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Sample records for cataract surgery review

  1. Cataract Surgery

    Science.gov (United States)

    ... and Videos: What Do Cataracts Look Like? Cataract Surgery Written by: Kierstan Boyd Reviewed by: Elena M ... how they work. What to expect with cataract surgery Before surgery: Your ophthalmologist will measure your eye ...

  2. Cataract Surgery in Anterior Megalophthalmos: A Review

    Science.gov (United States)

    GALVIS, Virgilio; TELLO, Alejandro; M. RANGEL, Carlos

    2015-01-01

    Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also called X-linked megalocornea. It is accompanied by early development of cataracts, zonular anomalies, and, rarely, vitreoretinal disorders. Subluxation of a cataract can occur in cataract surgery because of zonular weakness. In addition, in most patients, standard intraocular lens (IOL) decentration is a risk because of the enlarged sulcus and capsular bag. These unique circumstances make cataract surgery challenging. To date, several approaches have been developed. Implantation of a retropupillary iris-claw aphakic intraocular lens may be a good option because it is easier than suturing the IOL and can have better and more stable anatomic and visual outcomes, compared to other techniques. PMID:27350950

  3. 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.

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

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    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.

  5. 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.

  6. Cataract Surgery in Uveitis

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    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.

  7. Vitrectomy as a Risk Factor for Complicated Cataract Surgery.

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    Fenberg, Moss J; Hainsworth, Kenneth J; Rieger, Frank G; Hainsworth, Dean P

    2016-01-01

    A retrospective review of 98 cases of complicated cataract surgery and/or delayed intraocular lens (IOL) dislocation examined the relationship between vitrectomy and cataract surgery complications. Nine (9.2%) of the 98 patients had a history of vitrectomy, before or after cataract surgery, and each had complicated cataract surgery. Six patients who underwent vitrectomy before cataract surgery experienced intraoperative complications. Three patients in whom vitrectomy was performed after uneventful cataract surgery subsequently had delayed IOL dislocation.

  8. Improvements in Cataract Surgery

    NARCIS (Netherlands)

    Nibourg, Lisanne Maria

    2016-01-01

    Cataract is the leading cause of blindness and visual impairment in the elderly. It involves lens opacification due to biochemical changes in the lens. Cataract surgery provides restoration of good vision by removal of the opaque lens, followed by implantation of an intraocular lens (IOL) in the rem

  9. Cataract surgery - slideshow

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    ... this page: //medlineplus.gov/ency/presentations/100079.htm Cataract surgery - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 5 Go to slide ... 5 Overview The lens of an eye is normally clear. A cataract is when the lens becomes cloudy as you ...

  10. 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...

  11. Surgery for Congenital Cataract

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    David Yorston FRCS FRCOphth

    2004-01-01

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

  12. Viscoless microincision cataract surgery

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    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

  13. Cataract Surgery Tool

    Science.gov (United States)

    1977-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

  16. 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.

  17. Virtual Mentor Cataract Surgery Trainer

    Science.gov (United States)

    2010-09-01

    TITLE: Virtual Mentor Cataract Surgery Trainer PRINCIPAL INVESTIGATOR: Principal Investigator: John I. Loewenstein MD Co-Investigator: Bonnie A...AND SUBTITLE Virtual Mentor Cataract Surgery Trainer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-08-1-0531 5c. PROGRAM ELEMENT NUMBER...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Virtual Mentor Cataract Surgery

  18. Combined cataract and strabismus surgery.

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    Gayton, J L; Ledford, J K

    1993-08-01

    A patient with cataracts and congenital exotropia underwent combined cataract and strabismus surgery OU. A lateral rectus recession plus an extracapsular cataract extraction with intraocular lens implantation was done OD first; three months later, this procedure was repeated OS. The patient's postoperative course was benign in both cases, and her strabismus resolved after the second operation. A combined surgical approach to cataracts and strabismus (where only a single muscle is involved) was safe and useful in restoring this patient's vision, binocularity, and appearance.

  19. 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.

  20. 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

  1. Cataract and Cataract Surgery: Nationwide Prevalence and Clinical Determinants.

    Science.gov (United States)

    Park, Sang Jun; Lee, Ju Hyun; Kang, Se Woong; Hyon, Joon Young; Park, Kyu Hyung

    2016-06-01

    This study aimed to investigate the prevalence and clinical determinants of cataract and cataract surgery in Korean population. The 2008-2012 Korean National Health and Nutrition Examination Survey was analyzed, which included 20,419 participants aged ≥ 40 years. The survey is a multistage, probability-cluster survey, which can produce nationally representative estimates. Prevalence of cataract and cataract surgery was estimated. Clinical determinants for those were investigated using logistic regression analyses (LRAs). The prevalence of cataract was 42.28% (95% confidence interval [CI], 40.67-43.89); 40.82% (95% CI, 38.97-42.66) for men and 43.62% (95% CI, 41.91-45.33) for women (P = 0.606). The prevalence of cataract surgery was 7.75% (95% CI, 7.30-8.20); 6.38% (95% CI, 5.80-6.96) for men and 9.01% (95% CI, 8.41-9.61) for women (P Cataract was associated with older age (P Cataract surgery was consistently associated with older age, occupation, DM, asthma, and anemia in two LRAs, which compared participants with cataract surgery to those without cataract surgery and those having a cataract but without any cataract surgery, respectively. Hypertension, arthritis, and dyslipidemia were associated with cataract surgery at least in one of these LRAs. These results suggest that there are 9.4 million individuals with cataract and 1.7 million individuals with cataract surgery in Korea. Further studies are warranted to reveal the causality and its possible mechanism of developing/exacerbating cataract in novel determinants (i.e., anemia, asthma, and arthritic conditions) as well as well-known determinants.

