,hypertonic saline with topical steroids,transcomeal suturing,pneumatic descemetopexy (intracameral injection of air or another gas),intracameral injection of viscoelastic material,endothelial or penetrating keratoplasty.Diagnosis and appropriate treatment at early stage is critical for prognosis.In this paper,a systematic review of published trials was conducted to discuss the causes and therapeutic measures of Descemet membrane detachment after cataract surgery.%角膜后弹力层脱离是一种发生率小但可致盲的眼内手术并发症,其高危因素主要包括解剖结构的特殊性、手术操作的刺激、术中灌注液或黏弹剂的错误使用、手术器械不达标或重复使用,以及术者操作欠娴熟等.早期诊断与及时治疗对预后具有关键意义.主要治疗策略包括保守治疗、前房气体填塞、前房注射黏弹剂、手法复位、缝合、后弹力层置换及穿透性角膜移植等.本文对白内障术后角膜后弹力层脱离的临床特点、发生原因、治疗方法等进行综述.

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

    Directory of Open Access Journals (Sweden)

    Marzieh-Beigom Khezri

    2013-01-01

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

  11. Prostaglandin-Associated Periorbital Lipodystrophy in Cosmetic Eyelid Surgery: A Novel Cause of Facial Asymmetry.

    Science.gov (United States)

    Eftekhari, Kian; Mifflin, Mark D; Anderson, Richard L

    2016-03-01

    A 70-year-old woman presented to our practice with profound ptosis of the left upper eyelid and notable asymmetry of the periocular area. On examination, she was noted to have significant atrophy of the periocular tissues on the left side, with lower eyelid retraction. These features were present but less severe on the right side. Upon further questioning, she stated that she had cataract surgery on the left side that was complicated by a high intraocular pressure and required subsequent secondary surgery. She had taken a prostaglandin eyedrop for many months after her cataract surgery to keep the eye pressure low. Recently, a newly recognized adverse effect of prostaglandin eyedrops has been described in the ophthalmic literature in which patients develop periorbital lipodystrophy. This case emphasizes that this may occur unilaterally in patients taking the eyedrop in only one eye, and should be recognized prior to considering functional and aesthetic surgery of the periocular area. PMID:26374814

  12. 白内障手术中l期人工晶状体睫状沟缝线固定术的体会%Experience of intraocular lens implantation sutured in ciliary sulcus at l phase in cataract surgery

    Institute of Scientific and Technical Information of China (English)

    吕宏伟; 赵莉辉; 曾忠玲

    2016-01-01

    目的:探讨白内障复明术中l期人工晶状体睫状沟缝线固定手术的技巧,并发症和发生原因及处理方法。  方法:回顾36例37眼l期行人工晶状体睫状沟缝线固定术手术方法,并对手术效果及并发症予以分析。  结果:术后随访3~24lo,最佳矫正视力≥0.8者4眼(11%),0.4~0.8者19眼(51%),0.1~0.3者14眼(38%)。主要并发症为角膜轻水肿内皮混浊10眼(27%),玻璃体出血3眼(8%),所有患者无严重并发症。  结论:l期人工晶状体睫状沟缝线固定术是白内障常规手术方法的补充,安全、有效,可显著提高视力,减少并发症的发生。%AlM:To investigate the surgical skills, the causes and the treatment of the complications of intraocular lens implantation sutured in ciliary sulcus at l phase in cataract surgery. METHODS:Thirty-six cases ( 37 eyes ) that couldn’t implant intraocular lens normally were treated with intraocular lens sutured in ciliary sulcus. The surgical effect and complications were analyzed. RESULTS:Patients were followed up for 3-24mo. The postoperative best corrected visual acuity( BCVA) was ≥0. 8 in 4 eyes(11%), 0. 4-0. 8 in 19 eyes (51%), 0. 1-0. 3 in 14 eyes ( 38%) . There were 10 eyes ( 27%) with corneal endothelium edema, 3 eyes ( 8%) with vitreous hemorrhage, and all the symptoms disappeared after dealing. There were no serious complications and sequelae in all the patients CONCLUSlON:lntraocular lens implantation sutured in ciliary sulcus at l phase in cataract surgery is a complement of the conventional surgery method for cataract with safety and effectiveness. lt can increase the vision significantly and reduce the complications.

  13. Prevalence and surgery status of cataract among adults aged 50 years or above in Qidong City of Jiangsu Province: the China Nine-Province Survey%我国九省眼病调查中江苏省启东市50岁及以上人群白内障患病率和手术状况的调查

    Institute of Scientific and Technical Information of China (English)

    管怀进; 王羽; 高学成; 陆宏; 戴追; 李密; 王燕; 胡健艳; 施健; 赵家良; Leon B.Ellwein

    2012-01-01

    examination from September to December 2006.Lens and cataract operation status were evaluated by slit lamp.Multiple logistic regression analysis was employed to analyed the prevalence of cataract,cataract surgical coverage rate,cataract blindness social burden rate and outcomes of surgery among different ages,sex and educational background. Results In 5141 individuals,1098 cases of cataract were found,the prevalence of cataract was 21.35% among adults aged 50 or above.The prevalence of cataract was higher in the aged,female,illiterate persons ( P < 0.01 ).In 89 eyes with cataract surgery,25.84% and 42.70% of eyes were performed by the modern extra-capsular surgery and phocoemusification respectively.The rate of intraocular lens implantation was 69.66%.Post-operative presenting and best corrected visual acuity more than 0.7 was 24.70% and 48.31% of operated eyes respectively.The main causes of the post-operated eyes with worse visual acuity were retinal disorders post-capsular opacity and glaucoma.The cataract surgical coverage rate was 37.96%,and the cataract blindness social burden rate was 2.10%.The cataract blindness social burden rate was higher in the aged persons ( P < 0.01 ).Conclusions Cataract is the most common and important eye disease that may lead into blindness and severe visual impairment among older adults aged 50 years or above.The cataract surgical coverage rate is not so high in Qidong City,and even lower in the aged persons.The first important task in blindness prevention still is the elimination of cataract blindness.The visual outcomes of the cataract surgery should be further improved in the future.

  14. Application of ambulatory surgery in simple cataract patients%日间手术在单纯性白内障手术患者中的应用

    Institute of Scientific and Technical Information of China (English)

    刘扬宏; 曾继红

    2012-01-01

    目的 探讨日间手术应用于白内障手术患者的效果,为临床白内障手术选择最优的手术方式提供依据.方法 选取单眼单纯白内障患者160例采用随机数字表法随机分为日间手术组和住院手术组各80例,日间手术组患者在门诊完成术前检查,约定手术时间入院并行手术,24h内出院回家休养,住院手术组患者住院后完成术前检查等待安排手术,手术后观察几天无异常即可出院,比较两组患者术前待床天数、住院天数及医疗费用情况.结果 住院手术组术前待床天数为18.0d,日间手术组为1.2d;住院手术组住院时间为(5.15±1.36)d,日间手术组为(1.00±0.00)d,差异有统计学意义(t=27.286,P<0.01);住院手术组医疗费用为(6901.72±392.43)元,大干日间手术组的(6499.13±134.05)元,差异有统计学意义(t=8.683,P<0.01).结论 单纯性白内障手术采用日间手术的方式,能降低医疗费用,缩短住院时间,可作为首选治疗方式.%Objective To explore the effect of ambulatory surgery on cataract patients and provide basis for optimal cataract surgery mode.Methods 160 cataract patients without complications were selected and randomly divided into ambulatory surgery group (n =80) and hospitalization surgery group (n =80).The patients of the ambulatory surgery group completed their examinations in the outpatient section before they made an appointment and admitted for operation and were discharged in 24 h after surgery.The patients of the hospitalization surgery group completed their examinations after admission and then waited for the surgical arrangement,and they were kept for observation for a few days before discharge.Days on the waiting list,length of stay and medical cost were compared between the two groups.Results Days on the waiting list was 18.0 d in the hospitalization surgery group and 1.2 d in the ambulatory surgery group.Length of stay was (5.15 ± 1.36) d,( 1.00 ± 0.00) d

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

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    Rajiv Khandekar

    2015-01-01

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

  16. 四川省乐山市白内障手术情况调研%Investigation of cataract surgery in Leshan, Sichuan Province

    Institute of Scientific and Technical Information of China (English)

    韩宇; 汤静; 叶宏权

    2014-01-01

    cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future. METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to various surgery financial resources, surgical performances and surgical incision, were divided into phacoemulsification and intraocular lens implantation ( Phaco + IOL ) , extracapsular cataract extraction and intraocular lens implantation ( ECCE + IOL ) , and each method contained 2 groups. We analyzed the outcomes following preoperative examination, surgeons, surgical methods, surgical equipments, types of IOL, surgical quantity, surgical results, and intraoperative complication. RESULTS: In whole city there were 16 operating microscopes, 43 slit lamp microscopes, 12 non-contact tonometers, 1 intraocular lens Master, 8 optical A/B type ultrasonic examination systems, 4 YAG lasers and 12 phacoemulsification instruments. There 15 doctors could complete cataract surgery independently, and 5 of them were phacoemulsification surgeons. The total number of completed cataract surgeries reached 6 211 eyes, containing 3 564 eyes for Phaco+IOL ( 57%) ( preoperative visual acuity ≥0. 3 in Phaco+IOL1 were 1 520 eyes, 24%) and 2 647 eyes for ECCE+IOL ( 43%) ( 1 533 eyes in ECCE+IOL1, 25%). In various groups, off-blindness rate was 94. 80%-100%, off-disability rate was 90. 41%-100%, and 94. 96% - 100% received intraocular lens implantation, intraoperative complication rate was 1. 00%-15. 10%. CONCLUSION: The distribution of surgeons and equipments in the whole city is unbalanced, and the utilization rate of phaco equipment is low. The levels are different in various hospitals on surgical technique, surgical quantity and surgical results

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

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    Aleima Rodríguez Carvajal

    2011-04-01

    Full Text Available Background: Progressively aging populations are one of the most distinctive demographic phenomena of the last decades. The elderly represent a particular risk group because typical characteristics of this stage of life, commonly associated with loss, are added to regular causes of psychopathologic disorders in today's social life. Objective: To assess the impact of cataract surgery on the psychological state of the elderly. Methods: A descriptive correlational study was conducted. The sample included 80 elder patients who attended the outpatient cataract pre-surgery consultation in the General University Hospital of Cienfuegos. They all presented some kind of affective disorder. The following psychosocial variables were analyzed: anxiety, depression, self-esteem and lifestyle. Sociodemographic variables such as age, sex, skin color, personal address, people they live with, education and occupation were also considered. Results: Predominant groups were those of females, white skinned, over 71 years old, average school level, married, living in urban residences and within a multigenerational household. Depression levels were high (30 % before surgery. After surgery they decreased in a 5 %. High levels of anxiety also decreased from 53 % to 10 %. Inadequate self-esteem before surgery (65 % decreased to 20 % after surgery. Conclusions: Cataract surgery has a favorable effect on the psychological status of the elderly.Fundamento: el progresivo envejecimiento poblacional es uno de los fenómenos demográficos más característicos de las últimas décadas, los ancianos constituyen un grupo de riesgo, pues a los factores desencadenantes de trastornos psicopatológicos propios de la sociedad actual se le asocian otros más específicos inherentes a la etapa de pérdida que constituye la ancianidad. Objetivo: valorar la repercusión de

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

    Directory of Open Access Journals (Sweden)

    Roberta Ferrari Marback

    2012-12-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hsu M

    2011-09-01

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

  1. Dense cataract and microphthalmia (dcm) in BALB/c mice is caused by mutations in the GJA8 locus

    Indian Academy of Sciences (India)

    Baskar Bakthavachalu; Sarmishtha Kalanke; Sanjeev Galande; B. Ramanamurthy; Pradeep Parab; Kalidas N. Kohale; Vasudevan Seshadri

    2010-08-01

    A spontaneous mutation in BALB/c mice that causes congenital dense cataract and microphthalmia (dcm) was reported previously. This abnormality was found to be inheritable and the mode of inheritance indicated that this phenotype is due to mutation of an autosomal recessive gene. We performed genetic screen to identify the underlying mutations through linkage analysis with the dcm progenies of F1 intercross. We identified the region of mutation on chromosome 3 and further mapping and sequence analysis identified the mutation in the GJA8 gene that encodes for connexin 50. The mutation represents a single nucleotide change at position 64 (G to C) that results in a change in the amino acid glycine to arginine at position 22 (G22R) and is identical to the mutation previously characterized as lop10. However, the phenotype of these mice differ from that of lop10 mice and since it is one of the very few genetic models with recessive pattern of inheritance, we propose that dcm mice can serve as a useful model for studying the dynamics and interaction of the gap junction formation in mouse eye development.

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

    OpenAIRE

    Modi SS; Davison JA; Walters T

    2011-01-01

    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...

  3. The Pediatric Cataract Register (PECARE)

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Nyström, Alf; Rosensvärd, Annika;

    2015-01-01

    examination with a pencil light at age 5 weeks, whereas newborn red reflex examination using a handheld ophthalmoscope is routine protocol in Swedish maternity wards. Data regarding age of referral were derived from the Pediatric Cataract Register (PECARE). All children operated on before 1 year of age...... between January 2008 and December 2012 were included. Statistical comparison of the different screening strategies was made. RESULTS: The number of children undergoing surgery for congenital cataract before 1 year of age was 31 (17 bilateral cases) in Denmark and 92 (38 bilateral cases) in Sweden...... with red reflex examination, congenital cataract in Swedish children is detected significantly earlier than in Danish children....

  4. Cataract formation following vitreoretinal procedures

    OpenAIRE

    Feng H; Adelman RA

    2014-01-01

    Hao Feng, Ron A Adelman Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA Purpose: To evaluate the incidence and prevalence of cataract formation, progression, and extraction in patients that underwent vitreoretinal procedures and to evaluate factors that can potentially predispose patients to postoperative cataracts.Materials and methods: The medical records of consecutive patients who underwent vitreoretinal surgery at the Yale Eye Cent...

  5. Numerical analysis of aqueous humor hydromechanics after cataract surgery based on fluent%基于Fluent的白内障术后房水流体力学数值分析

    Institute of Scientific and Technical Information of China (English)

    梁书秀; 郝菲菲; 孙昭晨; 邵彦; 李亚新

    2014-01-01

    A hydrodynamic rigid three-dimensional model of natural convection based on fluent soft-ware has been made to study microfluidic flow in the human eye.The anterior and posterior chambers are regarded as study model,which is the main channel of aqueous humor,the pressure difference and tem-perature caused by the aqueous humor in the eyeball was calculated,the cornea temperature,aqueous humor flow and gap width between iris and pupil's influence on pressure difference was analyzed.Pres-sure difference of the model after cataract surgery was calculated in different gap width between iris and pupil.Compared with the model before surgery,the hydrodynamic reasons of cataract surgery complica-tions are analyzed,which will provide a new way to study surgery complications.%应用fluent软件,建立三维自然对流水动力刚体模型,探究了眼内微流体的运动。本研究将以眼球前房和后房即房水主要流动区域作为研究模型,求解眼球内部房水流动产生的压力差和温度场,分析了眼角膜温度、房水分泌流量和虹膜至晶状体的最小距离对眼内压差的影响。计算了虹膜至人工晶体不同间距下的白内障术后模型前后房眼内压的差值,通过和术前对比,分析了白内障术后并发症的水动力因素,为后续白内障术后并发症的研究提供了新的途径。

  6. COMPARISON OF ANTERIOR CHAMBER REACTION WITH SINGLE-PIECE AND THREE-PIECE INTRAOCULAR LENSES IN MANUAL SMALL INCISION CATARACT SURGERY

    Directory of Open Access Journals (Sweden)

    Usha

    2014-11-01

    Full Text Available OBJECTIVES: To study the anterior chamber reaction between single-piece and three-piece intraocular lenses in manual small incision cataract surgery. METHODS: Prospective study done at Mysore Race Club Charitable Eye Hospital. 140 Patients underwent suture less sclerocorneal tunnel cataract surgeries with single-piece or three-piece Polymethylmethacrylate (PMMA intra ocular lenses (3-piece IOL. Accurate Keratometry was done with the help of Bausch and Lomb Keratometer. IOL power was calculated by using SRK (Sanders-Retzlaff-Kraff II formula, with the help of non-immersion, contact type of A-Scan biometry. Single-piece IOLs were inserted in 70 patients. Three-piece IOL inserted in rest of 70 patients. Slit lamp examination for anterior chamber cells was graded according to Hogan system. Aqueous cells were measured by counting within the visible field under Slit lamp, keeping the beam at maximum intensity. Anterior chamber reaction (AC in 1stPostoperative week and at 8 weeks are compared and analyzed by ANOVA statistics. RESULTS: Single piece IOL group had anterior chamber reaction ranging from 1 to 2+ cells i.e., in 97%. In three-piece IOL group, 70%of eyes had 2+ cells and 12.8% had 3± cells. At 8 weeks, single- piece IOL showed either no cells or occasional cells in 98.6% of patients, compared to three –piece IOL group showing in 77%of cases. 23% had 1+ cells in later group. CONCLUSION: Single-piece implanted IOLs had significant less number of cells were seen in anterior chamber from 1 week to 8 weeks as compared to three-piece IOLs.

  7. The Indication of Surgical Treatment and Visual Rehabilitation in the Congenital Cataracts

    Directory of Open Access Journals (Sweden)

    Uğur Keklikçi

    2005-01-01

    Full Text Available Congenital cataracts constitute an important part of blindness in childhood. It’s a curable disease which is one of the most common causes of blindness in childhood. Main treatment is surgical operation. Timing of surgery, appropriate and rapid post sur- gery visual rehabilitation have a major effect on prognosis. Surgery should be perfor-med as soon as possible after the diagnosis in order to prevent amblyopia.Visual rehabi- litation of congenital cataract includes optical correction and amblyopia treatment. The most effective treatment of amblyopia is occlusion therapy. In this article congenital cataracts were evaluated in the light of recent literature and the importance of the timing of surgery and visual rehabilitation were attempted to be emphasized.

  8. EFFICACY OF PERIBULBAR ANAESTHESIA VERSUS TOPICAL WITH INTRACAMERAL LIGNOCAINE ANAESTHESIA IN MANUAL SMALL INCISION CATARACT SURGERY: A 1-YEAR RANDOMISED CONTROLLED TRIAL

    Directory of Open Access Journals (Sweden)

    Samyakta Ashok

    2016-05-01

    Full Text Available AIMS To study the efficacy of peribulbar anaesthesia versus topical with intracameral anaesthesia in manual small incision cataract surgery and to compare surgeon’s experience as well as surgical outcome under both techniques. METHODS In a randomised controlled trial conducted at KLES Dr. Prabhakar Kore Hospital and MRC Belgaum from January 2012 to December 2012; 120 patients who met inclusion criteria were randomised into peribulbar group or topical with intracameral group (60 in each. Parameters studied in both the groups were akinesia, analgesia and complications occurring during administration of anaesthesia; surgeon’s experience was evaluated in terms of patient’s cooperation, difficulty while doing surgery due to ocular movements, anterior chamber stability, time taken to complete surgery; surgical outcome was studied with regards to any complications during surgery, best corrected visual acuity at 6 weeks. RESULTS Lid akinesia (96.66% and globe akinesia (100% was seen only in peribulbar anaesthesia which obviously lacked in topical anaesthesia which was both statistically and clinically significant. Patients in topical group mainly had pain during scleral incision (18.33%, sclera-corneal tunnelling (10%, cortical wash (13.33% which were statistically and clinically significant compared to peribulbar group. Button holing (3.33% and posterior capsular rent (3.33% occurred in topical group due to unexpected eye movement which was clinically significant. Pain scale between both the groups showed no difference during surgery. Most of patients had mild pain 61.66% in peribulbar group and 51.66% patients in topical group. Pain scale was significant in peribulbar group after 4 hrs. of surgery (p<0.001. Patient cooperation and lesser ocular movements during surgery was better in peribulbar group and also clinically significant. Anterior chamber stability was similar in both the groups. Unwanted ocular movements and lid squeezing were common

  9. Modern Capabilities of Surgical Management of Patients with Open-Angle Glaucoma Combined with Cataract

    Directory of Open Access Journals (Sweden)

    Mantseva J.Y.

    2014-03-01

    Full Text Available Cataract and glaucoma affecting mainly elderly people sometimes are associated; therefore the problem of their combined treatment is urgent. The aim of the investigation was to assess the efficiency of modern surgery in patients with combined cataract and open-angle glaucoma. Materials and Methods. The present open prospective study is based on the examination and surgery findings of patients with associated cataract and different stages of open-angle glaucoma (200 eyes. Depending on surgery type patients were divided into three groups. Group 1 included 81 patients (100 eyes with combined cataract and glaucoma stabilized by medical treatment, who underwent phacoemulsification with intraocular lens implantation. Group 2 consisted of 44 patients (50 eyes with cataract associated with open-angle glaucoma, who underwent phacoemulsification with intraocular lens implantation in combination with sinusotomy with viscocanalodilatation. 44 patients (50 eyes with associated cataract and glaucoma, in whom phacotrabeculectomy was performed, composed group 3. Most patients had developed and advanced stages of glaucoma (81%. In addition, in the majority of patients the pseudoexfoliation syndrome (71.5% was found. Results. Phacotrabeculectomy and phacoemulsification with viscocanalodilatation were found to have a marked hypotensive effect in significant improvement of visual function in patients with associated cataract and glaucoma, regardless of glaucoma stage and pseudoexfoliation syndrome presence. Moreover, phacoemulsification with sinusotomy and viscocanalodilatation provides earlier visual acuity recovery with less early postoperative complications compared to phacotrabeculectomy, and hypotensive effect is comparable to phacotrabeculectomy after additional laser goniopuncture which was required postoperatively in 58% cases. Phacoemulsification, being a less traumatic procedure, causes less postoperative complications in patients with associated cataract

  10. Ultrashort-Pulse Lasers Treating the Crystalline Lens: Will They Cause Vision-Threatening Cataract? (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Krueger, Ronald R.; Uy, Harvey; McDonald, Jared; Edwards, Keith

    2012-01-01

    Purpose: To demonstrate that ultrashort-pulse laser treatment in the crystalline lens does not form a focal, progressive, or vision-threatening cataract. Methods: An Nd:vanadate picosecond laser (10 ps) with prototype delivery system was used. Primates: 11 rhesus monkey eyes were prospectively treated at the University of Wisconsin (energy 25–45 μJ/pulse and 2.0–11.3M pulses per lens). Analysis of lens clarity and fundus imaging was assessed postoperatively for up to 4½ years (5 eyes). Humans: 80 presbyopic patients were prospectively treated in one eye at the Asian Eye Institute in the Philippines (energy 10 μJ/pulse and 0.45–1.45M pulses per lens). Analysis of lens clarity, best-corrected visual acuity, and subjective symptoms was performed at 1 month, prior to elective lens extraction. Results: Bubbles were immediately seen, with resolution within the first 24 to 48 hours. Afterwards, the laser pattern could be seen with faint, noncoalescing, pinpoint micro-opacities in both primate and human eyes. In primates, long-term follow-up at 4½ years showed no focal or progressive cataract, except in 2 eyes with preexisting cataract. In humans, 70% reported acceptable or better distance vision and no or mild symptoms. Meanwhile, >70% without sparing (0 and 0.5 mm radius) lost 2 or more lines, and most reported poor or severe vision and symptoms. Conclusions: Focal, progressive, and vision-threatening cataracts can be avoided by lowering the laser energy, avoiding prior cataract, and sparing the center of the lens. PMID:23818739

  11. The first cataract surgeons in Latin America: 1611–1830

    Science.gov (United States)

    Leffler, Christopher T; Wainsztein, Ricardo D

    2016-01-01

    We strove to identify the earliest cataract surgeons in Latin America. Probably by 1611, the Genovese oculist Francisco Drago was couching cataracts in Mexico City. The surgeon Melchor Vásquez de Valenzuela probably performed cataract couching in Lima by 1697. Juan Peré of France demonstrated cataract couching in Veracruz and Mexico City between 1779 and 1784. Juan Ablanedo of Spain performed couching in Veracruz in 1791. Cataract extraction might have been performed in Havana and Caracas by 1793 and in Mexico by 1797. The earliest contemporaneously documented cataract extractions in Latin America were performed in Guatemala City by Narciso Esparragosa in 1797. In addition to Esparragosa, surgeons born in the New World who established the academic teaching of cataract surgery included José Miguel Muñoz in Mexico and José María Vargas in Caracas. Although cataract surgery came quite early to Latin America, its availability was initially inconsistent and limited. PMID:27143845

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

    Directory of Open Access Journals (Sweden)

    Sérgio Jacobovitz

    2003-06-01

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

  13. Preventing the Complications of Cataract Surgery in Poor Areas%贫困地区白内障手术并发症的预防

    Institute of Scientific and Technical Information of China (English)

    赵俊宏; 王志成; 张兰英; 赵燕麟

    2002-01-01

    Objective To probe into the ways to prevent the complications of cataract surgery in poor areas in China. Methods141patients with catarat (163eyes) were divided into three groups. In group A, arc-cystectomy was adopt; In group B, opentin-cysteetomy: In group C, arc-cystectomy with minimal antibacterial drug added in irrigate liquid. Results The postoperative isionand rate of inplanted lens in group A are higher respectively than those in group B. Conclusion There are some characteristics ofcataract surgery in poor area. Arc-cystectomy lesseu the syndromes of the surgery. The minimal dose of tobramycin used in irrigateliquid is doable.%目的探讨贫困地区白内障手术中预防严重手术并发症的方法.方法将141例(163眼)病人随即分为三组,A组采用弧形截囊,B组开罐式截囊;C组弧形截囊,前房灌注液中加入微量妥布霉素;比较三组的术后效果.结果A组术后一周视力及人工晶状体植入率高于B组,术后一周角膜水肿率低于B组,差异均有显著性(P<0.05);A、C两组比较差异无显著性(P>0.05).结论贫困地区白内障手术有其特点,弧形截囊能减少手术并发症的发生,灌注液中加入妥布霉素是有效和可行的.

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

    International Nuclear Information System (INIS)

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

  15. 飞秒激光辅助白内障摘除手术的临床分析%Clinic analysis of femtosecond laser-assisted cataract surgery

    Institute of Scientific and Technical Information of China (English)

    张广斌; 叶向彧; 陈伟; 毛祖红; 王乐; 李孟琼

    2016-01-01

    目的 评估飞秒激光辅助超声乳化白内障吸除手术的安全性及有效性.方法 病例对照研究.2013年4月至11月在厦门眼科中心行超声乳化白内障手术的患者233例(314只眼),将其分为飞秒激光组(153只眼)及传统超声乳化组(161只眼),比较两组术前一般情况,术中超声乳化能量释放量(CDE)、有效超声时间(EPT)、角膜内皮丢失量、房水闪光值及术后并发症.计量资料采用独立样本t检验;计数资料采用交互列表的卡方或者Fisher确切概率法分析.结果 两组术前一般情况(年龄、性别、眼压、眼轴、角膜曲率、前房深度、核分级)差异无统计学意义(P>0.05).飞秒激光组CDE、EPT分别为4.78%(3.18%~8.88%)和14.05 s(10.07 ~ 20.85 s),小于传统超声乳化组的8.82%(6.01%~19.16%)和23.65 s(18.36 ~ 46.96 s),差异有统计学意义(z=2.30,2.91;P<0.05).飞秒激光组撕囊相对直径和圆形度均较传统超声乳化组更精确(t=2.58,3.92;P<0.05).角膜内皮丢失量在术后1个月时飞秒激光组为73.50(-69.51~ 111.03)个/mm2,低于传统超声乳化组的118.06(53.55~299.03)个/mm2,差异有统计学意义(z=2.44;P<0.05).房水闪光值在术后1d激光组18.81(13.32~20.23) ph/ms,传统超声乳化组24.51(16.38~ 32.18) ph/m和1个月时飞秒激光组13.01(9.23~ 16.28) ph/ms,传统超声乳化组18.05(12.37~ 24.97) ph/ms,传统超声乳化组均高于飞秒激光组,差异有统计学意义(z=2.40,2.31;P<0.05).两组术后均无严重并发症出现.结论 飞秒激光辅助超声乳化白内障吸除手术具有较高安全性及有效性,可降低CDE和减少EPT,进而减少角膜内皮损伤和术后前房反应,且撕囊更精确、重复性更好.%Objective To evaluate the safety and effectiveness of femtosecond laser-assisted cataract surgery.Methods The interventional case series enrolled 314 eyes undergoing cataract surgery in Xiamen Ophthalmic Center between April and

  16. Influence of two types of cataract surgery on corneal endothelial cells%两种不同白内障术式对角膜内皮细胞的影响

    Institute of Scientific and Technical Information of China (English)

    李雷; 郑振优; 陈梨萍

    2013-01-01

    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 eyes) from March 2011 to October 2011, were randomly divided into two groups: phacoemulsification group ( group A ) and 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 ( P<0.05 ).Although all the postoperative data of corneal endothelial cell density were lower than the preoperative ones, they had been slightly increasing over time. The mean density of corneal endothelial cell in group A was significantly higher than that in group B at 7d, 1 month and 3 months after operation ( P <0.05 ). In both groups, the average proportion of corneal hexagonal cells at 7d, 1 month and 3 months after operation was obviously lower than that before surgery, with significant difference between the two groups.Postoperative corneal edema was less severe in group A than in group B (P<0.05). CONCLUSION:Phacoemulsification causes less damage to corneal endothelial cells and less postoperative corneal edema than small incision extracapsular cataract extraction.%目的:观察两种不同白内障手术方式对角膜内皮细胞的影响。方法:选择2011-03/10在我院眼科行白内障手术的年龄相关性白内障患者82例82眼,随机分为超声乳化手术组(A组)与小切口白内障囊外摘除手术组(B组)。观察两组在手术前后不同阶段的角膜内皮细胞变化及术后角膜水肿情况。结果:(1)术后7d时两组角膜内皮细胞平均密度均较术前降低(P<0.05),数值随时间略有增长,但至术后3mo时仍低于相应术前水平(P<0.05

  17. Improving cataract services in the Indian context

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    Gudlavalleti VS Murthy

    2014-04-01

    Full Text Available In many countries, the number of cataract operations performed is inadequate to deal even with the people who have newly become blind from cataract, let alone those who are already blind or visually impaired. There is, therefore, a backlog of cases needing surgery. This could be due to low surgical capacity (people are on a waiting list or to a lack of demand for cataract surgery (people haven’t come forward for the services they need and there is therefore no waiting list.

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

    LENUS (Irish Health Repository)

    Barry, Peter

    2012-02-01

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

  19. Lipid peroxidation and cataracts: N-acetylcarnosine as a therapeutic tool to manage age-related cataracts in human and in canine eyes.

    Science.gov (United States)

    Babizhayev, Mark A; Deyev, Anatoly I; Yermakova, Valentina N; Brikman, Igor V; Bours, Johan

    2004-01-01

    Cataract formation represents a serious problem in the elderly, with approximately 25% of the population aged >65 years and about 50% aged >80 years experiencing a serious loss of vision as a result of this condition. Not only do cataracts diminish quality of life, they also impose a severe strain on global healthcare budgets. In the US, 43% of all visits to ophthalmologists by Medicare patients are associated with cataract. Surgery represents the standard treatment of this condition, and 1.35 million cataract operations are performed annually in the US, costing 3.5 billion US dollars (year of costing, 1998). Unfortunately, the costs of surgical treatment and the fact that the number of patients exceeds surgical capacities result in many patients being blinded by cataracts worldwide. This situation is particularly serious in developing countries; worldwide 17 million people are blind because of cataract formation, and the problem will grow in parallel with aging of the population. In any event, surgical removal of cataracts may not represent the optimal solution. Although generally recognised as being one of the safest operations, there is a significant complication rate associated with this surgical procedure. Opacification of the posterior lens capsule occurs in 30-50% of patients within 2 years of cataract removal and requires laser treatment, a further 0.8% experience retinal detachments, approximately 1% are rehospitalised for corneal problems, and about 0.1% develop endophthalmitis. Although the risks are small, the large number of procedures performed means that 26,000 individuals develop serious complications as a result of cataract surgery annually in the US alone. Thus, risk and cost factors drive the investigation of pharmaceutical approaches to the maintenance of lens transparency. The role of free radical-induced lipid oxidation in the development of cataracts has been identified. Initial stages of cataract are characterised by the accumulation of

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

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    Abraar Karan

    2014-01-01

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

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

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    Béatrice Cochener

    2010-02-01

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

  2. 联合手术治疗青光眼合并白内障及翼状胬肉的临床效果观察%Clinical observation of glaucoma with cataract and pterygium implementation of joint surgery

    Institute of Scientific and Technical Information of China (English)

    鲁红宇; 张祥元

    2015-01-01

    ,again no recurrence of pterygium surgery. Postoperative bleb Ⅰ type 20(34. 5%),type Ⅱ bleb 35(60. 3%),Ⅲ type bleb 2(3. 4%),Ⅳ type bleb 1(1. 7%). Shallow anterior chamber surgery Ⅰ type 5(8. 6%),type Ⅱ shallow anterior chamber 3(5. 1%). Corneal edema 5(8. 6%),posterior capsular opacification 3(5. 1%)after treatment improved. Conclusion Glaucoma,cataract and pterygium,can effectively control the use of combined surgery intraocular pressure,improve vision,reduce eye complications caused by secondary surgery,reduce the financial burden on patients,surgery is an ideal way.

  3. Low-Dose Radiation Cataract and Genetic Determinants of Radiosensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Kleiman, Norman Jay [Columbia University

    2013-11-30

    The lens of the eye is one of the most radiosensitive tissues in the body. Ocular ionizing radiation exposure results in characteristic, dose related, progressive lens changes leading to cataract formation. While initial, early stages of lens opacification may not cause visual disability, the severity of such changes progressively increases with dose until vision is impaired and cataract extraction surgery may be required. Because of the transparency of the eye, radiation induced lens changes can easily be followed non-invasively over time. Thus, the lens provides a unique model system in which to study the effects of low dose ionizing radiation exposure in a complex, highly organized tissue. Despite this observation, considerable uncertainties remain surrounding the relationship between dose and risk of developing radiation cataract. For example, a growing number of human epidemiological findings suggest significant risk among various groups of occupationally and accidentally exposed individuals and confidence intervals that include zero dose. Nevertheless, questions remain concerning the relationship between lens opacities, visual disability, clinical cataract, threshold dose and/or the role of genetics in determining radiosensitivity. Experimentally, the response of the rodent eye to radiation is quite similar to that in humans and thus animal studies are well suited to examine the relationship between radiation exposure, genetic determinants of radiosensitivity and cataractogenesis. The current work has expanded our knowledge of the low-dose effects of X-irradiation or high-LET heavy ion exposure on timing and progression of radiation cataract and has provided new information on the genetic, molecular, biochemical and cell biological features which contribute to this pathology. Furthermore, findings have indicated that single and/or multiple haploinsufficiency for various genes involved in DNA repair and cell cycle checkpoint control, such as Atm, Brca1 or Rad9

  4. Clinical application value of hard nucleolus cataract surgery with sutureless large incision in primary hospitals%无缝线中切口硬核白内障手术在基层医院临床应用

    Institute of Scientific and Technical Information of China (English)

    何新

    2015-01-01

    Objective To summarize and explore the effect of hard nuclcolus cataract surgery with sutureless large incision.Methods A retrospective analysis was made on the clinical data of 168 patients with hard nucleolus cataract received extracapsular cataract extraction with sutureless large incision from January 2009 to December 2013 in People's Hospital of Xuan'en County.Results Through comparing uncorrected visual acuity when one day, one week and three months after surgery with before surgery in 168 patients with cataract surgery, there were significant differences (x2=255.21, P =0.000;x2=431.46, P =0.000;x2=401.98, P =0.000).Conclusions Extracapsular cataract extraction with sutureless large incision is inexpensive, safe and easy to master, and the learning curve is short and the effect is good.It is suitable for development in the primary hospitals.%目的 总结并探讨无缝线中切口硬核白内障手术的效果.方法 回顾性分析2009年1月至2013年12月在宣恩县人民医院眼科就诊的168只眼硬核患者行无缝线中切口白内障囊外摘除术临床资料.结果 168只眼手术后1天、手术后1周、手术后3个月裸眼视力与术前比较,差异有统计学意义(x2=255.21,P=0.000;x2=431.46,P=0.000;x2=401.98,P=0.000).结论 无缝线中切口白内障囊外摘除术投资少、安全、容易掌握、学习曲线短、效果好,适合在基层医院开展.

  5. Persistent strabismus after cataract extraction

    Directory of Open Access Journals (Sweden)

    Dujić Mirjana P.

    2005-01-01

    Full Text Available Background. Transient ocular misalignment as a complication of parabulbar and peribulbar anesthesia has already been reported in the literature. The aim of our study was to present a case of irreversible iatrogenic vertical strabismus after cataract surgery, which had to be operated on. Methods. Clinical and orthoptic evaluation of a female patient with vertical diplopia after phacoemulsification cataract surgery. Results. One week after the uneventful surgery, a 68-year-old patient complained of a sudden vertical deviation in the operated eye. The patient had not had a history of previous motility disorders. On examination, the patient showed hypertropia in the left eye of 15−20 degrees in primary position. Three and 6 months postoperatively, there was no a spontaneous improvement, while the persistent vertical deviation was 40 prism dioptres. Strabismus surgery was required 1 year after the cataract surgery. Conclusion. Diplopia is a complication of peribulbar anesthesia which could be persistent. The superior and inferior rectus muscle are especially vulnerable. Its occurrence may be technique - related and the incidence increases when hyaluronidase is not available.

  6. Effect of bimanual microincisional cataract surgery versus conventional coaxial small-incision cataract surgery on visual quality: A meta-analysis%双手微小切口与传统同轴超声乳化吸除术对术后视觉质量影响的Meta分析

    Institute of Scientific and Technical Information of China (English)

    苏琪; 宋秀君

    2010-01-01

    Objective To evaluate the efficacy of bimanual microincisional cataract surgery (B-MICS) versus conventional coaxial small-incision cataract surgery (C-SICS) for visual quality. Methods A systematic review of B-MICS and C-SICS was conducted by a computer search on Medline, EMCC, OVID, and CNKI and a supplementary manual search was also done. The effect was measured as an odds ratio (OR) and weighted mean difference (WMD). Review manager 4.2 software was used to perform the meta-analysis. A sensitivity analysis was then performed and a publication bias was evaluated by a funnel plot and Egger's regression test. Results Only relevant articles from the resource material were included and/or excluded using a strict criterion. A total of 9 articles were included in the meta-analysis. The ORs of naked visual acuity 0.5 or better at 1 day, 1 week, and 1 month after surgery were 1.82 (95%CI was 1.38-2.39), 2.36 (95%CI was 1.27-4.37) and 1.61 (95% CI was 1.08-2.41), respectively. The differences were statistically significant (P0.05). A summary WMD of the meta-analysis showed a significant reduction in surgically induced astigmatism in the B-MICS group (WMD =-0.35 D, 95%CI:-0.48- -0.21 D, P<0.01). Sensitivity analysis and publication bias showed that the outcomes of this research were stable and reliable. Conclusion The evidence currently available showed that B-MICS is a safer and more reliable surgery for restoration of visual acuity and reducing surgically induced astigmatism in patients with cataract.%目的 系统评价双手微小切口(B-MICS)与传统同轴白内障超声乳化吸除术(C-SICS)对术后视觉质量的影响.方法 通过计算机文献检索,结合手工检索,对纳入的有关B-MICS和C-SICS临床疗效的相关文献进行Meta分析,以比值比(OR)和加权均数差值(WMD)为效应量,应用Review Manager 4.2软件进行Meta分析.对检索所得资料进行敏感性分析,并评价其发表偏倚.结果 共有9篇文献纳入研究.术后1 d

  7. Cataract formation following vitreoretinal procedures

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    Feng H

    2014-09-01

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

  8. Cataract research using electronic health records

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    Waudby Carol J

    2011-11-01

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

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

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    Leonardo Akaishi

    2006-06-01

    Full Text Available OBJETIVOS: As técnicas e resultados da cirurgia de catarata melhoraram drasticamente com o avanço tecnológico. Um dos motivos para melhoria seria a menor utilização de ultra-som com novos aparelhos de facoemulsificação. O objetivo deste estudo é confirmar na prática a vantagem teórica da caneta NeoSoniX TM. MÉTODOS: Foi realizada uma análise na qual os autores compararam resultados dos parâmetros registrados pelo aparelho de facoemulsificação Legacy durante 300 cirurgias de catarata realizadas com caneta de ultra-som (handpiece convencional e 100 com a caneta NeoSoniX TM. Todas as cirurgias foram realizadas pelo mesmo cirurgião, com a mesma técnica cirúrgica. A escolha da "handpiece" foi aleatória, sendo comparadas, em relação ao grau de dureza das cataratas, os parâmetros de tempo do ultra-som, quantidade de solução salina balanceada e porcentagem de "average power" utilizadas durante as cirurgias. RESULTADOS: Foi realizada análise retrospectiva numa série cronológica de casos, mostrando que em qualquer que seja o grau de dureza da catarata, o tempo de utilização do ultra-som com a caneta NeoSoniX foi inferior ao da caneta convencional (pPURPOSE: The techniques and results of cataract surgery have improved dramatically with technological advancements. One of the reasons for this improvement would be the reduced use of ultrasound with the new phacoemulsification devices. The objective of this study is to confirm the theoretical advantage of the NeoSoniX handpiece. METHODS: The authors compared the results of the parameters recorded by the Legacy phacoemulsification system during 300 cataract surgeries performed with the use of the conventional ultrasound handpiece and 100 performed with the innovative NeosonixTM. All surgeries were performed by the same senior surgeon, using the same surgical technique. The choice of handpiece was random. The handpieces were compared considering cataract grade of hardness, in

  10. All-Cause and Cause-Specific Mortality Associated with Bariatric Surgery: A Review.

    Science.gov (United States)

    Adams, Ted D; Mehta, Tapan S; Davidson, Lance E; Hunt, Steven C

    2015-12-01

    The question of whether or not nonsurgical intentional or voluntary weight loss results in reduced mortality has been equivocal, with long-term mortality following weight loss being reported as increased, decreased, and not changed. In part, inconsistent results have been attributed to the uncertainty of whether the intentionality of weight loss is accurately reported in large population studies and also that achieving significant and sustained voluntary weight loss in large intervention trials is extremely difficult. Bariatric surgery has generally been free of these conflicts. Patients voluntarily undergo surgery and the resulting weight is typically significant and sustained. These elements, combined with possible non-weight loss-related mechanisms, have resulted in improved comorbidities, which likely contribute to a reduction in long-term mortality. This paper reviews the association between bariatric surgery and long-term mortality. From these studies, the general consensus is that bariatric surgical patients have: 1) significantly reduced long-term all-cause mortality when compared to severely obese non-bariatric surgical control groups; 2) greater mortality when compared to the general population, with the exception of one study; 3) reduced cardiovascular-, stroke-, and cancer-caused mortality when compared to severely obese non-operated controls; and 4) increased risk for externally caused death such as suicide.

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

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    Kenji Obayashi

    2015-08-01

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

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

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    Claudete I. Locatelli

    2003-07-01

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

  13. A case report of spontaneous mutation (C33>U) in the iron-responsive element of L-ferritin causing hyperferritinemia-cataract syndrome.

    LENUS (Irish Health Repository)

    Cao, Wei

    2010-01-15

    The hereditary hyperferritinemia cataract syndrome (HHCS) is an autosomal dominant disorder characterized by juvenile-onset cataracts and elevated serum ferritin levels. It is caused by mutation in the iron response element (IRE) within the 5\\'UTR of L-ferritin gene. The mutation results in a loss of post-transcriptional negative feedback exerted by the interaction between iron regulatory proteins 1, 2 (IRP1 and IRP2) and IRE, which leads to uncontrolled expression of L-ferritin. In this paper, we describe the molecular pathogenesis of non-hereditary hyperferritinemia cataract syndrome (non-H-HCS) in a patient with typical HHCS ocular lens morphology and high ferritin levels without obvious family history. Initial sequencing of the full-length L-ferritin cloned from genomic DNA demonstrated a mutation (C33>T) in the IRE of the affected patient but not in her unaffected family members. The mutation (C\\/T heterozygote) was also detected in cDNA derived from her blood mononuclear cells. Structure-prediction-modeling indicates that this mutation would significantly alter the secondary structure of the IRE, resulting in a loss of the interaction between IRP and IRE. By using IRP1\\/IRP2-human IgG1 Fc fusion proteins, we established a novel in vitro report system (modified ELISA) to verify impaired IRE\\/IRP binding. Both the C33>U and A40G mutations (the first identified mutation for HHCS) showed a dramatically decreased binding to IRP1\\/IRP2 protein, compared to the normal IRE RNA. Surprisingly, a decrease in L-ferritin mRNA levels was observed in the affected patient compared to controls suggesting a mechanism of transcriptional negative feedback by high intracellular L-ferritin protein levels not described heretofore. Taken together, spontaneous mutation in the IRE of L-ferritin may cause non-H-HCS by the same mechanism as HHCS. In addition, under abnormal circumstances, the protein level of L-ferritin may be principally controlled by post

  14. Ultrasonographic findings in patients examined in cataract detection-andtreatment campaigns: a retrospective study

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    Marcio Henrique Mendes

    2009-01-01

    Full Text Available INTRODUCTION: A cataract is defined as an opacity of any portion of the lens, regardless of visual acuity. In some advanced cases of cataracts, in which good fundus visualization is not possible, an ultrasound examination provides better assessment of the posterior segment of the globe. OBJECTIVES: This study aims to evaluate the ultrasonographic records of patients with advanced cataracts who were examined during cataract campaigns. METHODS: The ultrasonographic findings obtained from 215 patients examined in cataract campaigns conducted by the Hospital das Clínicas Department of Ophthalmology of the Faculdade de Medicina da Universidade de São Paulo between the years of 2005 and 2007 were evaluated, and the utility of this exam in changing the treatment procedures was studied. RESULTS: A total of 289 eyes from 215 patients were examined. Of the eyes examined, 77.5% presented with findings in the vitreous cavity and the posterior pole. A posterior vitreous detachment with no other complications was observed in 47.4% of the eyes. The remaining 30.1% presented with eye diseases that could result in a reduced visual function after surgery. The most frequent eye diseases observed were diffuse vitreous opacity (12.1% of the eyes and detachment of the retina (9.3% of the eyes. DISCUSSION: In many cases, the ultrasonographic evaluation of the posterior segment revealed significant anomalies that changed the original treatment plan or contra-indicated surgery. At the very least, the evaluation was useful for patient counseling. CONCLUSION: The ultrasonographic examination revealed and differentiated between eyes with cataracts and eyes with ocular abnormalities other than cataracts as the cause of poor vision, thereby indicating the importance of its use during ocular evaluation.