  2. Risk of Retinal Detachment After Pediatric Cataract Surgery

    DEFF Research Database (Denmark)

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

    2014-01-01

    PURPOSE: To determine the long-term risk of retinal detachment following pediatric cataract surgery and to identify risk factors for retinal detachment. METHODS: We included all children (aged 0 to 17 years) who during the time period of 1977 to 2005 underwent pediatric cataract surgery in Denmark...... 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...... (16% [95% CI: 6%-24%]). CONCLUSIONS: The estimated overall risk of retinal detachment 20 years after pediatric cataract surgery was 7%, but only 3% for isolated cataract. Particularly high risks of retinal detachment after cataract surgery were associated with mental retardation and having other...

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

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    Abdelghany, Ahmed A; Alio, Jorge L

    2014-01-01

    Refractive errors are frequently found following cataract surgery and refractive lens exchange. Accurate biometric analysis, selection and calculation of the adequate intraocular lens (IOL) and modern techniques for cataract surgery all contribute to achieving the goal of cataract surgery as a refractive procedure with no refractive error. However, in spite of all these advances, residual refractive error still occasionally occurs after cataract surgery and laser in situ keratomileusis (LASIK) can be considered the most accurate method for its correction. Lens-based procedures, such as IOL exchange or piggyback lens implantation are also possible alternatives especially in cases with extreme ametropia, corneal abnormalities, or in situations where excimer laser is unavailable. In our review, we have found that piggyback IOL is safer and more accurate than IOL exchange. Our aim is to provide a review of the recent literature regarding target refraction and residual refractive error in cataract surgery.

  4. Current developments in equine cataract surgery.

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    McMullen, R J; Utter, M E

    2010-03-01

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

  5. 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.

  6. Cataract Surgery in Eyes with Previous Glaucoma Surgery: Pearls and Pitfalls.

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    Dada, Tanuj; Bhartiya, Shibal; Begum Baig, Nafees

    2013-01-01

    The problem of cataract management in the patients of glaucoma who have undergone fltering surgery is a challenging proposition for any surgeon, as the surgery can lead to several complications in the already compromised eye. As glaucoma requires lifelong management, the development of cataract is a significant concern because its treatment may lead to loss of intraocular pressure (IOP) control. This review aims to highlight the intra- and postoperative measures that may increase the chances of bleb survival following cataract surgery. How to cite this article: Dada T, Bhartiya S, Baig NB. Cataract Surgery in Eyes with Previous Glaucoma Surgery: Pearls and Pitfalls. J Current Glau Prac 2013;7(3):99-105.

  7. 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.

  8. 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.

  9. 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...... module score on seven of 13 modules showed significant discriminative ability between the novices and experienced cataract surgeons. The intermodule reliability coefficient was 0.76 (p

  10. 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

  11. Outcomes of Cataract Surgery Following Treatment for Retinoblastoma

    Science.gov (United States)

    Kim, Hyeong Min; Lee, Byung Joo; Kim, Jeong Hun

    2017-01-01

    Purpose To evaluate the long-term visual outcomes and complications of cataract surgery in eyes previously treated for retinoblastoma. Methods We reviewed the medical records of patients who underwent cataract extraction and intraocular lens implantation at Seoul National University Children's Hospital for a secondary cataract that developed after retinoblastoma treatment. Results During the period between 1990 and 2014, 208 eyes of 147 patients received eye-salvaging treatment (radiotherapy, chemotherapy, and local therapy) for retinoblastoma at Seoul National University Children's Hospital. Among these eyes, a secondary cataract was detected in 17 eyes of 14 patients, and five eyes of five patients underwent cataract surgery. The median age of cataract formation was 97 months (range, 38 to 153 months). The medial interval between the diagnosis of retinoblastoma and cataract formation was 79 months (range, 29 to 140 months). All patients received posterior chamber intraocular lens insertion after irrigation and aspiration of the lens through a scleral tunnel incision. Anterior vitrectomy and posterior capsulotomy were performed in two eyes and a laser capsulotomy was subsequently performed in one eye. No intraoperative and postoperative complications occurred. The median follow-up after surgery was 36 months (range, 14 to 47 months). The final best corrected visual acuities were improved in all five eyes. No intraocular tumor recurrences or metastases occurred. Conclusions After retinoblastoma regression, cataract extraction in our series was not associated with tumor recurrence or metastasis. Visual improvement was noted in every patient. PMID:28243024

  12. 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

    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...... or proprietary interest in any material or method mentioned....