  15. 关于马来西亚医院白内障手术并发症的研究:相关因素、类型及预后%The temerloh hospital cataract complications study:factors associated with, types and outcomes of cataract surgery complications

    Institute of Scientific and Technical Information of China (English)

    Thevi Thanigasalam; Sagili Chandrasekhara Reddy; Karuthan Chinna

    2014-01-01

    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 ( ICCE ) and phacoemulsification converted to extracapsular cataract extraction ( ECCE ) were significantly associated with more complications ( P CONCLUSION: 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.%目的:研究白内障手术并发症的发生率及其相关影响因素,包括手术经验、手术类型、麻醉方式和术后视力。  方法:回顾性分析在马来西亚地区医院行白内障手术逾2a的患者。查看病人基本信息、手术类型、麻醉方式和医生手术经验,记录术中和术后的并发症以及术后最佳矫正视力。  结果:在1007名行白内障手术的患者

  16. Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation

    Directory of Open Access Journals (Sweden)

    Schulze SD

    2015-11-01

    Full Text Available Stephan D Schulze,1 Thomas Bertelmann,1 Irena Manojlovic,2 Stefan Bodanowitz,2 Sebastian Irle,3 Walter Sekundo11Department of Ophthalmology, Philipps University of Marburg, Marburg, 2Private Practice and Ambulatory Surgical Center, Bremen, 3Freelance Statistician, Friedberg, GermanyPurpose: To evaluate whether the use of balanced salt solution (BSS or an ophthalmic viscoelastic device (OVD during hydrophilic acrylic intraocular lens (IOL implantation variously impacts corneal endothelial cell characteristics in eyes undergoing uneventful phacoemulsifications.Methods: Prospective nonrandomized observational clinical trial. Patients were assigned either to the BSS plus® or to the OVD Z-Celcoat™ group depending on the substance used during IOL implantation. Corneal endothelium cell characteristics were obtained before, 1 week, and 6 weeks after surgery. Intraoperative parameters (eg, surgery time, phacoemulsification energy were recorded.Results: Ninety-seven eyes were assigned to the BSS plus and 86 eyes to the Z-Celcoat group. Preoperative corneal endothelium cell density (ECD and endothelium cell size were 2,506±310 cells/mm2/2,433±261 cells/mm2 and 406±47 µm2/416±50 µm2 (P=0.107/P=0.09. After 1 and 6 weeks, ECD decreased and endothelium cell size increased significantly in both groups (each P<0.001 without significant differences between both groups (each P>0.05. Irrigation–aspiration suction time (30.3±16.6 versus 36.3±14.5 seconds and overall surgical time (7.2±1.2 versus 8.0±1.4 minutes were significantly longer in the OVD Z-Celcoat group (each P<0.001. No complications or serious side effects occurred.Conclusion: Implantation of a hydrophilic acrylic IOL under BSS infusion seems to be a useful and faster alternative in experienced hands without generating higher ECD loss rates.Keywords: phacoemulsification, ophthalmic viscoelastic device, endothelial cell density, IOL

  17. Long-term follow-up for bimanual microincision cataract surgery: comparison of results obtained by surgeons in training and experienced surgeons

    Directory of Open Access Journals (Sweden)

    Cavallini GM

    2016-05-01

    Full Text Available Gian Maria Cavallini, Tommaso Verdina, Matteo Forlini, Veronica Volante, Michele De Maria, Giulio Torlai, Caterina Benatti, Giancarlo Delvecchio Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy Purpose: To determine the efficacy of bimanual microincision cataract surgery (B-MICS performed by surgeons in training, evaluating clinical results, posterior capsule opacification (PCO incidence, and clear corneal incision (CCI architecture in a long-term follow-up and comparing results with those obtained by experienced surgeons. Patients and methods: Eighty eyes of 62 patients operated on by three surgeons in training who used B-MICS technique for the first time were included in the study (Group A. Eighty eyes of 59 patients who underwent B-MICS by three experienced surgeons were included as a control group (Group B. Best corrected visual acuity, astigmatism, corneal pachymetry, and endothelial cell count were evaluated before surgery and at 1 month and 18 months after surgery. Anterior segment optical coherence tomography images were obtained to study the morphology of CCIs. PCO incidence was evaluated using EPCO2000 software. Results: Out of 160 surgeries included in the study, mean best-corrected visual acuity improvement at 18 months was 0.343±0.246 logMAR for Group A, and 0.388±0.175 logMAR for Group B, respectively. We found no statistically significant induced astigmatism nor corneal pachymetry changes in either group, while we noticed a statistically significant endothelial cell loss postoperatively in both groups (P<0.05. In Group A, mean PCO score was 0.163±0.196, while for Group B, it was 0.057±0.132 (P=0.0025. Mean length and inclination of the CCIs for Group A and Group B were, respectively, 1,358±175 µm and 1,437±256 µm and 141.8°±6.4° and 148.7°±5.1°. As regards corneal architecture in the 320 CCIs considered, we found posterior wound retractions and endothelial gaps, respectively

  18. 三角形巩膜瓣在青光眼白内障联合手术中的应用%Application of triangular scleral flap in combined surgery of glaucoma cataract

    Institute of Scientific and Technical Information of China (English)

    南中义; 屈伸平; 杜博

    2015-01-01

    Objective To investigate application of triangular scleral flap in combined surgery of glaucoma cataract. Methods Twenty-six patients(28 eyes)with glaucoma and cataract were used triangle sclera flap trabeculectomy,tunnel small incision cataract extraction,and posterior chamber intraocular lens implantation. The patients were followed up from 3 months to 6 months for observing the vision,intraocular pressure. Results There were 3 eyes of postoperative visual acuity ﹤ 0. 1 (10. 71% ),9 eyes of 0. 12 ~ 0. 3(32. 14% ),16 eyes ﹥ 0. 4(57. 14% ),all the visual acuity was improved in various de-grees. Preoperative intraocular pressure was 28 ~ 50 mm Hg(1 mm Hg = 0. 133 kPa). Postoperative intraocular pressure:26 eyes maintained at normal pressure,2 eyes intraocular pressure slightly higher than normal,auxiliary hypotensive eyedrop can maintain the normal intraocular pressure,achieve functional filtering blebs in 26 eyes(92. 86% ),no serious complications oc-curred. Conclusion Treatment using triangle sclera flap trabeculectomy,tunnel small incision cataract extraction,and posterior chamber intraocular lens implantation used for the treatment of glaucoma complicated with cataract surgery can effectively control intraocular pressure,and improve visual acuity.%目的:探讨三角形巩膜瓣在青光眼白内障联合手术中应用的可行性及疗效。方法对26例(28眼)青光眼合并白内障患者采用三角形巩膜瓣下小梁切除联合隧道小切口白内障摘除及后房型人工晶状体植入术,术后随访3个月至6个月,观察术后视力、眼压、滤过泡。结果术后矫正视力﹤0.1者3眼(10.71%),0.12~0.3者9眼(32.14%),

  19. Congenital cataract causing mutants of αA-crystallin/sHSP form aggregates and aggresomes degraded through ubiquitin-proteasome pathway.

    Directory of Open Access Journals (Sweden)

    Ilangovan Raju

    Full Text Available BACKGROUND: Mutations of human αA-crystallin cause congenital cataract by protein aggregation. How mutations of αA-crystallin cause disease pathogenesis through protein aggregation is not well understood. To better understand the cellular events leading to protein aggregation, we transfected cataract causing mutants, R12C, R21L, R21W, R49C, R54C, R116C and R116H, of human αA-crystallin in HeLa cells and examined the formation of intracellular protein aggregates and aggresomes by confocal microscopy. METHODOLOGY/PRINCIPAL FINDINGS: YFP-tagged human αA-wild-type (αA-wt was sub-cloned and the mutants were generated by site-directed mutagenesis. The αA-wt and the mutants were individually transfected or co-transfected with CFP-tagged αA-wt or αB-wild-type (αB-wt in HeLa cells. Overexpression of these mutants forms multiple small dispersed cytoplasmic aggregates as well as aggresomes. Co-expression of αB-wt with these mutants significantly inhibited protein aggregates where as co-expression with αA-wt enhanced protein aggregates which seems to be due to co-aggregation of the mutants with αA-wt. Aggresomes were validated by double immunofluorescence by co-localization of γ-tubulin, a centrosome marker protein with αA-crystallin. Furthermore, increased ubiquitination was detected in R21W, R116C and R116H as assessed by western blot analyses. Immunostaining with an ubiquitin antibody revealed that ubiquitin inclusions in the perinuclear regions were evident only in R116C transfected cells. Pulse chase assay, after cycloheximide treatment, suggested that R116C degraded faster than the wild-type control. CONCLUSIONS/SIGNIFICANCE: Mutants of αA-crystallin form aggregates and aggresomes. Co-expression of αA-wt with the mutants increased aggregates and co-expression of αB-wt with the mutants significantly decreased the aggregates. The mutant, R116C protein degraded faster than wild-type control and increased ubiquitination was evident in R

  20. Combined study on the causes of strabismus after the retinal surgery.

    Science.gov (United States)

    Hwang, J M; Wright, K W

    1994-12-01

    Extraocular muscle imbalance and diplopia after retina surgery have been previously reported, but the etiology is still controversial. In order to better understand the cause of strabismus after retinal surgery, the authors retrospectively studied 30 patients with persistent strabismus following retinal surgery and combined the result about seven patients of strabismus after retinal surgery in the previous report. Results showed multiple etiologies for the strabismus. Causes of strabismus included fat adherence syndrome (14 patients), non-specific restrictive adhesion (11), displacement of superior oblique tendon (2), scleral explant interfering with ocular motility (1), lost or slipped muscle with adhesion (2), sensory strabismus (2), macular pucker causing ectopic fovea (2), and previous strabismus before the retinal surgery (3). Knowledge of the varieties of abnormalities that can cause strabismus and diplopia will help both the retina and strabismus surgeon prevent and treat strabismus after retinal surgery. PMID:7853737

  1. Lutein and cataract: from bench to bedside.

    Science.gov (United States)

    Manayi, Azadeh; Abdollahi, Mohammad; Raman, Thiagarajan; Nabavi, Seyed Fazel; Habtemariam, Solomon; Daglia, Maria; Nabavi, Seyed Mohammad

    2016-10-01

    Cataract is one of the most important leading causes of blindness in the world. Extensive research showed that oxidative stress may play an important role in the initiation and progression of a cataract and other age-related eye diseases. Extra-generation of reactive oxygen and nitrogen species in the eye tissue has been shown as one of the most important risk factors for cataracts and other age-related eye diseases. With respect to this, it can be hypothesized that dietary antioxidants may be useful in the prevention and/or mitigation of cataract. Lutein is an important xanthophyll which is widely found in different vegetables such as spinach, kale and carrots as well as some other foods such as eggs. Lutein is concentrated in the macula and suppresses the oxidative stress in the eye tissues. A plethora of literature has shown that increased lutein consumption has a close correlation with reduction in the incidence of cataract. Despite this general information, there is a negligible number of review articles considering the beneficial effects of lutein on cataracts and age-related eye diseases. The present review is aimed at discussing the role of oxidative stress in the initiation and progression of a cataract and the possible beneficial effects of lutein in maintaining retinal health and fighting cataract. We also provide a perspective on the chemistry, sources, bioavailability and safety of lutein. PMID:26042352

  2. Capsulorhexis contraction after cataract surgery

    DEFF Research Database (Denmark)

    Corydon, Charlotte; Lindholt, Michael; Knudsen, Ellen B;

    2007-01-01

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

  3. Effect of sutureless small incision cataract surgery plus intraocular lens implantation on Africans with cataract: a report of 1 730 cases%小切口无缝线白内障摘除加人工晶体植入术1730例临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    庞永明; 李辉

    2011-01-01

    Objective To investigate the effect of suture less small incision cataract surgery (SICS) plus intraocular lens (IOL) implantation for Africans with cataract. Methods Sutureless SICS plus IOL implantation was conducted on 1 730 African patients with cataract, a total of 2 207 eyes. The clinical effect was evaluated. Results One week after the surgery, 1 403 eyes were found with vision ≥0.5 (63.6%), and 112 were found with vision ≥1.0 (5.1%), with astigmatism of (1.96±0.72) D. Three months after the surgery, 2 094 eyes were found with vision ≥0.5 (94.9%), and 136 were found with vision ≥ 1.0 (6.2%), with astigmatism of (0.87±0.54) D. Conclusion Sutureless SICS plus IOL implantation leads to a smaller chance of injury and provides ideal vision recovery, which is worthy to be extended in African.%目的 探讨小切口无缝线白内障囊外摘除加人工晶体植入术治疗非洲黑人白内障的临床疗效.方法对1 730例(2 207眼)黑人白内障患者行小切口无缝线白内障囊外摘除及人工晶体植入术,评估疗效.结果术后1周视力≥0.5者占63.6%(1 403眼),视力≥1.0者占5.1%(112眼),散光为(1.96±0.72)D.3个月后视力≥0.5者占94.9%(2094眼).视力≥1.0 (136眼)占6.2%,散光为(0.87±0.54)D.结论小切口无缝线白内障囊外摘除及人工晶体植入术损伤小、术后视力恢复好,在非洲地区有推广运用价值.

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

    Science.gov (United States)

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

    2006-01-01

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

  5. Structure-Function Correlation Analysis of Connexin50 Missense Mutations Causing Congenital Cataract: Electrostatic Potential Alteration Could Determine Intracellular Trafficking Fate of Mutants

    Directory of Open Access Journals (Sweden)

    Devroop Sarkar

    2014-01-01

    Full Text Available Connexin50 (Cx50 mutations are reported to cause congenital cataract probably through the disruption of intercellular transport in the lens. Cx50 mutants that undergo mistrafficking have generally been associated with failure to form functional gap junction channels; however, sometimes even properly trafficked mutants were found to undergo similar consequences. We hereby wanted to elucidate any structural bases of the varied functional consequences of Cx50 missense mutations through in silico approach. Computational studies have been done based on a Cx50 homology model to assess conservation, solvent accessibility, and 3-dimensional localization of mutated residues as well as mutation-induced changes in surface electrostatic potential, H-bonding, and steric clash. This was supplemented with meta-analysis of published literature on the functional properties of connexin missense mutations. Analyses revealed that the mutation-induced critical alterations of surface electrostatic potential in Cx50 mutants could determine their fate in intracellular trafficking. A similar pattern was observed in case of mutations involving corresponding conserved residues in other connexins also. Based on these results the trafficking fates of 10 uncharacterized Cx50 mutations have been predicted. Further experimental analyses are needed to validate the observed correlation.

  6. Laparoscopic cholecystectomy causes less sleep disturbance than open abdominal surgery

    DEFF Research Database (Denmark)

    Gögenur, I; Rosenberg-Adamsen, S; Kiil, C;

    2001-01-01

    BACKGROUND: The aim of this study was to examine subjective sleep quality before and after laparoscopic vs open abdominal surgery. METHODS: Twelve patients undergoing laparoscopic cholecystectomy and 15 patients undergoing laparotomy were evaluated with the aid of a sleep questionnaire from 4 day...

  7. Childhood Cataract: Magnitude, Management, Economics and Impact

    Directory of Open Access Journals (Sweden)

    BR Shamanna

    2004-01-01

    Full Text Available The prevalence of blindness among children in different regions varies from 0.2/1000 children to over 1.5/1000 children with a global figure estimated at 0.7/1000. This means that there are an estimated 1.4 million blind children worldwide.1 The proportion of blindness in children due to cataract varies considerably between regions from 10%-30% with a global average estimated at 14%, giving 190,000 children blind from cataract. 2 While the magnitude of childhood cataracts varies from place to place, it is a priority within all blindness control programmes for children. Children who are blind have to overcome a lifetime of emotional, social and economic difficulties which affect the child, the family and society.3 Loss of vision in children influences their education, employment and social life. The numbers blind with cataract do not reflect the years of disability and lost quality of life. Childhood blindness is second only to adult cataract as a cause of blind-person years. Approximately 70 million blind-person years are caused by childhood blindness of which about 10 million blind-person years (14% is due to childhood cataract. Timely recognition and intervention can eliminate blind-years due to childhood cataract, as the condition is treatable.

  8. Effects of intracameral cefuroxime injection on the prophylaxis of endophthalmitis after cataract surgeries:a Meta-analysis%前房内注入头孢呋辛预防白内障术后眼内炎的Meta分析

    Institute of Scientific and Technical Information of China (English)

    吴晓玉; 蒋林志

    2015-01-01

    AIM: To evaluate the effects of intracameral cefuroxime injection on the prophylaxis of postoperative endophthalmitis after cataract surgeries, and compare endophthalmitis conditions between intracameral cefuroxime injection group and no intervention control group, using Meta analysis to search literatures at home and abroad. METHODS: By searching through Pubmed, the Cochrane Library, EMBASE, QVIP, CNKI, Wanfang, the literatures published from January 1 st 2006 to January 31 rd 2015 were collected. The data in five literatures about the effects of intracameral cefuroxime injection on the prophylaxis of endophthalmitis after cataract surgeries were analyzed. By extracting data, incidence of endophthalmitis after cataract surgeries with taking the preventive measures or not taking was compared by Review Manager 5. 2. Adopting fixed effect model, values of odds ratio ( OR) and 95% Confidence Interval ( 95% CI ) were recorded and compared, analyzed sensitivity analysis, excluded heterogeneity and calculated outcomes. RESULTS: After comparing the incidence of endophthalmitis from intracameral cefuroxime injection group and control group, the result was statistically significant [OR=0. 11 (P  方法:检索国内外数据库如 Pubmed、The Cochrane Library、EMBASE、维普中文科技期刊数据库、中国知网、万方数据库经审稿人审核发表选取2006-01-01/2015-01-31的关于前房内注入头孢呋辛与对照组无干预措施对白内障术后眼内炎预防作用的文章,共纳入5篇文献,通过提取数据,观察采取与未采取该预防措施后白内障术后眼内炎的发病率,应用Review Manager 5.2软件,采用固定效应模型,统计比较OR值和95%CI,进行敏感性分析,排除异质性,得出结果。  结果:Meta分析比较前房内注入头孢呋辛与对照组,以白内障术后眼内炎的发病率作为指标,统计结果差异有明显的统计学意义( OR=0.11,95%CI=0.07~0.18,P  结论:前房内注入

  9. Are we monitoring the quality of cataract surgery services? A qualitative situation analysis of attitudes and practices in a large city in South Africa

    OpenAIRE

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

    2015-01-01

    Purpose: To evaluate the current quality "assurance" and "improvement" mechanisms, the knowledge, attitudes and practices of cataract surgeons in a large South African city. Methodology: A total of 17 in-depth semi-structured interviews were conducted with ophthalmologists in June 2012 at 2 tertiary institutions in the Republic of South Africa. Recruitment of the purposive sample was supplemented by snowball sampling. The study participants were 5 general ophthalmologists and 2 pediatric ...

  10. Main factors influencing postoperative visual function after refractive cataract surgery%屈光性白内障手术术后影响视觉质量的主要因素

    Institute of Scientific and Technical Information of China (English)

    龚敏; 刘谊

    2014-01-01

    人工晶状体( intraocular lens ,IOL)屈光力计算误差,角膜散光,前房深度以及IOL的位置等因素能导致术眼屈光状态的改变,影响白内障术后的整体视觉质量。我们将对手术过程顺利的屈光性白内障手术术后影响视觉质量的主要因素进行综述。%Factors including intraocular lens power calculation error, corneal astigmatism, anterior chamber depth and lens position can lead to the change of refractive status, they also influence the overall postoperative visual quality.This article provides a comprehensive review of the main factors affecting postoperative visual function after uneventful refractive cataract surgery.

  11. Mutations Impairing GSK3-Mediated MAF Phosphorylation Cause Cataract, Deafness, Intellectual Disability, Seizures, and a Down Syndrome-like Facies

    Science.gov (United States)

    Niceta, Marcello; Stellacci, Emilia; Gripp, Karen W.; Zampino, Giuseppe; Kousi, Maria; Anselmi, Massimiliano; Traversa, Alice; Ciolfi, Andrea; Stabley, Deborah; Bruselles, Alessandro; Caputo, Viviana; Cecchetti, Serena; Prudente, Sabrina; Fiorenza, Maria T.; Boitani, Carla; Philip, Nicole; Niyazov, Dmitriy; Leoni, Chiara; Nakane, Takaya; Keppler-Noreuil, Kim; Braddock, Stephen R.; Gillessen-Kaesbach, Gabriele; Palleschi, Antonio; Campeau, Philippe M.; Lee, Brendan H.L.; Pouponnot, Celio; Stella, Lorenzo; Bocchinfuso, Gianfranco; Katsanis, Nicholas; Sol-Church, Katia; Tartaglia, Marco

    2015-01-01

    Transcription factors operate in developmental processes to mediate inductive events and cell competence, and perturbation of their function or regulation can dramatically affect morphogenesis, organogenesis, and growth. We report that a narrow spectrum of amino-acid substitutions within the transactivation domain of the v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog (MAF), a leucine zipper-containing transcription factor of the AP1 superfamily, profoundly affect development. Seven different de novo missense mutations involving conserved residues of the four GSK3 phosphorylation motifs were identified in eight unrelated individuals. The distinctive clinical phenotype, for which we propose the eponym Aymé-Gripp syndrome, is not limited to lens and eye defects as previously reported for MAF/Maf loss of function but includes sensorineural deafness, intellectual disability, seizures, brachycephaly, distinctive flat facial appearance, skeletal anomalies, mammary gland hypoplasia, and reduced growth. Disease-causing mutations were demonstrated to impair proper MAF phosphorylation, ubiquitination and proteasomal degradation, perturbed gene expression in primary skin fibroblasts, and induced neurodevelopmental defects in an in vivo model. Our findings nosologically and clinically delineate a previously poorly understood recognizable multisystem disorder, provide evidence for MAF governing a wider range of developmental programs than previously appreciated, and describe a novel instance of protein dosage effect severely perturbing development. PMID:25865493

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

    Directory of Open Access Journals (Sweden)

    Millonig Gunda

    2010-04-01

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

  13. Hiatal hernia causing extrapericardial tamponade after coronary bypass surgery.

    Science.gov (United States)

    Papoulidis, Pavlos; Beatty, Jasmine Winter; Dandekar, Uday

    2014-10-01

    Cardiac tamponade is defined as compression of the heart due to accumulation of fluid in the pericardial sac, leading to raised pericardial pressures with haemodynamic compromise. We describe the case of a 76-year old female patient who underwent a routine off-pump coronary artery bypass graft operation and within 48 h developed classic signs of cardiac tamponade. The perioperative echocardiogram and operative findings at re-exploration revealed no clots or fluid collection. A giant hiatus hernia was found to be responsible for the tamponade through extrinsic compression. After insertion of a nasogastric tube and decompression of the stomach, there was a rapid improvement of the clinical picture. The remaining postoperative course was uneventful and the patient was discharged 5 days later, with referral to the general surgeon for further management. We conclude that, in cases of tamponade post-cardiac surgery, extrapericardial pathologies should be considered.

  14. Nutritional Optic Neuropathy Caused by Copper Deficiency After Bariatric Surgery.

    Science.gov (United States)

    Rapoport, Yuna; Lavin, Patrick J M

    2016-06-01

    A 47-year-old woman developed severe bilateral visual loss 4 years after a Roux-en-Y gastric bypass and 24 years after vertical banded gastroplasty. Her serum copper level was 35 μg/dL (normal, 80-155 μg/dL). She was prescribed elemental copper tablets. Because her methylmalonic acid was slightly elevated, she received vitamin B12 injections as well. Five weeks later, she reported that her vision had improved and, at 10 months, her vision had recovered from 20/400 bilaterally to 20/25 in each eye. This case highlights the importance of checking copper levels in addition to the "more routine" vitamin levels, such as B1, B6, B12, E, and serum folate in patients with suspected nutritional optic neuropathy after bariatric surgery, particularly if it involved a bypass procedure. PMID:26828841

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

    Directory of Open Access Journals (Sweden)

    Parikshit M Gogate

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  17. Otologic disorders causing dizziness, including surgery for vestibular disorders.

    Science.gov (United States)

    Bertholon, P; Karkas, A

    2016-01-01

    This chapter will focus on vertigo/dizziness due to inner-ear malformations, labyrinthine fistula, otosclerosis, infectious processes, and autoimmune inner-ear disorders. Inner-ear malformation due to dehiscence of the superior semicircular canal is the most recently described inner-ear malformation. Vertigo/dizziness is typically induced by sound and pressure stimuli and can be associated with auditory symptoms (conductive or mixed hearing loss). Labyrinthine fistula, except after surgery for otosclerosis, in the context of trauma or chronic otitis media with cholesteatoma, still remains a challenging disorder due to multiple uncertainties regarding diagnostic and management strategies. Otosclerosis typically manifests with auditory symptoms and conductive or mixed hearing loss on audiometry. Vertigo/dizziness is rare in nonoperated otosclerosis and should draw clinical attention to an inner-ear malformation. Computed tomography scan confirms otosclerosis in most cases and should rule out an inner-ear malformation, avoiding needless middle-ear surgical exploration. Labyrinth involvement after an infectious process is unilateral when it complicates a middle-ear infection but can be bilateral after meningitis. Labyrinth involvement due to an inflammatory disease is a challenging issue, particularly when restricted to the inner ear. The diagnosis relies on the bilateral and rapid aggravation of audiovestibular symptoms that will not respond to conventional therapy but to immunosuppressive drugs. PMID:27638078

  18. Complications in surgery: root cause analysis and preventive measures.

    Science.gov (United States)

    Chung, Kevin C; Kotsis, Sandra V

    2012-06-01

    Patients expect to receive quality medical care by relying on the concepts of evidence-based medicine. This quality care is expected to be provided at decreased costs for payors, some of whom have stopped reimbursement for cases involving "reasonably preventable" surgical complications. The purpose of this article is to introduce root cause analysis as a tool for identifying the causes of surgical complications. The authors also discuss preventive measures, such as improved communication, checklists, reporting systems, and the use of evidence-based medicine, that have been implemented to decrease surgical complications. These preventive measures can be used alone or together to decrease complications and improve overall patient care. PMID:22634659

  19. 小切口白内障青光眼联合手术临床观察%Clinical observation of combined surgery of cataract and glaucom a with small incision in traocularlen s miplantation and trabeculectom

    Institute of Scientific and Technical Information of China (English)

    梁裕琴; 向浩天

    2014-01-01

    目的:探讨小切口白内障非超声乳化囊外摘出后房型人工晶状体囊袋内植入联合小梁切除术(以下简称青白联合手术)治疗青光眼合并白内障的手术方法及临床疗效。方法对45例47眼青光眼合并白内障患者施行青白联合手术,术后观察术眼视力、眼压、滤过泡及术后并发症情况,术后随访3~24个月。结果术前术后视力及眼压比较差异有统计学意义(P<0.05),术后视力均较术前有不同程度的提高,小于0.02°5眼,占10.64%;0.02°~0.60°30眼,占63.83%;大于0.60°12眼,占25.53%;眼压控制在正常范围者39眼,占83.00%;8眼术后眼压在26mmHg左右。40眼(85.00%)形成弥散扁平的功能性滤过。其中,Ⅰ型滤过泡18眼,Ⅱ型滤过泡32眼。并发症:暂时性角膜水肿12眼,早期浅前房4眼,前房出血3眼,人工晶状体夹持1眼。术中术后未见严重的并发症。结论青白联合手术治疗青光眼合并白内障可以有效控制眼压和恢复有用视力,并发症少,操作简单,安全,投入少,费用低,适合在基层医院开展。%Objective To explore non-phacoemulsification small incision extracapsular cataract extraction,the capsular bag IOL implantation and trabeculectomy(hereinafter referred to as plainer combined surgery)treatment of glaucoma and cataract surgical method and clinical efficacy.Methods Operated to 45 patients with 47 white combined glaucoma and cataract combined surgery,in-traoperative visual acuity,intraocular pressure,bleb,and postoperative complications,followed postoperative up for 3 months to 24 months.Results The preoperative and postoperative visual acuity and intraocular pressure difference was statistically significant (P 0.60°12 eyes,accounting for 25.53%;IOP control in the normal range by 39,accounting for 83.00%;8 postoperative IOP at 26 mm Hg or so.40 eyes(85.00%)to form a flat diffuse

  20. Intraocular lenses and clinical treatment in paediatric cataract

    Directory of Open Access Journals (Sweden)

    Camila Ribeiro Koch Pena

    2015-06-01

    Full Text Available Pediatric cataract is the most common treatable cause of blindness in children. Prevalence, etiology and morphology vary with the socioeconomic development. The treatment goal is to reduce amblyopia, being difficult management especially in unilateral cases. The decision on aphakia or primary intraocular lens should be individualized as well as correction with contact lens or spectacles. The intraocular lens single-piece hydrophobic acrylic are the most implanted in children and the preferably is in the capsular bag. The Sanders-Retzlaff-Kraff theoretic (SRK/T stressing that is described as more predictable, following Holladay I and SRK II and the recommendation is to under correction +6.0 or +8.0 dioptrias expecting the growth of the eye. The posterior capsule opacity is the most frequent complication and varies with the material choice of the lens. Glaucoma is the most serious postoperative complication and depends on the timing of the surgery, primary lens implantation and time of post surgical follow-up. The adherence to occlusion therapy with patching is critical to the visual prognosis and is determined by the child’s age and laterality of the cataract. There was significant improvement in the surgery and in IOLs, however the final visual prognosis is still not desirable.

  1. 白内障手术显微器械两种处置方式的比较%Advantages and disadvantages of two disposal and supply modes for microscopic instruments of cataract surgery and countermeasures

    Institute of Scientific and Technical Information of China (English)

    刘肖; 黄丽群; 黄春艳

    2014-01-01

    OBJECTIVE To explore the advantages and disadvantages of centralized and decentralized disposal and supply modes of the microscopic instruments of cataract surgery so as to propose countermeasures for the centralized disposal and supply mode .METHODS The questionnaire survey was conducted for health care workers of department of ophthalmology by random selection of sets of surgeries ,then the health care workers′satisfaction with the centralized and decentralized disposal and supply modes in treatment of the microscopic instruments was investigated so as to raise the countermeasures to solve the problems in the centralized disposal and supply mode . RESULTS After the implementation of corresponding countermeasures ,the microscopic instruments of cataract surgery were treated with centralized disposal and supply mode in the supply room ,the qualified rate of sterile packages was 100 .00% ;the physicians′satisfaction with the cleaning quality and the performance of instruments reached 93 .0% ,significantly higher than 75 .00% of the disposal in the operating room ,and there was significant difference (P< 0 .01) .CONCLUSION The centralized treatment in the supply room can improve the cleaning quality of microscopic instruments in the department of ophthalmology ,ensure the performance of the instruments and qualified rate of sterile packages ,and improve the physicians′ satisfaction with the supply .It is an effective way to adjust the work process and standardize the requirements and countermeasures so as to realize the rapid turnover and real-time supply and ensure the successes of surgeries of a large number of cataract patients .%目的:探讨集中式与分散式处置供应白内障手术显微器械的优劣,为集中式处置供应提出解决对策。方法随机选择手术台次对医院眼科医务人员进行问卷调查,了解眼科医师对集中式与分散式两种不同的白内障手术显微器械处置供应方式的工作满意度,

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

    Directory of Open Access Journals (Sweden)

    Gupta S

    2009-01-01

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

  3. Assessing the elasticity change of cataract lens with OCE

    Science.gov (United States)

    Wu, Chen; Liu, Chih-Hao; Raghunathan, Raksha; Singh, Manmohan; Li, Jiasong; Han, Zhaolong; Larin, Kirill V.

    2016-03-01

    Cataract is one of the most common degenerative diseases that causes blindness. Careful quantification of lens biomechanical properties can greatly assist in early detection of the disease as well as personalization of treatment procedures. In this study, we utilize a phase-sensitive optical coherence elastography (OCE) system to assess the effects of the cold cataract on the biomechanical properties of porcine crystalline lens in vitro. Relaxation rates of air puff induced elastic waves were measured on the same crystalline lens with and without cold cataract. Results demonstrate that the relaxation rate and, thus, associated elasticity of the porcine lens, increased due to the presence of cold cataract.

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

    LENUS (Irish Health Repository)

    Charalampidou, Sofia

    2012-02-01

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

  5. Causes of cancellations on the day of surgery at a Tertiary Teaching Hospital

    OpenAIRE

    Kaddoum, Roland; Fadlallah, Racha; Hitti, Eveline; El-Jardali, Fadi; El Eid, Ghada

    2016-01-01

    Background Cancellation of elective scheduled operations on the day of surgery leads to an inefficient use of operating room (OR) time and a waste of resources. It also causes inconvenience for patients and families. Moreover, day of surgery (DOS) cancellation creates logistic and financial burden associated with extended hospital stay and repetitions of pre-operative preparations as well as opportunity costs of lost time and missed income. The objective of this study is to establish the rate...

  6. αA-crystallin R49Cneo mutation influences the architecture of lens fiber cell membranes and causes posterior and nuclear cataracts in mice

    Directory of Open Access Journals (Sweden)

    Andley Usha P

    2009-07-01

    Full Text Available Abstract Background αA-crystallin (CRYAA/HSPB4, a major component of all vertebrate eye lenses, is a small heat shock protein responsible for maintaining lens transparency. The R49C mutation in the αA-crystallin protein is linked with non-syndromic, hereditary human cataracts in a four-generation Caucasian family. Methods This study describes a mouse cataract model generated by insertion of a neomycin-resistant (neor gene into an intron of the gene encoding mutant R49C αA-crystallin. Mice carrying the neor gene and wild-type Cryaa were also generated as controls. Heterozygous knock-in mice containing one wild type gene and one mutated gene for αA-crystallin (WT/R49Cneo and homozygous knock-in mice containing two mutated genes (R49Cneo/R49Cneo were compared. Results By 3 weeks, WT/R49Cneo mice exhibited large vacuoles in the cortical region 100 μm from the lens surface, and by 3 months posterior and nuclear cataracts had developed. WT/R49Cneo mice demonstrated severe posterior cataracts at 9 months of age, with considerable posterior nuclear migration evident in histological sections. R49Cneo/R49Cneo mice demonstrated nearly complete lens opacities by 5 months of age. In contrast, R49C mice in which the neor gene was deleted by breeding with CreEIIa mice developed lens abnormalities at birth, suggesting that the neor gene may suppress expression of mutant R49C αA-crystallin protein. Conclusion It is apparent that modification of membrane and cell-cell interactions occurs in the presence of the αA-crystallin mutation and rapidly leads to lens cell pathology in vivo.

  7. Cx43, ZO-1, alpha-catenin and beta-catenin in cataractous lens epithelial cells

    Indian Academy of Sciences (India)

    Anshul I Arora; Kaid Johar; Devarshi U Gajjar; Darshini A Ganatra; Forum B Kayastha; Anuradha K Pal; Alpesh R Patel; Rajkumar S; Abhay R Vasavada

    2012-12-01

    Specimens of the anterior lens capsule with an attached monolayer of lens epithelial cells (LECs) were obtained from patients (=52) undergoing cataract surgery. Specimens were divided into three groups based on the type of cataract: nuclear cataract, cortical cataract and posterior subcapsular cataract (PSC). Clear lenses (=11) obtained from donor eyes were used as controls. Expression was studied by immunofluorescence, real-time PCR and Western blot. Statistical analysis was done using the student’s -test. Immunofluorescence results showed punctate localization of Cx43 at the cell boundaries in controls, nuclear cataract and PSC groups. In the cortical cataract group, cytoplasmic pools of Cx43 without any localization at the cell boundaries were observed. Real-time PCR results showed significant up-regulation of Cx43 in nuclear and cortical cataract groups. Western blot results revealed significant increase in protein levels of Cx43 and significant decrease of ZO-1 in all three cataract groups. Protein levels of alpha-catenin were decreased significantly in nuclear and cortical cataract group. There was no significant change in expression of beta-catenin in the cataractous groups. Our findings suggest that ZO-1 and alpha-catenin are important for gap junctions containing Cx43 in the LECs. Alterations in cell junction proteins may play a role during formation of different types of cataract.

  8. The Effect of Cataract on Eye Movement Perimetry

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    G. Thepass

    2015-01-01

    Full Text Available Purpose. To determine how different grades of cataract affect sensitivity threshold and saccadic reaction time (SRT in eye movement perimetry (EMP. Methods. In EMP, the visual field is tested by assessing the saccades that a subject makes towards peripheral stimuli using an eye tracker. Forty-eight cataract patients underwent pre- and postoperative EMP examination in both eyes. The subjects had to fix a central stimulus presented on the eye tracker monitor and to look at any detected peripheral stimulus upon its appearance. A multilevel mixed model was used to determine the factors that affected the sensitivity threshold and the SRT as a function of cataract grade. Results. We found no effect of cataract severity (LOCS III grades I through IV on SRT and the sensitivity thresholds. In cataract of LOCS III grade V, however, we found an increase by 27% and 21% (p<0.001, respectively, compared to the SRT and the sensitivity threshold in LOCS III grade I. Eyes that underwent cataract surgery showed no change in mean SRTs and sensitivity thresholds after surgery in LOCS III grade IV and lower. Conclusion. The present study shows that EMP can be readily used in patients with cataract with LOCS III grade IV and below.

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

    Directory of Open Access Journals (Sweden)

    Bárbara Suárez Rodríguez

    2010-11-01

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

  10. 先天性白内障术后无晶状体眼RGPCL矫正的临床效果观察%Clinical effects of infants aphakia corrected by rigid gas permeable contact lens after congenital cataract surgery

    Institute of Scientific and Technical Information of China (English)

    周建兰; 谢培英; 王丹; 常勇; 刘营

    2015-01-01

    目的:探讨硬性透气性接触镜(CRGPCL)在先天性白内障患儿术后无晶体眼的视力矫正及视功能改善的临床效果。方法回顾性分析2010年5月至2012年10月7例先天性白内障术后无晶体眼的患儿验配Meni-con ZRGPCL,并观察戴镜后1个月、3个月、6个月、1年的戴镜视力及视功能提高的情况。结果1年观察期内均未出现严重的并发症而导致停戴。所有患儿配戴RGPCL1年时矫正视力均较框架镜矫正有提高,双眼视功能检查有部分改善。结论 RGPCL为先天性白内障术后无晶体眼的患儿在视力提高及视功能改善方面提供了一个良好的矫正方式,规范配戴与定期复查也同时降低了戴镜风险。%Objective To investigate clinic effects of corrected visual acuity and visual function using by Rigid Gas Permeable Contact lens(RGPCL) in infant aphakia after Cataract surgery. Methods A retrospective analysis of 7 cases infants aphakia who fitted Menicon Z RGPCL in our center. We inspected the corrected visual acuity and visual function during periods of wearing RGPCL 1m,3m,6m and 1y. Results All children’s RGPCL corrected visual acuity and partial visual function were improved at 1st year. With the schedule of parents lens care, standard lens wearing,regular lens check and amblyopia training,there were no serious applications in 7 cases. Conclusions Infants aphakia corrected by RGPCL after Cataract surgery which obtains good corrected visual acuity and visual function and standard lens wearing and regular lens check reduce risks of lens use.

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

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Leite Arieta

    2004-02-01

    Full Text Available O objetivo deste experimento clínico foi determinar a freqüência dos exames considerados dispensáveis numa rotina pré-operatória de facectomias e avaliar os gastos com eles. Se o paciente foi sorteado para testes-seletivos, solicitou-se que nenhum teste fosse executado, a menos que o paciente apresentasse um novo problema médico, ou piora de uma doença preexistente, a qual requeresse os testes independentemente da realização da cirurgia. Para pacientes sorteados para testes-rotineiros, foram solicitados: eletrocardiograma, dosagem de hemoglobina e glicemia de jejum. Foram calculados os gastos com exames considerados desnecessários. A amostra de 1.025 pacientes incluiu 513 sorteados para testes seletivos e 512 para testes rotineiros. A freqüência de eventos adversos intra-operatórios foi semelhante nos dois grupos (p = 0,923. O grupo de testes seletivos realizou de 60,7% menos exames que o de testes rotineiros. Os resultados sugerem que a requisição seletiva de exames pré-operatórios em facectomias, além de não prejudicar o paciente do ponto de vista de complicações clínicas intra-operatórias, possibilita expressiva economia de recursos quando comparada à atual rotina.The objective of this clinical trial was to determine the frequency of medical tests considered unnecessary in routine preoperative evaluation for cataract surgery. Unnecessary costs with these tests were also evaluated. For patients assigned to the selective testing group, it was requested that no preoperative testing be performed unless the patient presented a new or worsening medical problem warranting medical evaluation with testing. For patients assigned to the routine testing group, three tests were requested: a 12-lead electrocardiogram, complete blood count, and serum glucose level. The costs of tests considered unnecessary were calculated. The sample of 1,025 patients consisted of 512 assigned to the routine testing group and 513 to the selective

  12. Application of capsular tension ring in surgery for cataract with lens subluxation%囊袋张力环在不全脱位晶状体白内障手术中的应用

    Institute of Scientific and Technical Information of China (English)

    高雪霞

    2010-01-01

    Objective To anality the application value of capsular tension ring in surgery for cataract with lens subluxation.Methods 12 patients( 12 eyes) diagnosed cataract with lens subluxation were involved.All patients received phacoemulsification with capsular tension ring and intraocular lens implantation.Results All patients completed 3 months of follow up.The intraocular lens of all patients were no moving and the intraocular pressuea of all patients were nomal.At the last postoperative examination,best corrected visual acuities of all eyes were increased.The visual acuities of 6 eyes were up 0.6 and 3 eyes were between 0.4 ~ 0.5,the visual acuities of 3 eyes were belowe 0.3.These was no serious complications in this study.Conclusion Capsular tension ring can maintain the stability of capsular of lens during surgery and wide the application rang of posterior chamber intraocular lens.Application of capsular tension ring can keep the stability of intraocular lens.It is helpful for vision increasing.%目的 分析囊袋张力环在伴晶状体不全脱位白内障超声乳化手术中的应用价值.方法 对12例(12眼)晶状体不全脱位白内障行囊袋内植入张力环联合超声乳化及后房型人工晶体植入.结果 术后随访3月,12例人工晶体均正位,眼压在正常范围,术后视力均较术前提高,0.6以上6眼,0.4~0.5者3眼,0.3以下者3眼.无严重并发症.结论 囊袋张力环能够保持白内障手术时晶状体囊袋的稳定性,拓宽了后房型人工晶体植入术的适用范围,防止术后人工晶体偏位,有助于患者视力的恢复.

  13. The survey on the related factors of phacoemulsification surgery and uveitis with complicated cataract%超声乳化术治疗葡萄膜炎并发性白内障相关因素探讨

    Institute of Scientific and Technical Information of China (English)

    裴世林

    2015-01-01

    目的 探讨超声乳化手术治疗葡萄膜炎并发性白内障手术适应证,手术方法以及并发症处理.方法 对2009~2013年在固始县人民医院眼科,以对光定位准确,色觉正常,无视网膜脱离的37只眼并发性白内障施行超声乳化手术,术中以不同方法对瞳孔粘连和炎性机化膜进行分离清除,并植入折叠型人工晶状体,对术后葡萄膜炎性反应等并发症进行相应的处理.结果 37只眼通过超声乳化治疗,均获得明显的视力提高达到复明效果.结论 超声乳化手术,以其切口小、反应轻、散光小等优点成为治疗葡萄膜炎并发性白内障的可靠方法.绝大多数葡萄膜炎并发性白内障患者在选好适应证的情况下应积极治疗且效果肯定,不要放弃治疗而失去复明机会.%Objective To explore the phacoemulsification surgical treatment of uveitis with procession of complications.Methods Adopting optical positioning accuracy, normal color vision, 37 phacoemulsification surgery without retinal detachment, separated clear surgery pupil adhesion, and inflammatory machine film in different ways, and foldable IOL implantation on postoperative of the uveal inflammatory reactions and other complications of the appropriate treatment.Results The treatment of 37 cases by phacoemulsification was an obvious vision in the improvement of recovery effect.Conclusions Phacoemulsification features its incision with a small and light response, and other astigmatism advantages, such as the treatment of uveitis and complicated cataract reliable method.The vast majority of patients with uveitis cataract should be actively treated in selected indications and certainly not to give up treatment and lost recovery opportunity.

  14. Risk factors for age-related cataract : A prospective cohort study

    OpenAIRE

    Lindblad, Birgitta Ejdervik

    2008-01-01

    Cataract is the most common cause of blindness in the world. Epidemiologic studies have shown that the etiology of cataract is multifactorial. Cataract increases with age and oxidative damage to the lens proteins is suggested to be of importance. The only currently available treatment is surgical extraction of the lens; two thirds of these operations are performed in women. Today in Sweden cataract extraction is the most common operation, with nearly 80,000 operations bei...

  15. 白内障术前结膜囊菌群分布和药敏试验研究%The Research about the distribution of conjunctival sac bacterial flora & experiment of drug sensitivity before cataract surgery

    Institute of Scientific and Technical Information of China (English)

    牛梅民; 张小娟; 黄怀洁; 李克勤; 廖忠; 杨怡; 陈振南; 陈琼志

    2012-01-01

    目的 探讨白内障术前结膜囊细菌种类和药物敏感情况,为临床用药提供依据.方法 对白内障术前205例(205眼)结膜囊采集标本进行细菌培养,观察培养阳性的细菌对常用抗菌药物的敏感性变化.结果 细菌培养阳性26例(26眼),阳性率为12.68%.白内障患者术前结膜囊主要细菌构成为革兰阳性球菌(96.15%),其中以表皮葡萄球菌为主(69.23%),其次为溶血性葡萄球菌、产色葡萄球菌、腐生葡萄球菌;革兰阴性杆菌为洋葱假单胞菌.大多数细菌对万古霉素、阿米卡星、替考拉宁、克林霉素、莫匹罗星、呋喃妥因、吗啉唑酮敏感,耐药性小于20%,普遍对氨苄西林、四环素、头孢西丁、苯唑西林、红霉素明显耐药(68.0%以上).结论 表皮葡萄球菌是白内障术前结膜囊存在的最常见条件致病菌,预防感染或抗感染可以选用阿米卡星、克林霉素、呋喃妥因等常用抗菌药物.%Objective To research the distribution of conjunctival sac bacterial flora & experiment of drug sensitivity before cataract surgery,base on this research,provide the basis for clinical medication.Methods Collect Conjunctival sac of 205 eyes from 205 cases and make germiculture,observe the movement of positive Gram' s sensibility which effect by common antibacterial.Results There were 26 eyes with cultured positive Gram from 205 case,the ratio of positive was 12.68%.The preoperative conjunctival sac of cataract patients was mainly made up of Gram positive bacteria(96.15%),and most of them were Staphylococcus epidermidi(69.23%),there were also Staphylococcus haemolyticus,Staphylococcus chromogenes and Staphylococcus saprophyticus,Gram negative bacilli was the Pseudomonas cepaci.Most of grams were sensitive to Vancomycin,Amikacin,Teicoplanin,Clindamycin,Mupirocin,Furadantin and Morpholine trazodone,the tolerance was less than 20%,and they usually had higher tolerance to Cephalexin Penicillin

  16. Unilateral otitis media with effusion caused by retained surgical gauze as an unintended iatrogenic complication of orthognathic surgery: case report.

    Science.gov (United States)

    Park, Chang Mook; Choi, Kang Young; Heo, Sung Jae; Kim, Jung-Soo

    2014-09-01

    Inadvertent retention of surgical gauze during an operation can have disastrous consequences for both the patient and the surgeon. Several cases have been reported, particularly after abdominal surgery. However, it has never to our knowledge been reported as a leading cause of dysfunction of the Eustachian tube after orthognathic surgery. We recently encountered a patient in whom it presented with unilateral otitis media with an effusion after orthognathic surgery. All surgeons involved with orthognathic surgery should be aware that remnants of surgical gauze after orthognathic surgery can compromise the Eustachian tube and cause otitis media with an effusion.

  17. "Vitreous loss: Incidence and complications in extracapsular Cataract extractions "

    Directory of Open Access Journals (Sweden)

    Nikeghbali A

    2000-09-01

    Full Text Available One of the dangerous complications of cataract extractions is vitreous loss. The purpose of this stuy is to evaluate the incidence of vitreous loss and its sepuale while teaching residents at Rasoul Akram Hospital in Iran. This study has been conducted on existing records of 730 eyes which were subjectd to extracapsular cataract extractions by 3rd and 4th year, right handed resident of Rasoul Akram hospital. The information was taken from the records of patients who had vitreous loss during cataract surgery and the following data was extracted. The presence of any systemic diseases, phase of operation where vitreous loss occurred, vision on the next day, one month and 3 months later, the cause of low vision and any post operative sequale of the eye were evaluated. Extracted data collected and the prevalence of vitreous loss and its sequale were indentified and presented. Forty-nine eyes (6.7% had vitreous loss, thirty-one of them were in the left eye (63.3% and eighteen of them were in the right eye (36.7%. Regarding the stage of operation in which vitrous loss had occurred: twenty –eight eyes while nucleous delivery (57.7% eighteen eyes during aspiration of cortical material (36.7% and in three cases during IOL implantation. Five eyes had pseudoexfoliaton syndrome, four patients were diabetic and three had high myopia. Post operational sequale of these 49 eyes were: thirty-five with transient corneal edema (71.4%. Nine with misshaped pupils (18.9%, four with high astigmatism (8.1%, tow with cystoid macular edema (4%, two with retinal detachment (4% and seven with cloudy vitreous. (14.3%. The incidence of vitreous loss is more than expected. More extensive research to evaluated the prognositc factors according to the eye (OD/OS and the stage of the operation the leads to vitreous loss and to decrease its incidence is still needed.

  18. 前房内给予莫西沙星预防眼内炎在白内障手术中的应用%Application of intracameral moxifloxacin to prevent endophthalmitis in cataract surgery

    Institute of Scientific and Technical Information of China (English)

    Servet Cetinkaya; Yasemin F Cetinkaya; Nursen O Acir; Zeynep Dadaci

    2015-01-01

    目的:评价在白内障手术中采用前房内应用莫西沙星预防眼内炎的安全性和效果。  方法:选取2012年1-6 mo在我院行白内障手术患者65例65眼。部分患者手术结束时前房给予莫西沙星,另外一部分作为对照组未使用莫西沙星。对患者术前和术后logMAR最佳矫正视力、眼内压、角膜水肿、前房形态进行检查。  结果:共33例患者(男19,女14)使用了莫西沙星,平均年龄64.81±11.61(41~82)岁;32例患者(男15,女17)没有使用,平均年龄65.43±11.10(42-81)岁。患者的年龄(P=0.827)和性别(P=0.396)无统计学差异。术前两组的最佳矫正视力均接近20/130。术后,莫西沙星组和对照组的最佳矫正视力分别为20/25和20/23( P=0.160)。术前莫西沙星组眼内压为14.93±2.77(11-21) mmHg,对照组为15.06±2.42(12-21)mmHg(P=0.850)。术后,两组眼内压均无统计学差异[莫西沙星组:14.06±2.31(10-19) mmHg;对照组:14.03±2.36(10-19) mmHg ( P=0.726)]。两组角膜水肿(P=0.623)与前房细胞发生率(P=0.726)均无统计学差异。  结论:白内障手术后给予莫西沙星预防眼内炎是安全而有效的。%AIM:To evaluate the safety and efficacy of intracameral moxifloxacin in preventing endophthalmitis after cataract surgery. METHODS:Sixty-five eyes of 65 patients underwent cataract surgery between January and June 2012. Some patients received intracameral moxifloxacin at the end of surgery, while others did not ( controls ) . Pre - and postperative logarithm of the minimum angle of resolution ( logMAR ) best corrected visual acuity ( BCVA) , intraocular pressure ( IOP) , corneal edema, and anterior chamber ( AC) status were examined. RESULTS: Thirty - three patients ( 19 males, 14 females); average age, 64. 81±11. 61y ( range: 41-82y) received moxifloxacin and 32 patients ( 15 males, 17 females); average age, 65. 43±11. 10y ( range: 42-81y) did not. The differences in patient age (P=0. 827

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

    Directory of Open Access Journals (Sweden)

    Gudlavalleti VS Murthy

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    V.N.L.S. Oliva

    2010-06-01

    Full Text Available Desenvolveu-se uma técnica de bloqueio peribulbar comparando-a à técnica de anestesia oftálmica com bloqueio neuromuscular parcial em cães submetidos à facectomia extracapsular. Doze cães, de diferentes raças, foram alocados em dois grupos (G1 e G2 e anestesiados com acepromazina (0,05mg/kg, IV e propofol (5mg/kg, IV e mantidos com isofluorano sob ventilação espontânea. Os cães do G1 receberam o bloqueio peribulbar com ropivacaína 0,75%, e os do G2 o bloqueio neuromuscular parcial com brometo de pancurônio (0,01mg/kg, IV. Utilizaram-se, como parâmetros comparativos, escores de posicionamento do globo ocular, controle do reflexo oculocardíaco e pressão intraocular (mmHg. Foi possível propor uma técnica eficaz para cães baseando-se na técnica de bloqueio peribulbar posterior realizada no homem. Em ambos os grupos, o globo ocular permaneceu centralizado. Não ocorreram alterações eletrocardiográficas atribuídas ao reflexo oculocardíaco. Houve redução significativa da pressão intraocular em G1 após o bloqueio (10,7±0,6 e 14,7±0,6. Conclui-se que o bloqueio peribulbar proporcionou condições cirúrgicas apropriadas para a realização da facectomia, com a vantagem de promover bloqueio sensitivo do olho.A peribulbar block technique was developed and its clinical efficacy was compared with neuromuscular blockade in dogs undergoing cataract surgery. Twelve dogs of different breeds were randomly and equally allocated in two groups. After given acepromazine (0.05mg/kg, IV, anesthesia was induced with propofol (5mg/kg, IV and maintained with isoflurane in oxygen during spontaneous breathing. A peribulbar block with 0.75% ropivacaine was performed in G1 dogs while partial neuromuscular blockade with pancuronium (0.01mg/kg IV was provided in G2 dogs. Globe position scores, oculocardiac reflex, and intra-ocular pressure (mmHg were evaluated at pre-defined intervals during surgery. Peribulbar blocks were successful performed

  1. Comparison of age-specific cataract prevalence in two population-based surveys 6 years apart

    Directory of Open Access Journals (Sweden)

    Rochtchina Elena

    2006-04-01

    Full Text Available Abstract Background In this study, we aimed to compare age-specific cortical, nuclear and posterior subcapsular (PSC cataract prevalence in two surveys 6 years apart. Methods The Blue Mountains Eye Study examined 3654 participants (82.4% of those eligible in cross-section I (1992–4 and 3509 participants (75.1% of survivors and 85.2% of newly eligible in cross-section II (1997–2000, 66.5% overlap with cross-section I. Cataract was assessed from lens photographs following the Wisconsin Cataract Grading System. Cortical cataract was defined if cortical opacity comprised ≥ 5% of lens area. Nuclear cataract was defined if nuclear opacity ≥ Wisconsin standard 4. PSC was defined if any present. Any cataract was defined to include persons who had previous cataract surgery. Weighted kappa for inter-grader reliability was 0.82, 0.55 and 0.82 for cortical, nuclear and PSC cataract, respectively. We assessed age-specific prevalence using an interval of 5 years, so that participants within each age group were independent between the two surveys. Results Age and gender distributions were similar between the two populations. The age-specific prevalence of cortical (23.8% in 1st, 23.7% in 2nd and PSC cataract (6.3%, 6.0% was similar. The prevalence of nuclear cataract increased slightly from 18.7% to 23.9%. After age standardization, the similar prevalence of cortical (23.8%, 23.5% and PSC cataract (6.3%, 5.9%, and the increased prevalence of nuclear cataract (18.7%, 24.2% remained. Conclusion In two surveys of two population-based samples with similar age and gender distributions, we found a relatively stable cortical and PSC cataract prevalence over a 6-year period. The increased prevalence of nuclear cataract deserves further study.

  2. Comparison in effect of different metal ions, pH and reducing agent on the protease activity in human hyper mature and mature cataract.

    Science.gov (United States)

    Sami, Amtul Jamil; Sami, Amtul Naseer; Kanwal, Noreen

    2007-08-01

    This study was undertaken to isolate and characterize the protease activity of human eye lens sample of mature and hyper mature cataract. Samples were collected just after surgery of the cataract lens and were stored at -20 degrees C. The total protein extract was isolated from 5 samples in each case (mature and hyper mature cataract) and clear supernatant obtained after centrifugation was used as an enzyme source. The optimum pH for the proteases of mature cataract was 7.5 while the proteases of hyper mature cataract were recorded for maximum activity at pH 5.5 and 7.5. The optimum temperature for both enzyme sources was 50 degrees C. Effect of different metal ions such as potassium, lead, silver, zinc and borate was studied. In each case protease activity was increased. Reducing agent e.g. beta mercaptoethanol also caused an increase in activity indicating the involvement of sulfhydryl groups. Protease activity was also located on agar plates. PMID:17657864

  3. Comparison in effect of different metal ions, pH and reducing agent on the protease activity in human hyper mature and mature cataract

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    This study was undertaken to isolate and characterize the protease activity of human eye lens sample of mature and hyper mature cataract. Samples were collected just after surgery of the cataract lens and were stored at -20 ℃. The total protein extract was isolated from 5 samples in each case (mature and hyper mature cataract) and clear supernatant obtained after centrifugation was used as an enzyme source. The optimum pH for the proteases of mature cataract was 7.5 while the proteases of hyper mature cataract were recorded for maximum activity at pH 5.5 and 7.5. The optimum temperature for both enzyme sources was 50 ℃. Effect of different metal ions such as potassium, lead, silver, zinc and borate was studied. In each case protease activity was increased. Reducing agent e.g. β mercaptoethanol also caused an increase in activity indicating the involvement of sulfhydryl groups. Protease activity was also located on agar plates.

  4. The application of hard IOLs implantation with single haptic suspended in cataract surgery%硬性晶状体单襻悬吊在白内障手术中的运用

    Institute of Scientific and Technical Information of China (English)

    林远丽

    2013-01-01

    Objective Proposed a practical IOLs implantation in the first stage for posterior capsular rupture during cataract surgery. Methods Suture the upper haptic of one postures hard IOLs without hole onto ciliary sulcus using 10-0 nylon line with needle.Then place the lower haptic into the remaining capsular bag or the ciliary sulcus with visible capsular. Results 8 patients accept IOLs implantation on joint upper haptic suspension surgery without obvious lens displacement or drop during followed up for 3~6 months.All of them recovered useful eyesight. Conclusion Our surgical method can implantation IOLs successfully in the first stage and achieve expected eyesight improvement. Moreover,this method save patients from pain of secondary surgery without increasing extra cost,special materials or surgical instruments. This is an optional supplement operation for basic-level hospitals.%  目的针对白内障手术中后囊膜破裂提出一种实用的Ⅰ期人工晶状体植入术。方法使用常规无孔一体式硬性人工晶状体,用10-0带针尼龙线缝合固定晶状体上襻于睫状沟内,将下襻直接放入残留的囊袋或者可见囊膜口的睫状沟内。结果8例后囊膜破裂患者均实施了人工晶状体植入联合上襻悬吊手术,术后均恢复了可用视力,随访3个月~6个月均未见晶状体明显移位和后坠。结论硬性晶状体单襻悬吊术Ⅰ期顺利植入人工晶状体,既能提高患者视力,又能避免二次手术带来的痛苦,不增加患者的费用,不需要特殊材料及手术器械,对于基层医院是一种可选的补充手术方式。

  5. 25-G玻璃体手术系统在儿童白内障手术中的应用%Dry pars palna capsulotomy and anterior vitrectomy using 25-gauge vitrectomy system during, children cataract surgery

    Institute of Scientific and Technical Information of China (English)

    谢立信; 黄钰森

    2009-01-01

    Objective To describe the initial surgical experience and report the safety and feasibility of dry pars plana capsulotomy and anterior vitrectomy using a 25-gauge vitrectomy system in pediatric cataract surgery.Methods This Was a prospective case series study.After anterior continuous curvilinear capsulorhexis (ACCC) and phacoemulsification with intraocular lens (IOL) implantation in the capsule for all patients,a pars plana capsulotomy and anterior vitrectomy Was performed with a 25-gauge vitrectomy system using a dry technique in 40 eyes of 30 children with cataracts.Results All procedures were uneventful and all IOLs were implanted in the capsular bag.No intraoperative complications were noted attributable to the small-gauge instruments.The average follow-up period was eight months (range,4 to 30).Postoperative intraocular pressure remalned stable in most cases, except two eyes (5%) with transient hypotony during the first day after surgery.The postoperative inflammatory response Was mild.Ultrasound biomicroscopy showed complete healing of the sclerotomy at four weeks after surgery.No posterior synechia,posterior capsule opacification,IOL capture,vitreous prolapse,choroidal detachment or retinal detachment was observed throughout the follow-up period. Conclusions Dry pars plana capsulotomy and anterior vitrectomy using a 25-gauge vitrectomy system is safe and effective for the management of posterior lens capsules and anterior vitreous in pediatric cataract surgery.Prospective and comparative study is recommended to evaluate this procedure and traditional method.%目的 探讨儿童白内障手术中在无灌注状态下应用25-G玻璃体切除头切除视轴区晶状体后囊膜和玻璃体前皮质的安全性和有效性.方法 为前瞻性系列病例研究.对连续30例(40只眼)儿童白内障在全身麻醉下进行晶状体前囊环形撕开、白内障吸出和囊袋内折叠式人工晶状体(IOL)植入后,在前房保留黏弹剂

  6. The Retinal Nerve Fiber Layer Thickness Changes Evaluated by Optical Coherence Tomography After Phacoemulsification Surgery

    OpenAIRE

    Cumali Değirmenci; Filiz Afrashi; Serhad Nalçacı; Suzan Güven Yılmaz

    2014-01-01

    Objectives: To evaluate the retinal nerve fiber layer (RNFL) thickness by optical coherence tomography (OCT) before and after cataract surgery. Materials and Methods: In our study, we included 44 eyes of 44 patients who underwent uncomplicated cataract surgery and had no preexisting pathology involving the retina, optic nerve, or cornea. All patients were scanned by OCT for RNFL measurements 1 day before and 1 month after cataract surgery. The grading of cataract was based on the ...

  7. Cataracts and Other Common Eye Diseases | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... have had cataract surgery. Common symptoms are: Blurry vision Colors that seem faded Glare Not being able to see well at night Double vision Frequent prescription changes in your eyewear At first ...

  8. 江苏省2012年白内障手术率及其影响因素%Cataract surgery rate and its impacting factors in Jiangsu Province in 2012

    Institute of Scientific and Technical Information of China (English)

    管怀进; 张晓俊; 朱蓉嵘; 杨梅

    2013-01-01

    目的 了解江苏省2012年白内障手术率(CSR)及其影响因素,探讨进一步提高我国CSR的方法.方法 通过政府网站查阅2012年江苏省13个市(地级)和南通市7个县(市、区)上报于卫生部白内障复明手术信息报告系统的白内障手术数量和各地国内生产总值(GDP)、人均GDP,计算CSR.采用Spearman相关方法分析全省各市(地级)、南通市各县(市、区)GDP与根据上报数据计算得到的CSR的相关性,同时用卡方检验方法分析各地公立医院与民营医院及其完成白内障手术比例的差异.结果 2012年江苏省共上报白内障手术74 143例,全省CSR为939例/百万人群/年,其中,南通市最高(1362例/百万人群/年),宿迁市最低(129例/百万人群/年).各市(地级)CSR与地区GDP呈正相关(spearman r=0.59,P=0.03),与地区人均GDP不相关(spearman r=0.50,P=0.08).南通市各县(市、区)CSR与其GDP、人均GDP均不相关(spearman r=-0.04,P=0.94;spearman r=-0.29,P=0.53).南通市民营眼科机构共9家(33.3%)、手术4557例(45.9%),其中,民营眼科机构比例最高的如皋市(71.4%)的CSR已达到3317例/百万人群/年.结论 社会经济水平与CSR有一定关系,医院“主动下乡筛查白内障患者”、“减免手术费用”模式有助于提高我国的CSR.%Objective To survey the cataract surgery rate (CSR) according to the report data and its influencing factors of Jiangsu Province in 2012 so as to further improve CSR in China.Methods Through government websites in 2012,gross domestic product (GDP) and GDP per capital of 13 cities in Jiangsu Province and 7 counties of Nantong City reported to the Ministry of Health in China were collected to calculate CSR.The relationship between GDP and CSR of Jiangsu Province and Nantong City were analyzed with Spearman' s rank correlation,and the differences in the proportion of cataract surgery between government and private hospitals were analyzed by Chi-square test.Results CSR in

  9. Study on macular edema after cataract surgery in patients with type-2 diabetes%2型糖尿病患者行白内障手术后黄斑水肿状况研究

    Institute of Scientific and Technical Information of China (English)

    郭媛; 张杰; 张春刚

    2015-01-01

    目的:研究2型糖尿病患者行白内障手术后黄斑水肿状况。方法择取在该院接受治疗糖尿病眼底病变的100例(102眼)和同期非糖尿病眼底病变的100例患者(104眼)作为对照组,采用相同的手术及术后护理。分别于术前、术后1周、6周和6个月对所有患者进行视力和眼底检查,于术前和术后6周进行荧光素血管造影(FFA),记录两组的黄斑水肿和视力恢复情况。结果糖尿病组黄斑中心凹度显著大于对照组,术后6周的 FFA 糖尿病黄斑水肿发生率高于对照组。术后对照组的矫正视力明显优于糖尿病组。结论糖尿病患者在白内障手术后患黄斑水肿的人数多于对照组,术后患者视力的恢复也不及对照组。%Objective To study the macular edema (ME) after cataract surgery in patients with type-2 diabetes. Methods 100 patients with type-2 diabetes as diabetes group and 100 patients without diabetes as controls were enrolled, using the same surgery and postoperative nursing to all the patients. Visual acuity and fundus were examined pre-operation and at postoperative 1 week, 6 weeks and 6 months. Visual recovery and postoperative ME were observed in all the patients. Fluorescein fundus angiography (FFA) were performed to all the patients pre-operation and at postoperative 6 weeks. Results The concavity of macular center and incidence of postoperative macular edema in diabetes group were significantly greater in than the control group. The corrected visual acuity in control group were significantly better than that in control group of diabetic group. Conclusion Incidence of postoperative macular edema in diabetes group were significantly greater than the control group, the recovery of visual acuity in control were better than diabetes group.

  10. Catarata polar anterior piramidal deslocada para a câmara anterior causando edema de córnea: relato de caso Corneal edema caused by a pyramidal anterior polar cataract dislocated to the anterior chamber: case report

    Directory of Open Access Journals (Sweden)

    Ramon Coral Ghanem

    2004-08-01

    Full Text Available Cataratas polares anteriores piramidais são opacidades cônicas que se projetam para a câmara anterior a partir da cápsula anterior do cristalino. Na grande maioria dos pacientes a opacidade permanece aderida e estável durante toda a vida. O objetivo deste trabalho é documentar uma manifestação incomum desse tipo de catarata: a deiscência espontânea das pirâmides para a câmara anterior causando descompensação endotelial e edema corneal bilateral. Relatamos o caso de uma paciente feminina, de 66 anos, branca, que apresentava edema corneal localizado inferiormente no olho direito associado à lesão nodular branco-esclerótica compatível com a pirâmide anterior da catarata polar. O olho esquerdo apresentava edema corneal difuso intenso e presença de uma catarata polar anterior com a região piramidal deslocada para a câmara anterior. Sabe-se que a pirâmide anterior pode permanecer inabsorvida na câmara anterior por longo período, pois é composta de tecido colágeno denso. Isto causa perda endotelial progressiva e edema corneal e deve ser considerada indicação de remoção cirúrgica da catarata polar anterior e de seu fragmento. Ressalta-se, também, a importância do bom senso no julgamento das cataratas polares anteriores, considerando-se tamanho da opacidade, simetria das opacidades e componente cortical associado, na tentativa de se evitar ambliopia.Pyramidal anterior polar cataracts are conical opacities that project into the anterior chamber from the anterior capsule of the lens. In the vast majority of patients the opacity remains bound and stable throughout life. We report an unusual complication of this type of cataract: spontaneous dehiscence of the pyramids to the anterior chamber causing bilateral endothelial damage and corneal edema. 66-year-old white woman presented with inferior corneal edema in the right eye and diffuse corneal edema in the left eye. A white nodular lesion was observed in the inferior angle

  11. Observation of F-ERG on the light-induced retinal damage during microscopic cataract surgery%显微白内障手术光性视网膜损伤的F-ERG观察

    Institute of Scientific and Technical Information of China (English)

    严良; 陆豪; 张茂英; 李海生

    2001-01-01

    Objective To observe the influence of microscopic lightillumination on the retinal function during the cataract extraction surgery.Methods Applying the standardized F-ERG recording technique to measure the amplitude of a-wave and b-wave of the maximal combined response(MCR) of F-ERG in 45 cases(45 eyes) of cataract patients pre-operation and post-operation. According to different lens opacity (as WHO classification) different operative methods (group A-PHACO, group B-ECCE)are used. The exposuring time under microscope light in group A was 25~40min(mean 31.4min±4.1min), the light intensity was moderate, whereas the exposuring time in group B was 50~75min(mean 59.8min±8.7min), the light intensity was moderate to high. Comparing different microscopic light illumination(time and intensity)with ERG response to evaluate its damage to the retinal function.Results The amplitudes of a-wave and b-wave one month post-operation are larger than those of pre-operation;The amplitude of F-ERG in group A post-operation is significantly larger than that of pre-operation (P<0.01);In group B it was somewhat larger than it was post-operation(0.01<P<0.05).Conclusions ERG response of cataract eyes will be increased in various degrees post-operation, which suggests that lens opacity can reduce the response; The longer the operation and the exposure time spent under microscope light, the lower the F-ERG response gets 1 month post-operation. We can come to the conclusion that continuous surgery under microscopic light illumination can induce the retinal light damage.%目的 观察现代囊外白内障术中显微镜光照对视网膜功能的影响。方法 应用国际标准化视网膜电流图(F-ERG)记录45例45眼白内障术前及(白内障囊外摘出)术后1moF-ERG最大反应(MCR)(a、b波振幅)。按(WHO)晶状体混浊度分级采用不同术式,A组PHACO术、B组ECCE术。A组术中实际曝光于显微镜下25~40min(31.4min±4.1min),中度光强;B组50

  12. Risk of occupational radiation-induced cataract in medical workers

    International Nuclear Information System (INIS)

    The objective of this study was determination of criteria for recognition of a pre senile cataract as a professional disease in health care personnel exposed to small doses of ionizing radiation. Method: The study included 3240 health workers in medical centers of Serbia in the period 1992-2002. A total of 1560 workers were employed in the zone (group A) and 1680 out of ionizing radiation zone (group B). Among group A, two groups had been selected: 1. Group A-1: Health workers in the ionizing radiation zone who contracted lens cataract during their years of service while dosimetry could not reveal higher absorbed dose (A-1=115); 2. Group A-2: Health workers in the ionizing radiation zone with higher incidence of chromosomal aberrations and without cataract (A-2=100). Results: More significant incidence of cataract was found in group A, χ2=65.92; p<0.01. Radiation risk was higher in health workers in radiation zone than in others, relative risk is 4, 6. Elevated blood sugar level was found in higher percentage with health workers working in radiation zone who developed cataract. Conclusion: Low doses of radiation are not the cause of occupational cataract as individual occupational disease. X-ray radiation may be a significant cofactor of cataract in radiological technicians. (author)

  13. 应用25G玻璃体切除术治疗白内障术后眼前段拥挤征%25-Gauge transconjunctival sutureless vitrectomy for crowded anterior segment after cataract surgery.

    Institute of Scientific and Technical Information of China (English)

    李雯; 荣翱

    2012-01-01

    Objective To investigate the application of 25-gauge transconjunctival sutureless vitrectomy system(25GTSV)on the treatment of crowded anterior segment(CAS)after phacoemulsification and intraocular lens implantation.Methods 15 cases(15 eyes)of CAS after cataract surgery were treated with posterior capsulotomy and anterior segment vitrectomy with 25GTSV.The follow-up periods were 6 ~ 12months[(8.0 ± 1.5)months].The visual acuity,intraocular pressure(IOP)and the depth of anterior chamber were recorded,the condition of cornea,pupil,intraocular lens and complication were observed.Results All operations were successful.The visual acuity of all cases were improved in different degree after treatment.The best corrected visual acuity before treatment,1 week after treatment and at the end of the followup period was(0.05 ± 0.02),(0.2 ± 0.1)and(0.4 ± 0.1)respectively.There were significant difference before and after treatment(t =0.00,P =0.00).The mean IOP 1 week after treatment and at the end of the follow-up period was(17.3 ± 1.8)mmHg and(16.5 ± 1.3)mmHg respectively.They were lower obviously than the mean IOP before surgery which was(40.1 ± 7.5)mmHg.There were significant difference between them(t =0.00,P =0.00).The mean depth of anterior chamber before treatment,1 week after treatment and at the end of the follow-up period was(0.69 ±0.17)mm,(2.7 1 ±0.43)mm and(2.85 ±0.52)mm respectively.There were significant difference before and after treatment(t =0.00,P =0.00).After surgery,the edema of cornea disappeared,the pupil is round and a round hyalomere with diameter of 3.0 ~ 4.0 mmwas formed at the center of lens ' posterior capsule in all eyes.No obvious complications were observed intraoperatively and postoperatively.Conclusion 25GTSV with micro-incision can release and cure CAS after cataract surgery effectively and safely.%目的 评价25G经结膜无缝合玻璃体切除手术系统(25G TSV)在白内障行超声乳化联合人工晶状体植入术后眼前

  14. Can use of a cold light source in endoscopic middle ear surgery cause sensorineural hearing loss?

    Directory of Open Access Journals (Sweden)

    Suat Terzi

    2016-01-01

    Full Text Available Objectives: To investigate possible sensorineural hearing loss created by the use of a cold light source in patients undergoing endoscopic tympanoplasty surgery. Materials and Methods: The medical records of 203 patients, who underwent endoscopic Type 1 tympanoplasty surgery in our ear, nose, and throat clinic between 2012 and 2015, were checked retrospectively. Ninety-one patients were male and 112 were female, and their mean age was 34.4 ± 11.2 years. Results of audiometric measurements performed during the preoperative period and repeated 1 and 3 months postsurgery were compared to each other. Results: The mean duration of the operations was determined to be 52.4 ± 9.1 min. In addition, average preoperative bone-conduction was 11.4 ± 7.4 dB nHL. However, it was 9.57 ± 7.1 dB nHL and 9.51 ± 7.4 dB nHL, respectively, in the 1st and 3rd postoperative months. Levels of postoperative average bone-conduction at the 1st and 3rd month, as well as the thresholds of bone-conduction at 500, 1000, and 2000 Hz, were significantly lower than the preoperative results (P 0.05. Conclusion: Based on our findings, the increased heat generated by the use of a cold light source during an endoscopic tympanoplasty surgery is unlikely to cause the development of sensorineural hearing loss.

  15. Outcome after emergency surgery in patients with a free perforation caused by gastric cancer.

    Science.gov (United States)

    Tsujimoto, Hironori; Hiraki, Shuichi; Sakamoto, Naoko; Yaguchi, Yoshihisa; Horio, Takuya; Kumano, Isao; Akase, Takayoshi; Sugasawa, Hidekazu; Aiko, Satoshi; Ono, Satoshi; Ichikura, Takashi; Kazuo, Hase

    2010-01-01

    Perforation of gastric cancer is rare and it accounts for less than 1% of the incidences of an acute abdomen. In this study, we reviewed cases of benign or malignant gastric perforation in terms of the accuracy of diagnosis and investigated the clinical outcome after emergency surgery in patients with a free perforation caused by gastric cancer. On the basis of pathological examination, gastric cancer was diagnosed in 8 patients and benign ulcer perforation in 32 patients. The sensitivity, specificity and accuracy of intraoperative diagnosis by pathological examination were 50, 93.8 and 85%, respectively. Except for age, there were no differences in the other demographic characteristics between patients with gastric cancer and benign ulcer perforation. The median survival time of patients with perforated gastric cancer was 195 days after surgery. Patients with gastric cancer perforation had a poorer overall survival rate than those who had T3 tumors without perforation. In addition, in patients with perforation, recurrence of peritoneum occurred more frequently. In conclusion, to improve the survival rate of patients with perforated gastric cancer and to improve the accuracy of intraoperative diagnosis, endoscopic examination and/or pathological examination of the frozen section should be performed, if possible. A balanced surgical strategy using laparoscopic local repair as the first-step of surgery, followed by radical open gastrectomy with lymphadenectomy may be considered.

  16. Outbreak of postoperative empyema caused by Serratia marcescens in a thoracic surgery unit.

    Science.gov (United States)

    Ulu-Kilic, A; Parkan, O; Ersoy, S; Koc, D; Percin, D; Onal, O; Metan, G; Alp, E

    2013-11-01

    An increase in the number of cases of postoperative empyema due to S. marcescens was recognized in the intensive care unit (ICU) of our Division of Thoracic Surgery between 3 and 19 March 2013. Pleural samples from patients and environmental samples from the operating room and ICU were obtained. A total of eight isolates (six from pleural fluid and two from portable suction devices in ICU) were identified as Serratia marcescens. All isolates were found to be identical by repetitive sequence-based polymerase chain reaction. This is the first report of an outbreak caused by S. marcescens related to a contaminated portable suction machine.

  17. Global prevalence of childhood cataract: a systematic review.

    Science.gov (United States)

    Sheeladevi, S; Lawrenson, J G; Fielder, A R; Suttle, C M

    2016-09-01

    Childhood cataract is an avoidable cause of visual disability worldwide and is a priority for VISION 2020: The Right to Sight. There is a paucity of information about the burden of cataract in children and the aim of this review is to assess the global prevalence of childhood cataract. The methodology for the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a literature search for studies reporting estimates of prevalence or incidence of cataract among children (agedLibrary, Medline and Embase up to January 2015. No restrictions were imposed based on language or year of publication. Study quality was assessed using a critical appraisal tool designed for systematic reviews of prevalence. Twenty prevalence and four incidence studies of childhood cataract from five different geographical regions were included. The overall prevalence of childhood cataract and congenital cataract was in the range from 0.32 to 22.9/10000 children (median=1.03) and 0.63 to 9.74/10000 (median=1.71), respectively. The incidence ranged from 1.8 to 3.6/10000 per year. The prevalence of childhood cataract in low-income economies was found to be 0.42 to 2.05 compared with 0.63 to 13.6/10000 in high-income economies. There was no difference in the prevalence based on laterality or gender. This review highlights substantial gaps in the epidemiological knowledge of childhood cataract worldwide, particularly from low and lower middle-income economies. More studies are needed using standard definitions and case ascertainment methods with large enough sample sizes. PMID:27518543

  18. Vision related quality of life: A cataract study

    Directory of Open Access Journals (Sweden)

    Latinović Slobodanka

    2007-01-01

    Full Text Available Introduction. Since 1996, advanced methods and new instruments for the assessment of vision quality of life (VisQoL index (37 and 15 have been developed and applied at the University Eye Clinic in Novi Sad. Many researches assume that postoperative results should not be evaluated only by postoperative visual acuity, but also by subjective perception of visual function and the patients ability to perform everyday activities, i.e. by quality of life. Therefore, our clinical results were based on both parameters of visual function, as the most objective attributes for assessing outcomes of certain types of cataract surgery. Material and Methods. Based on the results of the Cataract Study in Vojvodina in 2004, 5.7% of patients waiting for cataract surgery were already blind, 16.5% had low vision with cataract on both eyes, and 57% of patients had monocular blindness. Results and Discussion. With improvement of visual acuity to 0.5 or higher, after cataract surgery in 96.5% of patients, the cumulative VisQoL 15-index changed from 59.3 to 95.5. Intraocular lens implantation contributed most to the significant improvement in the vision related quality of life. Our study showed that pseudophakic patients had better quality of life than aphakic patients, who had the same visual acuity and refractive correction. Difficulties in performing everyday activities, such as shopping, using the telephone and reading, were found in 12.7% of aphakic, but only in 3% of pseudophakic patients. Conclusion. Advanced phacoemulsification techniques enable operated cataract patients immediate vision recovery, better quality of life, and personal satisfaction with visual function in everyday activities.

  19. Persistent fetal vasculature: ocular features, management of cataract and outcomes

    Directory of Open Access Journals (Sweden)

    Marcia Beatriz Tartarella

    2013-06-01

    Full Text Available PURPOSES: To describe ocular features, management of cataract and functional outcomes in patients with persistent fetal vasculature. METHODS: Retrospective, descriptive case series of patients with persistent fetal vasculature. Data were recorded from the Congenital Cataract Section of Federal University of São Paulo, Brazil from 2001 to 2012. All patients were evaluated for sex, age at diagnosis, systemic findings, laterality, age at surgery, and initial and final follow-up visual acuities. Follow-up and complications after cataract surgery were recorded. Ultrasound was performed in all cases and ocular eco-Doppler was performed in most. RESULTS: The study comprised 53 eyes from 46 patients. Age at diagnosis ranged from 5 days of life to 10 years-old (mean 22.7 months. Twenty-seven patients were male (58.7%. Persistent fetal vasculature was bilateral in 7 patients (15.2%. Forty-two eyes (79.2% had combined (anterior and posterior forms PFV presentation, 5 eyes (9.4% had only anterior persistent fetal vasculature presentation and 6 eyes (11.3% had posterior persistent fetal vasculature presentation. Thirty-eight eyes (71.7% were submitted to cataract surgery. Lensectomy combined with anterior vitrectomy was performed in 18 eyes (47.4%. Phacoaspiration with intraocular lens implantation was performed in 15 eyes (39.5%, and without lens implantation in 5 eyes (13.2%. Mean follow-up after surgery was 44 months. Postoperative complications were posterior synechiae (3 cases, retinal detachment (2 cases, phthisis (3 cases, posterior capsular opacification (8 cases, inflammatory pupillary membrane (5 cases, glaucoma (4 cases, intraocular lens implantation displacement (1 case and vitreous hemorrhage (2 cases. Complications were identified in 19 (50% of the 38 operated eyes. Visual acuity improved after cataract surgery in 83% of the eyes. CONCLUSIONS: Patients with persistent fetal vasculature have variable clinical presentation. There is an

  20. Pseudoexfoliation syndrome and secondary cataract

    OpenAIRE

    Kuchle, M.; A. Amberg; Martus, P.; Nguyen, N.; NAUMANN, G.

    1997-01-01

    AIM/BACKGROUND—The pseudoexfoliation (PEX) syndrome is frequently associated with impairment of the blood-aqueous barrier. This study analysed if this might stimulate secondary cataract following cataract extraction.
METHODS—This historical cohort study included 197 eyes of 197 patients (99 with and 98 without PEX) that underwent extracapsular cataract extraction with posterior chamber lens implantation (PMMA optic) between 1985 and 1991. Secondary cataract was defined as opacification of the...

  1. Country-Wide Monitoring of Cataract Surgical Outcomes

    Directory of Open Access Journals (Sweden)

    Moses C Chirambo

    2002-01-01

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

  2. Spine surgery may cause more spinal epidural hematomas than spinal puncture

    Institute of Scientific and Technical Information of China (English)

    AN Jian-xiong; FANG Qi-wu; Erin A.Sullivan; John P.Williams

    2013-01-01

    Background Spinal epidural hematoma (SEH) is a rare but acute and possibly devastating clinical event.The purpose of this study is to assess the multiple etiologies of SEH seen in an academic medical center over a 15-year span.We have examined the etiologies of SEH occurring in a single institution,the University of Pittsburgh Medical Center (UPMC) over the last fifteen years using an electronic record keeping system and database:the Medical Archive Retrieval System (MARS).Methods We screened MARS from 1986-2001 using key words:epidural,hematoma and spinal.All potential SEH cases were reviewed and only those confirmed by surgical intervention were identified as positive SEH and reported in this study.Results There were 17 cases of confirmed SEH.Among them,seven cases were from spontaneous bleeding,seven cases following spinal surgery,and three cases from traumatic spinal fracture.There were no findings of SEH that were related to spinal or epidural anesthesia.Among the seven patients with spontaneous SEH; two were receiving anti-coagulants for deep venous thrombosis (DVT) and had elevated prothrembin time (PT) and activated partial thromboplastine time (APTT),one had hemophilia (type B),four had hypertension,and three out of seven had chronic renal or liver disease.Among postoperative SEH patients,two of the seven patients were receiving chemotherapy and radiation therapy and one had ongoing hemodialysis for renal failure.Among three patients with traumatic SEH,two had ankylosing spondylitis.Six patients had a history of alcohol abuse.Conclusions Spontaneous bleeding is by far the leading cause of SEH with spinal surgery being the second leading cause.Patients with multiple co-morbidities that result in coagulopathy from a variety of causes include liver or renal disease,alcohol abuse,radiation therapy,or chemotherapy.Neuraxial anesthesia is an extremely rare cause of SEH.

  3. Leading Causes of Blindness

    Science.gov (United States)

    ... have had cataract surgery. Common symptoms are: Blurry vision Colors that seem faded Glare Not being able to see well at night Double vision Frequent prescription changes in your eye wear Treatment ...

  4. Epidemiology of 411 140 cataract operations performed in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012

    DEFF Research Database (Denmark)

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

    2015-01-01

    140 cataract operations were performed in 243 856 patients. Patients who had cataract surgery in public hospitals had an overall statistically significantly 62% higher mortality compared to patients who had cataract surgery in private hospitals/clinics. The decrease in mean age at first eye cataract...... period (p operated in private hospitals/clinics compared to patients operated in public hospitals (p operations performed in private hospitals/clinics that led to cases......PURPOSE: To study the epidemiology and mortality in patients who had cataract surgery in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012 and to assess the validity of the Danish cataract registries. METHODS: Register- and chart-based study. RESULTS: A total of 411...

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

    Directory of Open Access Journals (Sweden)

    João Carlos Arraes

    2006-06-01

    ções pós-operatórias significativas.PURPOSE: To evaluate astigmatism variation between preoperative, 1st and 12th postoperative month of patients who underwent cataract surgery with limbal relaxing incisions (LRI aiming to reduce the preoperative astigmatism. METHODS: Sixteen patients who underwent cataract surgery by the phacoemulsification technique with a 5.5 mm escleral incision, at the Altino Ventura Foudation, between April and July of 2002. The limbal relaxing incisions were performed according to Gills' modified nomogram (1D - 1 LRI of 6 mm; 1-2D - 2 LRI of 6 mm; 2-3D - 2 LRI of 8 mm. They were done in the most curved meridians, determined by preoperative corneal topography. RESULTS: Significant reduction in preoperative astigmatism was observed in the 1st postoperative month in 2 limbal relaxing incisions of the 6 mm group (57% topographic astigmatism and 87% refractional and in 2 limbal relaxing incisions of the 8 mm group (50% topographic astigmatism and 65% refractional, maintaining the reduction with no significant alteration until the 12th postoperative month. The 1 limbal relaxing incision of the 6 mm group did not yield significant astigmatism reduction, but there was no significant alteration until de 12th postoperative month. There were also no complications such as postoperative discomfort, glare, aniseiconia, diplopia, incision infection and corneal thinning or ectasia. CONCLUSION: Two limbal relaxing incisions of 8 and 6 mm aiming to correct preoperative astigmatism of 2 to 3D and 1 to 2D, respectively, were safe and effective with a stable effect in the first postoperative follow-up year. The 1 limbal relaxing incision of 6 mm aiming to reduce 1 diopter of preoperative astigmatism was not effective, but it did not induce any significant postoperative complications.

  6. Cataract Surgical Rate between 2006 and 2010 in Tehran Province

    Directory of Open Access Journals (Sweden)

    Hassan HASHEMI

    2015-10-01

    Full Text Available Background: Considering population aging in Iran and the importance of cataract surgery in the old age, this study was performed to show the cataract surgical rate (CSR between 2006 and 2010 in Tehran Province.Methods: Eighteen centers were randomly selected from cataract surgery centers in Tehran. In each center, one week in every season was randomly selected and the number of cataract surgeries in the week was calculated. In total, 20 weeks were selected in each center in five years.Results: The CSR increased linearly from 8011 cases per 1,000,000 population in 2006 to 12465 cases per 1,000,000 population in 2010. As for patients below 40 years of age, the percentage of the male patients was more while after the age of 40 years, the percentage of the female patients was more in all age groups. At least 96.2% of the surgeries in each year were performed using the phacoemulsification method. From 2006 to 2010, the percentage of outpatient surgery increased from 48.7% to 72.5%. On the other hand, hospitalization for one night or more had a decreasing trend from 2006 to 2010.Conclusion: During 2006-2010, the CSR was acceptable in Tehran in comparison with other studies. However, attention should be paid to the increase in the population of the elderly people. Although more than 95% of the surgeries in the Province of Tehran are performed using the phacoemulsification method, the rate should increase to 100% in the eligible cases. 

  7. How to prevent endophthalmitis in cataract surgeries?

    OpenAIRE

    Kelkar Aditya; Kelkar Jai; Amuaku Winfried; Kelkar Uday; Shaikh Aarofil

    2008-01-01

    Postoperative endophthalmitis is a very devastating complication and every step should be taken to reduce its occurrence. Unattended air conditioning filter systems are often the culprits and regular maintenance of the filters is of paramount importance. Shedders of pathogenic organisms amongst the theater personnel should be identified by regular screening and should be promptly treated. In addition to the use of Povidone iodine 5% solution in the conjunctival sac few minutes prior to...

  8. Efeito da facectomia no posicionamento palpebral superior: comparação entre as técnicas de facoemulsificação e a extracapsular Changes in the position of the upper eyelid after cataract surgery: a comparison between phacoemulsification and extracapsular techniques

    Directory of Open Access Journals (Sweden)

    Roberto Pinto Coelho

    2003-10-01

    Full Text Available OBJETIVO: Comparar o efeito de duas técnicas de facectomia (facoemulsificação e extracapsular no posicionamento da pálpebra superior. MÉTODOS: Foi analisado o posicionamento palpebral de dois grupos de pacientes submetidos à cirurgia de catarata: facoemulsificação e extracapsular. As imagens foram digitalizadas (antes e 30 dias após a cirurgia e processadas com o programa NIH 1.62. O posicionamento palpebral foi medido em relação a uma linha horizontal que unia os cantos medial e lateral da fenda palpebral, passando pelo centro da pupila. RESULTADOS: O posicionamento palpebral foi afetado de maneira diferente segundo a técnica utilizada. Na facoemulsificação a diferença média entre a posição palpebral superior pós e pré-operatória foi de -0,54 mm. Na extracapsular esta diferença aumentou para -1,41 mm. O teste t de Student (amostras pareadas mostrou que as médias das diferenças entre os dois grupos são significativamente diferentes (p=0,0068. CONCLUSÃO: A técnica de cirurgia de facoemulsificação induziu menor variação do posicionamento palpebral em relação à cirurgia extracapsular no pós-operatório recente.PURPOSE: To compare changes in the upper eyelid position after cataract surgery with phacoemulsification and extracapsular techniques. METHODS: The upper eyelid position was measured in two groups of patients before and 30 days after cataract surgery performed with phacoemulsification and extracapsular techniques. Palpebral fissure images (before and after the cataract surgery were digitized and then processed using the NIH 1.62 software. Eyelid position was measured relative to a horizontal line passing through the pupil center and connecting both canthi of the palpebral fissure. RESULTS: The palpebral position was differently affected according to the techniques. In phacoemulsification the mean difference between eyelids position before and after surgery was -0.54 mm. In the extracapsular technique this

  9. A Case of Nonalcoholic Steatohepatitis and Small Intestinal Bacterial Overgrowth with Peripheral Edema Caused by Intestinal Bypass Surgery and Relieved by Repair

    OpenAIRE

    Sung, Young Kyung; Gwak, Geum Youn; Choi, Moon Seok; Koh, Kwang Chul; Paik, Seung Woon; Yoo, Byung Chul; Lee, Joon Hyeok

    2012-01-01

    Intestinal bypass surgery, particularly jejuno-ileal bypass surgery, performed for the purpose of weight reduction may cause an unexpected exacerbation of nonalcoholic steatohepatitis (NASH). Here, we report a case of NASH caused by small intestinal bacterial overgrowth, which developed after jejuno-colic bypass surgery and resolved dramatically after surgical correction.

  10. Vascular Endothelial Growth Factor in Anterior Chamber Liquid Patients with Diabetic Retinopathy, Cataract and Neovascular Glaucoma

    OpenAIRE

    Kuzmin, Anatoly; Lipatov, Dmitry; Chistyakov, Timofei; Smirnova, Olga; Arbuzova, Margarita; Ilin, Alexander; Shestakova, Marina; Dedov, Ivan

    2013-01-01

    Introduction The aims of this study were: (1) to investigate the association of vascular endothelial growth factor isoform A (VEGF-A) concentration in the anterior chamber liquid (ACL) with vascular proliferation in patients with diabetic retinopathy (DR) who had undergone surgical treatment for cataract and neovascular glaucoma; (2) to analyze the association of VEGF-A level in ACL with the cataract surgery outcomes. Materials and Methods Undiluted aqueous fluid samples were obtained from 20...

  11. Congenital Cataract:Progress in Surgical Treatment and Postoperative Recovery of Visual Function

    Institute of Scientific and Technical Information of China (English)

    Mingyue Wang; Wei Xiao

    2015-01-01

    Congenital cataract is a common cause of childhood low vi-sion or blindness worldwide..Early surgery should be per-formed in sensitive vision development period to avoid vision deprivation in cases of strabismus and nystagmus develop-ment. Postoperative recovery of visual function is of great sig-nificance for these patients and should include proper postop-erative aphakia correction by the application of a contact lens and secondary implantation of an intraocular lens (IOL). Pa-tients should receive amblyopic training after surgery to im-prove their postoperative visual acuity..Although recent ad-vances in surgery techniques and materials have brought better postoperative visual acuity and less complications , a few post-operative complications can still hamper vision condition and vision development,.including posterior capsule opacification and secondary glaucoma. Surgery in early infancy are risk fac-tors for these two complications..Life-long follow-up is essen-tial for these patients..Further study will continue to address the surgery timing issue and methods that prevent postopera-tive complications.

  12. Priorización de pacientes en lista de espera para cirugía de cataratas: diferencias en las preferencias entre ciudadanos Prioritizing patients on waiting list for cataract surgery: preference differences among citizens

    Directory of Open Access Journals (Sweden)

    Laura Sampietro-Colom

    2006-10-01

    Full Text Available Objetivos: Estimar y comparar las preferencias de los ciudadanos sobre la priorización de pacientes en lista de espera para cirugía de cataratas. Método: Análisis de conjunto. Identificación y selección de criterios de priorización: 4 grupos focales/nominales de población general, pacientes/familiares, profesionales relacionados, y especialistas de Catalunya (n = 36. Estimación de las preferencias (puntuaciones de los criterios: entrevista a una muestra representativa de los 4 grupos (n = 771 y aplicación del modelo del rank-ordered logit. Las diferencias se estudiaron mediante análisis separado por grupo y su comparación. Resultados: Los criterios seleccionados y su importancia relativa fueron: incapacidad visual (45%, limitación de las actividades (15%, limitación para trabajar (14%, tener alguna persona que le cuide (11%, ser cuidador (8% y probabilidad de recuperación (7%. Existieron diferencias entre grupos en la puntuación de los criterios. La población general y los pacientes/familiares valoraron más la incapacidad visual que los otros grupos (p 0,9, la ordenación final de éstos en la lista de espera podía variar hasta 27 posiciones al aplicar las preferencias obtenidas de un grupo o de otro. Conclusiones: Se consideró relevantes los criterios clínicos y los sociales. La existencia de diferencias sobre cómo deberían priorizarse los pacientes en espera recomienda tener en cuenta las preferencias de todas las partes afectadas.Objectives: To estimate and compare citizen preferences regarding patient prioritization for cataract surgery. Method: A conjoint analysis was performed. Priority criteria were identified and selected using 4 focus/nominal groups consisting of the general public, patients/relatives, allied health-professionals and specialists from Catalonia (n = 36. Preferences elicitation (score of criteria: representative sample survey of the above mentioned groups (n = 771 and rank-ordered logit model

  13. Toric Intraocular Lens Implantation for Correction of Astigmatism in Cataract Patients with Corneal Ectasia

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    Efstratios A. Parikakis

    2013-11-01

    Full Text Available Our purpose was to examine the long-term efficacy of toric intraocular lens (IOL implantation in cataract patients with high astigmatism due to corneal ectasia, who underwent phacoemulsification cataract surgery. Five eyes of 3 cataract patients with topographically stable keratoconus or pellucid macular degeneration (PMD, in which phacoemulsification with toric IOL implantation was used to correct high astigmatism, are reported. Objective and subjective refraction, visual acuity measurement and corneal topography were performed in all cases before and after cataract surgery. In all cases, there was a significant improvement in visual acuity, as well as refraction, which remained stable over time. Specifically, in subjective refraction, all patients achieved visual acuity from 7/10 to 9/10 with up to -2.50 cyl. Corneal topography also remained stable. Postoperative follow-up was 18-28 months. Cataract surgery with toric IOL implantation seems to be safe and effective in correcting astigmatism and improving visual function in cataract patients with topographically stable keratoconus or PMD.

  14. Mechanisms of cataract development in adult Atlantic salmon growers relative to dietary histidine and plant feed ingredients

    OpenAIRE

    Tröße, Christiane

    2010-01-01

    Cataracts are defined as opacities of the eye lens and can be caused by a large number of risk factors. In aquaculture, cataracts in farmed Atlantic salmon (Salmo salar L.) represent an ethical problem and can cause economical losses. A series of studies have shown the cataract mitigating effect of dietary histidine (His) levels above the currently recommended minimum requirement in Atlantic salmon smolt and that dietary His levels are reflected in the concentrations of the His...

  15. Mouse models of congenital cataract.

    Science.gov (United States)

    Graw, J

    1999-06-01

    Mouse mutants affecting lens development are excellent models for corresponding human disorders. The mutant aphakia has been characterised by bilaterally aphakic eyes (Varnum and Stevens, J Hered 1968;59:147-50); the corresponding gene was mapped to chromosome 19 (Varnum and Stevens, Mouse News Lett 1975;53:35). Recent investigations in our laboratory refined the linkage of 0.6 cM proximal to the marker D19Mit10. Several candidate genes have been excluded (Chuk1, Fgf8, Lbp1, Npm3, Pax2, Pitx3). The Cat3 mutations are characterised by vacuolated lenses caused by alterations in the initial secondary lens fibre cell differentiation. Secondary malformations develop at the cornea and iris, but the retina remains unaffected. The mutation has been mapped to chromosome 10 close to the markers D10Mit41 and D10Mit95. Several candidate genes have been excluded (Dcn, Elk3, Ldc, Mell8, Tr2-11). The series of Cat2 mutations have been mapped close to the gamma-crystallin genes (Cryg; Löster et al., Genomics 1994;23:240-2). The Cat2nop mutation is characterised by a mutation in the third exon of Crygb leading to a truncated gamma B-crystallin and the termination of lens fibre cell differentiation. The Cat2 mutants are interesting models for human cataracts caused by mutations in the human CRYG genes at chromosome 2q32-35. PMID:10627821

  16. Estudo prospectivo comparativo dos ciclos de ultra-som 14% e 67% do WhiteStarTM na cirurgia de catarata por facoemulsificação com a técnica " nuclear preslice" Comparative prospective study of 14% and 67% duty cycles of the ultrasound power with WhiteStarTM in the phacoemulsification cataract surgery using the nuclear preslice technique

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Pereira

    2008-10-01

    élulas endoteliais.PURPOSE: To compare the 14% and 67% duty cycles of ultrasound power, continuous module, manual pulse control in the Sovereign® phacoemulsification system with WhiteStarTM power modulation for cataract surgery. The phacoemulsification nuclear preslice technique was used to evaluate effective ultrasound time, ultrasound percentage, salt solution amount and endothelial cell loss. METHODS: This was a prospective and comparative clinical trial in 32 patients (38 eyes with senile nuclear cataract NO3 NC3 and NO4 NC4 (LOCS III divided into two groups: A and B. To perform the cataract surgery phacoemulsification with nuclear preslice technique, manual pulse control was used; for group A with 14% duty cycle (n=21 and group B with 67% duty cycle (n=17. Both groups were subdivided according to crystalline opaque level in two subgroups. Preoperative measures included complete ophthalmologic examination, biometry, pachymetry and specular microscopy and 3 months after surgery specular microscopy. RESULTS: The surgeries that were used with the 67% duty cycle had significantly more ultrasound effective time than the 14% group in more dense cataracts. The ultrasound percentage in the 67% duty cycle, in different cataract densities, was significantly higher than in the 14% duty cycle. There was no difference in the salt solution amount used in the surgeries. There was no statistically significant difference of endothelial cell loss between both ultrasound cycles. There was a statistically significant correlation between the endothelial cell loss and the variables: ultrasound effective time (EPT and salt solution amount used in surgeries in both cycles. CONCLUSIONS: This clinical trial showed less effective time of ultrasound and ultrasound percentage in the 14% duty cycle for more dense cataracts. The salt solution amount used and the endothelial cell loss were the same in both cycles. The ultrasound effective time and the salt solution amount used in the surgery were correlated

  17. Nephron-sparing surgery for treatment of reninoma: a rare renin secreting tumor causing secondary hypertension

    Directory of Open Access Journals (Sweden)

    Fabio Cesar Miranda Torricelli

    2015-02-01

    Full Text Available Main findings A 25-year-old hypertensive female patient was referred to our institution. Initial workup exams demonstrated a 2.8 cm cortical lower pole tumor in the right kidney. She underwent laparoscopic partial nephrectomy without complications. Histopathologic examination revealed a rare juxtaglomerular cell tumor known as reninoma. After surgery, she recovered uneventfully and all medications were withdrawn. Case hypothesis Secondary arterial hypertension is a matter of great interest to urologists and nephrologists. Renovascular hypertension, primary hyperadosteronism and pheocromocytoma are potential diagnosis that must not be forgotten and should be excluded. Although rare, chronic pyelonephritis and renal tumors as rennin-producing tumors, nephroblastoma, hypernephroma, and renal cell carcinoma might also induce hypertension and should be in the diagnostic list of clinicians. Promising future implications Approximately 5% of patients with high blood pressure have specific causes and medical investigation may usually identify such patients. Furthermore, these patients can be successfully treated and cured, most times by minimally invasive techniques. This interesting case might expand knowledge of physicians and aid better diagnostic care in future medical practice.

  18. 儿童白内障手术人工晶状体度数计算准确性分析%Accuracy of intraocular lens power calculation in pediatric cataract surgery

    Institute of Scientific and Technical Information of China (English)

    赵姝芝; 蔡可丽

    2011-01-01

    Objective To determine the accuracy of intraocular lens (IOL) power calculation in a group of pseudophakic children. Methods A relrospective analysis of biometric and refractive data was performed on 62 eyes of 37 infants and children, who successfully underwent cataract extraction and IOL implantation. SRKII were used to calculate the IOL power. The postoperative refractive outcome was taken as the spherical equivalent of the refraction at 2 months afier surgery by retinoscopy. The data were analyzed to assess the effects of age at the time of surgery, axial length, and primary or secondary intraocular lens implantation on the accuracy of calculation of IOL power. Results For the overall group the mean and median prediction errors were 1.56D (SD 1.43). There were 32 eyes'absolute predictions errors lower than 1D (52%). The mean absolute prediction errors in eyes with axial lengths≤20 mm were 2.75 D (SD 1.66), and in eyes >20 mm were 1.06 D (SD 0.93). The mean absolute prediction errors in eyes in children aged≤2 years were 2.38 D (SD 1.65), and in children aged >2 years were 1.04D (SD 0.99). The differences between the absolute prediction errors for both axial length and age were statistically significant (P <0.01). The mean-absolute prediction errors in eyes with primary IOL implantation were 1.37D (SD 1.35), and secondary intraocular lens implantation were 2.03D (SD 1.56). The differences between the absolute prediction errors primary or secondary intraocular lens implantation, were not statistically significant (P =.22). Conclusions For the overall group IOL power calculation is generally acceptable. In eyes with axial lengths less than 20 mm and in children younger than 2 years of age larger errors can arise, and the variations increase. This study demonstrates the need for an IOL formula specifically designed for pediatric use.%目的 分析儿童眼人工晶状体度数计算的准确性.方法 回顾性研究37例(62只眼)行先天性白内

  19. An unusual cause of hypoglycemia in a middle-aged female after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Ranjan Pathak

    2014-04-01

    Full Text Available Non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS is a disorder characterized by postprandial hypoglycemia and islet cell hypertrophy. It is an uncommon complication of weight-loss surgery. However, with the rising incidence of gastric bypass surgeries, it is important to be able to recognize the clinical picture of NIPHS and not to incorrectly ascribe the symptoms to late dumping syndrome.

  20. Bilateral Electrical Cataract: A Case Report

    Directory of Open Access Journals (Sweden)

    Selçuk Sızmaz

    2011-06-01

    Full Text Available To present a rare complication, such as bilateral cataracts, in a man who sustained a high-voltage electrical injury. A 35- year-old man was admitted with a complaint of decrease in visual acuity. He had a history of a contact with a power line carrying 30.000 volts of electricity while working at a construction site. Examination at a burn center revealed second-degree facial, neck and left foot burns. One month later, the patient underwent amputation of fourth and fifth toes of his left foot. During the next 6 months, he noted decreasing vision in both eyes. Ocular examination 1 year after the accident revealed that the patient’s visual acuity had deteriorated to 1/10 in both eyes. The cornea on the left eye showed superficial punctate opacities. The lenses in both eyes had anterior subcapsular cortical lens opacities and posterior subcapsular opacities. Uncomplicated bilateral phacoemulsification surgery with intraocular lens implantation was performed and the patient’s visual acuity returned to 10/10 in both eyes. We noted that the fundus remained normal in both eyes. Electrical cataracts are still a serious potential complication that may occur after electrical injury. Awareness of this by burn team members is important for providing optimal treatment to those who have suffered an electrical injury. (Turk J Ophthalmol 2011; 41: 197-9

  1. Targeting CYP450 modulation to decrease the risk of induced cataract in the experimental model

    Directory of Open Access Journals (Sweden)

    Patel D

    2010-01-01

    Full Text Available Background: Diabetes is one of the major causes of cataract. Some drugs prescribed for the treatment of diabetes are the modulators of CYP450, which may alter the risk of cataract. Objective: To study the effect of CYP450 modulation in galactosemic cataract. Materials and Methods: Male Sprague-Dawley suckling rats were allotted to four groups (n = 6, as follows: Group 1: Normal control, Group 2: Galactose control, Group 3: CYP450 inhibitor pretreated and Group 4: CYP450 inducer pretreated. Cataract was induced in animals of all groups except group 1 by feeding them galactose (50%, 21 days after parturition. From the eighteenth day of life, CYP450 inhibitor (nifedipine; 8.1 mg/kg and CYP450 inducer (pioglitazone; 3.8 mg/kg were given orally to groups 3 and 4, respectively. The maturation pattern of the cataract was observed by an operating microscope, every third day. Biochemical changes in the lenses of all groups, for example, CYP450 activity expressed as ΅M NADPH oxidized / unit time, alterations in the levels of total proteins, soluble proteins, and reduced glutathione (GSH following the induction of cataract, were estimated. Results: The microscopic examination of the lenses indicated that CYP450 inhibitor pre-treatment delayed (fourteenth day the occurrence of cataract, while CYP450 inducer pretreatment demonstrated an early (ninth day cataract as compared to galactose control rats (twelfth day. A significant decrease and increase in CYP450 activity was observed with the CYP450 inhibitor and inducer pre-treatment, respectively. There was no alteration in the GSH level, but a significant increase in total and soluble protein was found in groups 3 and 4 as compared to group 2. Conclusion: CYP450 may have a role in the initiation of cataract without any effect on the maturation pattern, as revealed by the delayed occurrence of cataract with the CYP450 inhibitor and an early onset of cataract with the CYP450 inducer.

  2. 前后段联合手术治疗玻璃体视网膜疾病合并白内障的临床研究%Clinical study on joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract

    Institute of Scientific and Technical Information of China (English)

    陈平

    2012-01-01

    Objective To study on the effect of joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract.Methods 78 vitreoretinal diseases patients complicated with cataract(86 eyes)were recruited.All the cases accepted vitrectomy and cataract extraction at the same time.The vision improving situation and postoperative complications of the treatment were analyzed.Results After the joint surgery of anteriorposterior,the visual improvement rate was 88.4%(76/86 eyes),and with unchanged vision in 7.0%,and decreased vision in 4.7%.In 4 patients with decreased vision,1 case was a secondary neovascular glaucoma,and 2 cases were macular hemorrhage or hiatus,1 case was a retinal detachment.In phase Ⅰ,72 eyes did not implant artificial lens,63 eyes(87.5%)got postoperatively improved vision,and 14 eyes implanted artificial lens,and all of them got improved vision(100.0%),and the difference was not statistically significant(P > 0.05).The total postoperative complication rate was 10.5%(9/86 eyes).Conclusion Joint surgery of anterior-posterior in the treatment of vitreoretinal diseases complicated with cataract had determined curative effect and lower complication rate,which deserved further study and widely using.%目的 研究前后段联合手术治疗玻璃体视网膜疾病合并白内障的临床效果.方法 选择伴有不同程度晶状体混浊的玻璃体视网膜疾病患者共78例,均一次性予玻璃体切割和白内障摘出前后段联合手术,观察其视力改善情况与并发症.结果 该组78例患者86眼中,术后视力提高88.4%(76/86),视力不变7.0%(6/86),视力下降4.7%(4/86).4眼视力下降患者中1眼为继发新生血管性青光眼,2眼为伴黄斑出血或裂孔,Ⅰ眼为术后视网膜再脱离.Ⅰ期未植入人工晶状体的72眼,术后矫正视力提高63眼(87.5%),Ⅰ期植入人工晶状体14眼,视力均改善(100%),两者差异无统计学意义(P>0.05).前后段

  3. Lensectomy for complicated cataract in juvenile chronic iridocyclitis.

    Science.gov (United States)

    Kanski, J J

    1992-02-01

    Experience with the removal of complicated cataract by lensectomy in patients with juvenile chronic iridocyclitis (JCI) has so far been limited. The results of lensectomy were reviewed retrospectively in 131 patients with JCI (187 eyes). The mean follow up period was 5 years 4 months. The main operative complication was accidental loss of lens material into the vitreous cavity. The postoperative complications were glaucoma (23 eyes, 15%), phthisis (14 eyes, 8%), secondary pupillary membranes (11 eyes, 6%), and retinal detachment (six eyes, 3%). The incidence of postoperative phthisis was related to the level of intraocular pressure (IOP) at the time of surgery. Twenty four per cent of hypotonous eyes and 4% of eyes with normal or elevated IOP became phthisical. Visual acuity was improved in 77%, was worse in 13%, and unchanged in 10% of eyes. The main causes of a postoperative visual acuity of 6/60 or less were glaucoma, amblyopia, and phthisis. Lensectomy did not appear to alter the course of uveitis.

  4. Peripheral radial chop technique for phacoemulsification of hard cataracts

    Institute of Scientific and Technical Information of China (English)

    LI Shao-wei; XIE Li-xin; SONG Zhen-hua; MENG Li; JIANG Jian

    2007-01-01

    Background Phacoemulsification yields successful outcomes in eyes with standard cataract. Though techniques have been improved, it is still challenging to perform phacoemulsification in cases of hard cataracts for difficulty in nuclear management and much more complications. This study aimed at describing and evaluating the efficacy and safety of a peripheral radial chop technique to remove hard cataracts.Methods In this prospective study conducted between January 2003 and January 2004, 107 consecutive eyes with hard cataract underwent modified phacoemulsification surgery with peripheral radial chop technique by the Bausch & Lomb Millennium phacoemulsifier with preset parameters of power less than 30%; vaccum, 150 mmHg; and bottle height,85 cm when a DP8145 phaco tip was used, and vaccum, 380 mmHg; bottle height, 95 cm when a DP8245 phaco tip was used.Results The mean ultrasonic power was 14.7% (range 9% to 19%), ultrasonic time was 1.98 minutes (range 1.55 to 3.18 minutes). At 1, 7 and 30 days postoperatively, the eyes with uncorrected visual acuity 0.5 or better accounted for 76.42%, 87.16% and 90.67% respectively. At 1 month, the endothelial cell loss rate was 9.74% (range 8% to 17%). There were 6 cases of posterior capsule rupture in an early period of study. No serious intraoperative or postoperative complications were noted.Conclusions The peripheral radial chop technique was effective without serious complications in hands of an experienced surgeon.

  5. Increased aquaporin 1 and 5 membrane expression in the lens epithelium of cataract patients.

    Science.gov (United States)

    Barandika, Olatz; Ezquerra-Inchausti, Maitane; Anasagasti, Ander; Vallejo-Illarramendi, Ainara; Llarena, Irantzu; Bascaran, Lucia; Alberdi, Txomin; De Benedetti, Giacomo; Mendicute, Javier; Ruiz-Ederra, Javier

    2016-10-01

    In this work we have analyzed the expression levels of the main aquaporins (AQPs) expressed in human lens epithelial cells (HLECs) using 112 samples from patients treated with cataract surgery and 36 samples from individuals treated with refractive surgery, with transparent lenses as controls. Aquaporin-1 (AQP1) is the main AQP, representing 64.1% of total AQPs in HLECs, with aquaporin-5 (AQP5) representing 35.9% in controls. A similar proportion of each AQP in cataract was found. Although no differences were found at the mRNA level compared to controls, a significant 1.65-fold increase (p=0.001) in AQP1protein expression was observed in HLECs from cataract patients, with the highest differences being found for nuclear cataracts (2.1-fold increase; p<0.001). A similar trend was found for AQP5 (1.47-fold increase), although the difference was not significant (p=0.161). Moreover we have shown increased membrane AQP5 protein expression in HLECs of patients with cataracts. No association of AQP1 or AQP5 expression levels with age or sex was observed in either group. Our results suggest regulation of AQP1 and AQP5 at the post-translational level and support previous observations on the implication of AQP1 and 5 in maintenance of lens transparency in animal models. Our results likely reflect a compensatory response of the crystalline lens to delay cataract formation by increasing the water removal rate.

  6. A case-control study to assess the relationship between poverty and visual impairment from cataract in Kenya, the Philippines, and Bangladesh.

    Directory of Open Access Journals (Sweden)

    Hannah Kuper

    2008-12-01

    Full Text Available BACKGROUND: The link between poverty and health is central to the Millennium Development Goals (MDGs. Poverty can be both a cause and consequence of poor health, but there are few epidemiological studies exploring this complex relationship. The aim of this study was to examine the association between visual impairment from cataract and poverty in adults in Kenya, Bangladesh, and the Philippines. METHODS AND FINDINGS: A population-based case-control study was conducted in three countries during 2005-2006. Cases were persons aged 50 y or older and visually impaired due to cataract (visual acuity < 6/24 in the better eye. Controls were persons age- and sex-matched to the case participants with normal vision selected from the same cluster. Household expenditure was assessed through the collection of detailed consumption data, and asset ownership and self-rated wealth were also measured. In total, 596 cases and 535 controls were included in these analyses (Kenya 142 cases, 75 controls; Bangladesh 216 cases, 279 controls; Philippines 238 cases, 180 controls. Case participants were more likely to be in the lowest quartile of per capita expenditure (PCE compared to controls in Kenya (odds ratio = 2.3, 95% confidence interval 0.9-5.5, Bangladesh (1.9, 1.1-3.2, and the Philippines (3.1, 1.7-5.7, and there was significant dose-response relationship across quartiles of PCE. These associations persisted after adjustment for self-rated health and social support indicators. A similar pattern was observed for the relationship between cataract visual impairment with asset ownership and self-rated wealth. There was no consistent pattern of association between PCE and level of visual impairment due to cataract, sex, or age among the three countries. CONCLUSIONS: Our data show that people with visual impairment due to cataract were poorer than those with normal sight in all three low-income countries studied. The MDGs are committed to the eradication of extreme

  7. A population-based study relevant to seasonal variations in causes of death in children undergoing surgery for congenital cardiac malformations

    OpenAIRE

    Eskedal, Leif T.; Hagemo, Petter S.; Eskild, Anne; Frøslie, Kathrine F; Seiler, Stephen; Thaulow, Erik

    2007-01-01

    Aims: Our objectives were, first, to study seasonal distribution of perioperative deaths within 30 days after surgery, and late death, in children undergoing surgery for congenitally malformed hearts, and second, to study the causes of late death. Methods: We analysed a retrospective cohort of 1,753 children with congenital cardiac malformations born and undergoing surgery in the period from 1990 through 2002 with a special focus on the causes of late death. The data was obtained from the...

  8. Cataract after total body irradiation and bone marrow transplantation degree of visual impairment

    International Nuclear Information System (INIS)

    Purpose: To assess the degree of visual impairment as a result of cataract formation after total body irradiation (TBI) for bone marrow transplantation. Methods and Materials: The data from 93 patients who received TBI in 1 or 2 fractions as a part of their conditioning regimen for bone marrow transplantation were analyzed with respect to the degree of visual impairment as a result of cataract formation. The probability to develop severe visual impairment (SVI) was determined for all patients, and the degree of visual impairment was assessed for 56 patients with stabilized cataract, using three categories: no, mild, or severe. Results: For all 93 patients, the probability of developing a cataract causing SVI was 0.44. For allogeneic patients, it was 0.33 without and 0.71 with steroid treatment (p<0.001). All SVI-free probability curves reached a plateau distinct from the cataract-free curves. Apparently, cataracts developing late in the follow-up period rarely cause SVI. Of the patients with stabilized cataract, 32% had no visual impairment, 16% had mild, and 52% severe impairment. No or mild visual impairment was present in 61% of all patients with stable cataract and no steroid treatment compared with only 13% of the patients treated with steroids (p=0.035). Conclusion: SVI occurs in only some of the patients (52%) with stable cataract after TBI for bone marrow transplantation in 1 or 2 fractions. Steroid treatment markedly increases the probability of developing visual problems as result of a cataract after TBI

  9. 高度近视合并白内障术后不同屈光状态与日常视觉活动质量的关系%The relationship between the different refractive states and daily activity after cataract surgery in highly myopic eyes

    Institute of Scientific and Technical Information of China (English)

    张婉琪; 张少斌; 邱坤良

    2015-01-01

    Objective To evaluate postoperative daily visual activity of highly myopes after cataract surgery. Methods Data of studied 120 eyes of 60 cases with cataract surgery and high myopia who underwent cataract surgery in our hospital were retrospectively analyzed. The patients were divided into three groups based on postoperative diopters:group A ( -1. 0 ~ -2. 0D), group B ( -2. 25 ~ -3. 0D) and group C ( -3. 25~ -4. 0D). The questionnaires of Activities of Daily Vision Scale (ADVS) were collected to assess the vision three months after the cataract surgery. Results The numbers of patients who satisfied with the surgery were 11 in group A, 8 in group B, and 13 in group C, and the difference were not statistically significant among three groups (χ2 =4. 23,P=0. 38). No statistically significant difference was observed among three groups in postoperative life self-care ability, mental state and interest survey (χ2 =4. 23,P=0. 38). Depending on the postoperative visual qualities, there were no statistically significant differences in night vision (χ2 =3. 39,P=0. 415) and the vision for watching TV among three groups (χ2 =4. 20,P=0. 38). But for reading and writing capabilities, the vision of patients in group A was poorer than that of patients in group B and C (χ2 =10. 62,P=0. 005;χ2 =16. 25,P=0. 0015;χ2 =4. 64,P=0. 2). Patients in group C had better fine resolution than those in group A and B (χ2 =5. 26,P =0. 072;χ2 =19. 54,P<0. 001;χ2 =9. 09,P=0. 011). There was statistically significant difference in wearing glasses among three groups (χ2 =29. 67,P<0. 001). For distant vision, the wearing rate were 40% in group A, 95% in group B and 100% in group C. For near vision, the wearing rate were 75% in group A, 40% in group B and 30% in group C. Conclusion Cataract surgery in highly myopic eyes can improve qualities of vision and life. For patients who are not used to wearing glasses and working at near distant, it ’ s appropriated to reserve a minor degree of

  10. Cause Analysis of Open Surgery Used After Percutaneous Vertebroplasty and Kyphoplasty

    Science.gov (United States)

    Xu, Zhengwei; Hao, Dingjun; Liu, Tuanjiang; He, Baorong; Guo, Hua; He, Limin

    2016-01-01

    Background The aim of this study was to analyze reasons why open surgery was done after percutaneous vertebroplasty and kyphoplasty. Material/Methods Patients (587 vertebral bodies) treated with percutaneous vertebroplasty or kyphoplasty in the Xi’an Honghui Hospital of Shanxi Province from January 2008 to January 2012 were retrospectively analyzed and 13 patients were enrolled in the study. These 13 patients had serious adverse events after percutaneous vertebroplasty or kyphoplasty. Their average age was 64.5 years old. Nine patients had spinal cord injury and 4 had nerve root injury. All the patients underwent open surgery within 4–12 h after definitive diagnosis. Results All 13 cases were followed up (average time 14.1 months, range 3–47 months). Reasons for open surgery included cement extravasation (6 cases, 46.2%), puncture mistake (3 cases, 23.1%), and false selection of indications (4 cases, 30.8%). At last follow-up, skin feeling was better than that before open surgery in 4 cases with nerve root injury, and muscle strength recovered to grade 5 (3 cases) and grade 4 (1 case). In 9 cases with spinal cord injury, 7 patients improved and 2 remained at the same ASIA level. Conclusions The main reasons for open surgery after percutaneous vertebroplasty and kyphoplasty were cement extravasation (the most common reason), puncture mistake, and false selection of indications. PMID:27444135

  11. Cause Analysis of Open Surgery Used After Percutaneous Vertebroplasty and Kyphoplasty.

    Science.gov (United States)

    Xu, Zhengwei; Hao, Dingjun; Liu, Tuanjiang; He, Baorong; Guo, Hua; He, Limin

    2016-01-01

    BACKGROUND The aim of this study was to analyze reasons why open surgery was done after percutaneous vertebroplasty and kyphoplasty. MATERIAL AND METHODS Patients (587 vertebral bodies) treated with percutaneous vertebroplasty or kyphoplasty in the Xi'an Honghui Hospital of Shanxi Province from January 2008 to January 2012 were retrospectively analyzed and 13 patients were enrolled in the study. These 13 patients had serious adverse events after percutaneous vertebroplasty or kyphoplasty. Their average age was 64.5 years old. Nine patients had spinal cord injury and 4 had nerve root injury. All the patients underwent open surgery within 4-12 h after definitive diagnosis. RESULTS All 13 cases were followed up (average time 14.1 months, range 3-47 months). Reasons for open surgery included cement extravasation (6 cases, 46.2%), puncture mistake (3 cases, 23.1%), and false selection of indications (4 cases, 30.8%). At last follow-up, skin feeling was better than that before open surgery in 4 cases with nerve root injury, and muscle strength recovered to grade 5 (3 cases) and grade 4 (1 case). In 9 cases with spinal cord injury, 7 patients improved and 2 remained at the same ASIA level. CONCLUSIONS The main reasons for open surgery after percutaneous vertebroplasty and kyphoplasty were cement extravasation (the most common reason), puncture mistake, and false selection of indications. PMID:27444135

  12. Challenges for the cataract surgeon treating people with dementia: a qualitative study exploring anesthetic choices

    Directory of Open Access Journals (Sweden)

    Jefferis JM

    2014-09-01

    Full Text Available Joanna Mary Jefferis,1–3 Michael Patrick Clarke,1,3 John-Paul Taylor,2 Katie Rhian Brittain4 1Newcastle Eye Centre, Royal Victoria Infirmary, 2Institute for Ageing and Health, 3Institute of Neurosciences, 4Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK Background: In light of the growing number of people with dementia and age-related cataract, as well as changing anesthetic practices for cataract surgery, this study aimed to explore the experiences of cataract surgeons in managing patients with dementia and making anesthetic decisions.Methods: This was a qualitative study using semistructured interviews with senior cataract surgeons from two centers in England. Fourteen surgeons were interviewed, and a thematic approach informed by grounded theory was used for the analysis.Results: Choice of anesthesia for people with dementia was a central theme arising from the data. Surgeons varied in their thresholds for using general anesthesia. Decisions about suitability for local anesthesia were limited by time constraints and generally made rapidly and based on instinct; dementia was not always apparent at the point of preassessment. Surgeons used a variety of topical, sub-Tenon’s, and sharp needle blocks for people with dementia. Surgeons discussed techniques to help patients tolerate local anesthesia, such as clear communication, a primary nurse, hand-holding, and support from an anesthetist. However, within our sample, some surgeons had had negative experiences of operating on people with dementia, where an incorrect judgment had been made that they could tolerate local anesthetic cataract surgery. Conclusion: This study highlights the differing practices of cataract surgeons when making anesthetic choices for people with dementia and the challenges they face. In order to avoid the situation of a patient with dementia becoming distressed during awake surgery, increased time at preassessment and anesthetic support

  13. 眼外导光照明视网膜光凝联合前房注气在白内障玻璃体视网膜术中应用%Microscopically eye light illumination, retinal laser photocoagulation combined with gas anterior chamber tamponade in cataract joint vitreoretinal surgery

    Institute of Scientific and Technical Information of China (English)

    刘鹏飞

    2016-01-01

    目的 探讨显微镜下眼外导光照明、视网膜激光光凝联合前房注气在白内障联合玻璃体视网膜手术中的疗效及可行性.方法 回顾性分析2010年1月至2014年7月在唐山市眼科医院就治的47例(47只眼)合并晶状体后囊破裂的眼内异物患者实施白内障联合玻璃体视网膜手术.其中周边视网膜格子样变性39只眼,视网膜裂孔者7只眼,玻璃体积血30只眼,视网膜脱离7只眼,锯齿缘解离2只眼.实施白内障摘除、玻璃体切除、视网膜光凝、人工晶状体植入、眼内注气术,术中显微镜下眼外导光照明、视网膜激光光凝联合前房注气.术后观察视力、人工晶状体、视网膜情况及并发症.术后随访6~11个月,平均(6.14±2.15)月.结果 47例患者中,42只眼充填C3F8,5只眼充填硅油.44只眼视力不同程度改善.41只眼人工晶状体正位,1只眼人工晶状体略偏斜.3只眼发生孔源性视网膜脱离.8只眼继发性青光眼,药物治疗1周至2周眼压恢复正常.2只眼角膜内皮面增生膜生长.结论 显微镜下眼外导光照明、视网膜激光光凝联合前房注气在白内障联合玻璃体视网膜手术中操作方便,安全可靠,减少了手术并发症发生,有很好的实用价值.此术式是白内障玻璃体视网膜联合手术的有力补充.%Objective To study the clinical efficacy and feasibility associated with microscopically eye light illumination,retinal laser photocoagulation combined with gas anterior chamber tamponade in the cataract joint vitreoretinal surgery.Methods It was a retrospective analysis of 47 cases (47 eyes) with intraocular foreign bodies and lens capsule rupture was performed cataract joint vitreoretinal surgery.Among 47 cases,peripheral lattice retinal degeneration in 39 eyes,peripheral retinal tear in 7 eyes,vitreous hemorrhage in 30 eyes,retinal detachment in 7 eyes,retinal serrated edge disintegrate in 2 eyes.The patients were performed cataract

  14. Natural therapies for ocular disorders, part two: cataracts and glaucoma.

    Science.gov (United States)

    Head, K A

    2001-04-01

    Pathophysiological mechanisms of cataract formation include deficient glutathione levels contributing to a faulty antioxidant defense system within the lens of the eye. Nutrients to increase glutathione levels and activity include lipoic acid, vitamins E and C, and selenium. Cataract patients also tend to be deficient in vitamin A and the carotenes, lutein and zeaxanthin. The B vitamin riboflavin appears to play an essential role as a precursor to flavin adenine dinucleotide (FAD), a co-factor for glutathione reductase activity. Other nutrients and botanicals, which may benefit cataract patients or help prevent cataracts, include pantethine, folic acid, melatonin, and bilberry. Diabetic cataracts are caused by an elevation of polyols within the lens of the eye catalyzed by the enzyme aldose reductase. Flavonoids, particularly quercetin and its derivatives, are potent inhibitors of aldose reductase. Glaucoma is characterized by increased intraocular pressure (IOP) in some but not all cases. Some patients with glaucoma have normal IOP but poor circulation, resulting in damage to the optic nerve. Faulty glycosaminoglycan (GAG) synthesis or breakdown in the trabecular meshwork associated with aqueous outflow has also been implicated. Similar to patients with cataracts, those with glaucoma typically have compromised antioxidant defense systems as well. Nutrients that can impact GAGs such as vitamin C and glucosamine sulfate may hold promise for glaucoma treatment. Vitamin C in high doses has been found to lower IOP via its osmotic effect. Other nutrients holding some potential benefit for glaucoma include lipoic acid, vitamin B12, magnesium, and melatonin. Botanicals may offer some therapeutic potential. Ginkgo biloba increases circulation to the optic nerve; forskolin (an extract from Coleus forskohlii) has been used successfully as a topical agent to lower IOP; and intramuscular injections of Salvia miltiorrhiza have shown benefit in improving visual acuity and

  15. Metalworking defects in surgery screws as a possible cause of post-surgical infections

    Science.gov (United States)

    Spector, Mario; Peretti, Leandro E.; Romero, Gustavo

    2016-04-01

    In the first phase of this work, surface defects (metalworking) in stainless steel implantable prostheses and their possible relation to infections that can be generated after surgery was studied. In a second phase, the results obtained in the aforementioned stage were applied to knee cruciate ligaments surgery screws, considering the fact that a substantial number of Mucormycetes infections have been reported after arthroscopic surgery in Argentina since the year 2005. Two types of screws, transverse and interference screws, were analyzed. The Allen heads presented defects such as burrs and metalworking bending as a result of the machining process. These defects allow the accumulation of machining oil, which could be contaminated with fungal spores. When this is the case, the gaseous sterilization by ethylene oxide may be jeopardized. Cortical screws were also analyzed and were found to present serious metalworking defects inside their heads. To reduce the risk of infection in surgery, the use of screws with metalworking defects on the outer surface, analyzed with stereomicroscope and considering the inside part of the Allen as an outer surface, should be avoided altogether.

  16. Eating in mice with gastric bypass surgery causes exaggerated activation of brainstem anorexia circuit

    Science.gov (United States)

    Mumphrey, Michael B.; Hao, Zheng; Townsend, R. Leigh; Patterson, Laurel M.; Münzberg, Heike; Morrison, Christopher C.; Ye, Jianping; Berthoud, Hans-Rudolf

    2016-01-01

    Background/Objective Obesity and metabolic diseases are at an alarming level globally and increasingly affect children and adolescents. Gastric bypass and other bariatric surgeries have proven remarkably successful and are increasingly performed worldwide. Reduced desire to eat and changes in eating behavior and food choice account for most of the initial weight loss and diabetes remission after surgery, but the underlying mechanisms of altered gut-brain communication are unknown. Subjects/Methods To explore the potential involvement of a powerful brainstem anorexia pathway centered around the lateral parabrachial nucleus (lPBN) we measured meal-induced neuronal activation by means of c-Fos immunohistochemistry in a new high-fat diet-induced obese mouse model of Roux-en-Y gastric bypass (RYGB) at 10 and 40 days after RYGB or sham surgery. Results Voluntary ingestion of a meal 10 days after RYGB, but not after sham surgery, strongly and selectively activates calcitonin gene-related peptide neurons in the external lPBN as well as neurons in the nucleus tractus solitaries, area postrema, and medial amygdala. At 40 days after surgery, meal-induced activation in all these areas was greatly diminished and did not reach statistical significance. Conclusions The neural activation pattern and dynamics suggest a role of the brainstem anorexia pathway in the early effects of RYGB on meal size and food intake that may lead to adaptive neural and behavioral changes involved in the control of food intake and body weight at a lower level. However, selective inhibition of this pathway will be required for a more causal implication. PMID:26984418

  17. Estudo comparativo da eficácia de colírios antiinflamatórios não esteróides na manutenção da dilatação pupilar durante a cirurgia de catarata Comparative efficacy of nonsteroidal antiinflammatory eye drops in maintenance of pupillary dilation during cataract surgery

    Directory of Open Access Journals (Sweden)

    Rafael Naves Tomás

    2003-12-01

    Full Text Available OBJETIVO: Antiinflamatórios não hormonais, com efeitos antiprostaglandínicos, têm sido usados no pré-operatório de cirurgia de catarata para manutenção da midríase per-operatória. Infelizmente, ainda não existe um antiprostaglandínico ideal. Este é um estudo de corte transversal, randomizado, grupo-placebo e duplo-mascarado, comparando a eficácia do cetorolac de trometamina, flurbiprofeno sódico, diclofenaco sódico e um placebo, hipromelose, quanto à manutenção peroperatória da midríase. MÉTODOS: Cento e dezesseis pacientes, submetidos à extração extracapsular da catarata com implantação de lente intra-ocular, foram separados aleatoriamente em quatro grupos, que receberam a mesma rotina de dilatação e de instilação dos antiprostaglandínicos. O grupo I recebeu cetorolac de trometamina; grupo II, flurbiprofeno sódico; grupo III, diclofenaco sódico e grupo IV, hipromelose, o placebo. Os dados referentes à pupila foram obtidos por meio de questionário objetivo proposto aos cirurgiões no início e ao final da cirurgia. RESULTADOS: Os resultados mostraram diferença significativa entre o grupo I e o placebo quanto à manutenção da dilatação peroperatória. Também foi significativa a diferença entre o grupo I e os demais grupos em relação à suficiência da midríase para o início do ato cirúrgico e para a ocorrência de miose intra-operatória. Não se registrou diferença significante entre o uso de flurbiprofeno e de diclofenaco quando comparados ao placebo para os mesmos parâmetros (pBACKGROUND AND PURPOSE: Nonsteroidal antiinflammatory drugs, with antiprostaglandin effect, have been used in the preoperative period of cataract surgery for maintenance of mydriasis during the surgery. Unfortunately, the ideal antiprostaglandin has yet to be introduced. This study is a transversal cut, randomized, placebo-group and double-masked clinical trial comparing the efficacy of ketorolac tromethamine

  18. Effects of manual small incision cataract surgery versus phacoemulsification on visual quality and postoperative complications: a Meta-analysis%小切口囊外白内障摘除术与超声乳化白内障吸除术对视觉质量及并发症的Meta分析

    Institute of Scientific and Technical Information of China (English)

    郭强; 沈迅; 韩敬力

    2013-01-01

    目的 系统评价小切口囊外白内障摘除术(MSICS)与超声乳化白内障吸除术(PHACO)对术后视觉质量的影响及手术的并发症.方法 通过计算机文献检索,结合手工检索,对纳入的有关MSICS和PHACO临床疗效的相关文献进行Meta分析,以OR和加权均数差(WMD)为效应量,应用RevMan5.0软件进行Meta分析.结果 共有9篇文献纳入研究.MSICS与PHACO术后1周裸眼视力(OR =0.93,95% CI 0.68~ 1.27)、手术后囊破裂(OR=1.07,95% CI 0.73~1.58)、角膜水肿(OR=0.90,95% CI0.70~ 1.16)、术后1个月手术源性散光(WMD=0.08,95% CI-0.02~0.17)比较差异均无统计学意义(P>0.05).结论 MSICS与PHACO临床疗效相似,MSICS更符合中国国情.%Objective To evaluate the postoperative complications and visual quality after manual small incision cataract surgery (MSICS) versus phacoemulsification (PHACO).Methods A systematic review of MSICS and PHACO was conducted by a computer search on Medline,Pubmed,CBM and CNKI and a supplementary manual search was also done.The effect was measured as an odds ratio (OR) and weighted mean difference (WMD).RevMan 5.0 software was used to perform the Meta-analysis.Results A total of 9 articles were included in the Meta-analysis.Naked visual acuity at 1 week after surgery (OR =0.93,95% CI 0.68-1.27),posterior capsular ruptured after surgery (OR =1.07,95% CI 0.73-1.58),corneal edema after surgery (OR =0.90,95 % CI 0.70-1.16),surgically induced astigmatism at 1 month after surgery (WMD =0.08,95% CI-0.02-0.17) in MSICS and PHACO was no statistically significant difference (P >0.05).Conclusion MSICS is safe and reliable surgery as same as PHACO for the patients with cataract,MSICS is more consistent with China' s national conditions.

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

    OpenAIRE

    Millonig Gunda; Muckenthaler Martina U; Mueller Sebastian

    2010-01-01

    Abstract The hereditary hyperferritinaemia-cataract syndrome (HHCS) is characterised by an autosomal dominant cataract and high levels of serum ferritin without iron overload. The cataract develops due to L-ferritin deposits in the lens and its pulverulent aspect is pathognomonic. The syndrome is caused by mutations within the iron-responsive element of L-ferritin. These mutations prevent efficient binding of iron regulatory proteins 1 and 2 to the IRE in L-ferritin mRNA, resulting in an unle...

  20. A novel locus on canine chromosome 13 is associated with cataract in the Australian Shepherd breed of domestic dog.

    Science.gov (United States)

    Ricketts, Sally L; Pettitt, Louise; McLaughlin, Bryan; Jenkins, Christopher A; Mellersh, Cathryn S

    2015-06-01

    Hereditary cataract is a common ocular disorder in the purebred dog population and is a leading cause of visual impairment and blindness in dogs. Despite this, little is known to date about the genetics underlying this condition. We have used a genome-wide association study and targeted resequencing approach to identify a novel locus for cataracts in the Australian Shepherd breed of dog, using dogs that are clear of an HSF4 mutation, previously identified as the major susceptibility locus in this breed. Cataract cases were defined as dogs with bilateral posterior cataracts, or bilateral nuclear cataracts. Controls were at least 8 years of age with no evidence of cataracts or other ocular abnormality. Using 15 bilateral posterior polar cataract cases and 68 controls, we identified a genome-wide statistical association for cataracts in the Australian Shepherd on canine chromosome 13 at 46.4 Mb (P value: 1.5 × 10(-7)). We sequenced the 14.16 Mb associated region in ten Australian Shepherds to search for possible causal variants underlying the association signal and conducted additional fine-mapping of the region by genotyping 28 intronic variants that segregated correctly in our ten sequenced dogs. From this analysis, the strongest associated variants were located in intron 5 of the SCFD2 gene. Further study will require analysis of additional cases and controls and ocular tissue from dogs affected with bilateral cataracts that are free of the HSF4 mutation.

  1. 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

    Directory of Open Access Journals (Sweden)

    Somaia Mitne

    2003-12-01

    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.OBJETIVO: Avaliar a concordância entre tomografia de coerência óptica (OCT e angiofluoresceinografia (AF no diagnóstico do edema macular cistóide (EMC secundário a cirurgia de catarata. MÉTODOS: Estudo retrospectivo observacional comparativo de 25 olhos com provável EMC. Pacientes com baixa de acuidade visual e alterações na biomicroscopia de fundo após cirurgia de catarata foram submetidos aos exames de OCT e AF na mesma visita. O diagnóstico do EMC foi realizado considerando a presença de vazamento de fluoresceína na angiografia e o espessamento retiniano e/ou espaços cistóides e/ou líquido subretiniano pela OCT. RESULTADOS: Vinte e cinco olhos de 25 pacientes foram avaliados. Vinte e dois olhos mostraram resultados semelhantes no OCT e AF, sendo que 15 olhos apresentaram EMC e 7 olhos não apresentaram EMC. Dois olhos com EMC

  2. Mutation in type II procollagen (COL2A1) that substitutes aspartate for glycine alpha 1-67 and that causes cataracts and retinal detachment: evidence for molecular heterogeneity in the Wagner syndrome and the Stickler syndrome (arthro-ophthalmopathy)

    OpenAIRE

    Körkkö, J; Ritvaniemi, P; Haataja, L; Kääriäinen, H; Kivirikko, K I; Prockop, D J; Ala-Kokko, L

    1993-01-01

    A search for mutations in the gene for type II procollagen (COL2A1) was carried out in affected members of a family with early-onset cataracts, lattice degeneration of the retina, and retinal detachment. They had no symptoms suggestive of involvement of nonocular tissues, as is typically found in the Stickler syndrome. The COL2A1 gene was amplified with PCR, and the products were analyzed by denaturing gradient gel electrophoresis. The results suggested a mutation in one allele for exon 10. S...

  3. Clinical observation on the manual small incision cataract surgery combined with rigid posterior chamber intraocular lens implantation performed by medical team in Africa%援非洲医疗队手法小切口白内障手术效果观察

    Institute of Scientific and Technical Information of China (English)

    郎莉莉; 陈建梅; 崔红平

    2016-01-01

    Objective To investigate the clinical effects of manual small incision cataract surgery combined with rigid posterior chamber intraocular lens implantation in 376 Moroccan cataract cases performed by medical team in Africa.Methods From March 2013 to February 2015 in Morocco,432 eyes of 376 Moroccan patients had undertaken manual small incision cataract surgery combined with rigid posterior chamber lens implantation.The postoperative visual acuity,intraoperative and postoperative complications were analyzed.Results The visual acuities at ≤0.04 were obtained in 9 eyes (2.08%),0.05 ~ 0.25 in 65 eyes(15.05%),0.3 ~0.5 in 236 eyes(54.63%),and≥0.6 in 122 eyes(28.24%) at 1 week postoperatively.The intraoperative complications were stated as follows.The posterior capsular rupture and vitreous prolapse occurred in 28 eyes (6.48%) with nucleus fallen into vitreous cavity in 1 eye,among which 22 eyes were applied posterior chamber lens implantation at stage Ⅰ,the intraocular lens had not been implanted in 6 eyes.Nine eyes (2.08%) complicated with iris prolapse and 12 eyes (2.78%) with progressive miosis.Two eyes(0.46%) complicated with iridodialysis which was sutured intraoperatively.The postoperative complications included the following items.At 1 week postoperatively,corneal edema occurred in 78 eyes(18.06%).The anterior chamber inflammatory responses occurred in 52 eyes(12.04%).The irregular pupil was noticed in 35 eyes (8.10%).The vitreous hemorrhage occurred in 1 eyes(0.23%)which was related to diabetic retinopathy.Other complications were not observed,such as endophthalmitis,secondary glaucoma,intraocular lens dislocation or bullous keratopathy.Conclusion Manual small incision cataract surgery combined with rigid posterior chamber lens implantation is an optimal cataract surgical method in some poverty-striken districts of Africa with the advantages of safety,effectiveness,satisfied results and low cost.And Chinese medical team also

  4. Meta-analysis of clinically randomized controlled trials on manual small incision sutureless cataract surgery and phaco%手法小切口无缝线白内障摘除术与超声乳化吸除术临床随机对照研究的Meta分析

    Institute of Scientific and Technical Information of China (English)

    张社德; 张天锋; 罗荣; 钟秀华

    2012-01-01

    Objective To evaluate the efficacy and safety in the treatment of age-related cataract by comparing manual small incision sutureless cataract surgery (MSICS) with phacoemulsification (Phaco).Methods In a systematic review and meta-analysis,trials were identified by searching databases for randomized clinically controlled trials on the treatment of age-related cataract by manual small incision sutureless cataract surgery and phacoemulsification.The following databases were searched up to February 2012:Cochrane Library,Embase,PubMed,CBM,CNKI and VIP.The quality of the included trials was assessed and meta-analyses were performed with RevMan 5.1 software.Results A total of 13 randomized clinically controlled trials involving 2870 eyes were included.There were no statistically significant differences in the ratio of postoperative visual acuity ≥0.3 (Z=0.61,P>0.05),endothelial cell loss (Z=0.78,P>0.05),or postoperative complications (Z=0.74,P>0.05).But there were statistically significant differences in postoperative astigmatism between the two groups 6 weeks after surgery (Z=10.16,P<0.01).MSICS was far more economical and time saving than phacoemulsification.Conclusion Meta-analysis shows that MSICS has equal efficacy and safety compared to Phaco in the treatment of age-related cataract.Because MSICS is far more economical and time saving,it should be recommended for use in basic hospitals in China.%目的 系统评价手法小切口无缝线白内障摘除(MSICS)与白内障超声乳化吸除术(Phaco)治疗年龄相关性白内障的疗效及安全性.方法 循证医学研究.计算机检索Cochrane Library、Embase、PubMed、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普中文期刊数据库(VIP).全面收集MSICS治疗年龄相关性白内障的临床随机对照试验,评价纳入研究的质量,提取有效数据,采用RevMan 5.1软件进行Meta分析.结果 共纳入13个临床随机对照试验,共2870

  5. A Prospective, Open-label Study to Compare the Efficacy and the Safety of Topical Loteprednol Etabonate and Topical Flurbiprofen Sodium in Patients with Post-Operative Inflammation after Cataract Extraction

    Science.gov (United States)

    Bannale, Sheshidhar G.; Pundarikaksha, H.P.; Sowbhagya, H.N.

    2012-01-01

    Purpose To study the effect of the topical Non-Steroidal Anti Inflammatory Drug (NSAID), Flurbiprofen 0.03%, as an alternative to the topical steroids for the postoperative control of inflammation in cataract surgeries. Methods The effect of the topical NSAID, flurbiprofen sodium 0.03%, was studied and compared with that of the topical steroid – Loteprednol etabonate 0.5% suspension (as eye drops) in a prospective, open labelled study. Both the groups (20 patients each) were similar in the baseline parameters. The postoperative inflammatory response following the standard, small incision, extra capsular cataract extraction was assessed in both the groups for 28 post-operative days. The parameters which were considered for the study were conjunctival hyperaemia, ciliary congestion, corneal oedema, cells in the anterior chamber, aqueous flare and ocular pain. The severity of the postoperative inflammatory responses for both the drugs was graded on the post-operative days 1, 7, 14, 21 and 28 and it was statistically analyzed. Results The 2 groups did not differ statistically in the effect of the treatment for any of the variables, which included aqueous cells, flare, ciliary congestion and conjunctival congestion (p< 0.001). Both the drugs were well tolerated and no severe adverse Drug Reactions (ADRs) were caused by the topical NSAID and the topical steroid. Conclusion The topical NSAID, Flurbiprofen, is as effective as the topical corticosteroid, Loteprednol and it can be used as an alternative in the routine postoperative treatment following uncomplicated cataract surgeries. PMID:23285440

  6. Bacterial infection as a likely cause of adverse reactions to polyacrylamide hydrogel fillers in cosmetic surgery

    DEFF Research Database (Denmark)

    Christensen, Lise; Breiting, Vibeke; Bjarnsholt, Thomas;

    2013-01-01

    patients and 24 controls were systematically examined for the presence of bacteria by culture, 16S rRNA gene sequencing, Gram stain, and fluorescence in situ hybridization. Results. Bacteria, mostly normal skin bacteria such as Staphylococcus epidermidis and Propionibacterium acnes, were identified...... in the presence of polyacrylamide filler in cosmetic surgery, possibly due to a biofilm mode of growth. Adequate skin preparation and use of sterile technique in these procedures are mandatory, but antibiotic prophylaxis prior to injection of nondegradable gels like polyacrylamide should be explored as well....

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

    Directory of Open Access Journals (Sweden)

    Li-Quan Zhao

    2014-02-01

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

  8. Comparação da eficácia da ropivacaína 1% quando associada ou não à hialuronidase na anestesia peribulbar para cirurgia de catarata A comparison of 1% ropivacaine efficacy when associated or not with hyaluronidase in peribulbar anaesthesia in cataract surgery

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    Hélio Francisco Shiroma

    2002-09-01

    : 1% ropivacaine with addition of 100 tru/ml hyaluronidase, and Group S 1% ropivacaine, without hyaluronidase. The onset time for globe akinesia was studied at intervals of 2 minutes, using Nicoll's score. We evaluated pain by analogic score during the surgery and the necessity of complementing the anaesthesia. The peribulbar block was considered satisfactory when the Nicoll's score was less than 4. Results: The mean time of onset of block in group C was 4.07 minutes (± 3.24, and in group S 5.03 (± 3.28. There was no statistically significant difference between the groups. Both were similar regarding pain score, no pain was observed in 57.14% of group C, and in 68.97% of group S. The supplementary anesthetic was necessary in 2 cases of group C and in 3 cases of group S. Two cases of bradycardia (heart rate < 50 bpm were observed during the surgery, and in one case administration of atropine IV was necessary. Conclusion: 1% ropivacaine provided a good quality of anesthesia for cataract extraction, with a faster onset of action in the group with hyaluronidase 100 iu/ml, although without significant difference.

  9. Adams-Oliver syndrome associated with cutis marmorata telangiectatica congenita and congenital cataract: a case report.

    Science.gov (United States)

    Fayol, Laurence; Garcia, Patricia; Denis, Danièle; Philip, Nicole; Simeoni, Umberto

    2006-04-01

    A female infant presented with Adams-Oliver syndrome (AOS), intrauterine growth retardation, severe cutis marmorata telangiectatica congenita, bilateral congenital cataract, and periventricular lesions. The here-reported association of bilateral congenital cataract with AOS is original. Adams-Oliver syndrome is a genetic defect that causes a vas