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

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    Venkatesh Rengaraj

    2005-01-01

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

  14. 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.

  15. Pre-cataract surgery test using speckle pattern

    Science.gov (United States)

    Jutamulia, Suganda; Wihardjo, Erning; Widjaja, Joewono

    2016-11-01

    A laser diode device for pre cataract surgery test is proposed. The operation is based on the speckle generated on the retina by the cataract lens, when the cataract lens is illuminated with a coherent laser light.

  16. 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.

  17. Outsourced cataract surgery and postoperative endophthalmitis

    DEFF Research Database (Denmark)

    Solborg Bjerrum, Søren; Kiilgaard, Jens F; Mikkelsen, Kim Lyngby;

    2013-01-01

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

  18. New technology update: femtosecond laser in cataract surgery

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    Nagy ZZ

    2014-06-01

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

  19. [Cataract surgery - essentials for the general practitioner].

    Science.gov (United States)

    Amstutz, Ch; Thiel, M A; Kaufmann, Claude

    2010-08-11

    Age-related cataracts are mainly caused by life-long accumulation of oxidative stress on the lens fibres. Symptoms include reduced visual acuity, requiring more light for reading, and glare. The only treatment that provides a cure for cataracts is surgery. Phacoemulsification represents the preferred method of lens removal. It involves fragmentation of the lens using ultrasound and insertion of an artificial intraocular lens. The preoperative assessment the general practitioner provides to surgeon and anesthesia team has an important share in the low complication rate of the procedure in the event of co-existing systemic disease. Growing patient expectation for spectacle independence following cataract surgery is met to some extent using techniques for astigmatism control and presbyo-pia-correcting intraocular lenses.

  20. 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

  1. 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.

  2. 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

  3. [Appropriate cataract surgery training can promote work of blindness prevention].

    Science.gov (United States)

    Zhang, Mingzhi

    2014-03-01

    Cataract is the first blinding eye disease in the world and China. However, due to various reasons, cataract surgery rate (CSR) in China is much lower than in developed countries and even some developing countries. Properly and standardized training of cataract surgery for ophthalmologists from primary hospital and young eye doctors is one of the key point to improve CSR. For above, we had explored actively to establish an appropriate and suitable training model of cataract surgery. Ophthalmologist in primary hospital can provide high quality medical services to cataract patients in accordance with their own conditions after training and promote the sustainable development of blindness prevention work.

  4. 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......-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...

  5. 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

  6. Prevalence of corneal astigmatism before cataract surgery.

    Science.gov (United States)

    Mohammadi, Mehran; Naderan, Mohammad; Pahlevani, Rozhin; Jahanrad, Ali

    2016-12-01

    The purpose of this study was to describe and analyze the prevalence and pattern of corneal astigmatism in cataract surgery candidates. In a prospective cross-sectional study, preoperative demographics, and keratometric and refractive values of cataract surgery candidates were collected from January 2013 to December 2014. Axial length (AL) and flat and steep keratometry measurements were optically measured by a partial coherence interferometry device (IOLMaster). This study consisted of 2156 eyes of 1317 patients with a mean age of 64.92 ± 11.48 (SD) (30-88 years). The mean of AL was 23.33 ± 1.37 mm, and the mean of corneal astigmatism was 1.12 ± 1.10 diopter (D) (range 0.0-7.00), in all patients. Furthermore, the mean of flat and steep keratometry were 43.70 ± 1.70 and 44.83 ± 1.79 D, respectively. Corneal astigmatism was 1.50 D or less in 1590 eyes (73.7 %), more than 1.50 D in 566 eyes (26.2 %), 3.00 D or more in 161 eyes (7.4 %), WTR in 796 eyes (36.9 %), ATR in 1010 eyes (46.8 %), and oblique in 350 eyes (16.2 %). ATR astigmatism axis significantly increased with the increase in age. Corneal astigmatism of most cataract surgery candidates fell between 0.50 and 1.50 D. The results of our study however is confined to our demographics might provide useful data for cataract patients, surgeons, and intraocular lens manufacturers for different purposes.

  7. 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

  8. 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.

  9. Outcomes of Cataract Surgery in Vitrectomized Eyes

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    Nilüfer Koçak

    2013-01-01

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

  10. Descemet's membrane detachments post cataract surgery: a management paradigm

    Science.gov (United States)

    Samarawickrama, Chameen; Beltz, Jacqueline; Chan, Elsie

    2016-01-01

    Descemet's membrane detachments (DMD) are relatively common after cataract surgery and most do not require any treatment. However, if large DMD are not treated appropriately, significant visual morbidity can ensue. We aim to develop a guideline for the management of DMD post cataract surgery based on a retrospective review of all cases encountered at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia over a 4-year period from 2010 to 2014. We suggest conservative management if the visual axis is not involved; however, after 3mo surgical intervention may be warranted to prevent corneal sequelae. In cases where the visual axis is involved we suggest early intervention with air tamponade. The main risk factor for irreversible corneal oedema and subsequent endothelial transplant appears to be direct endothelial trauma rather than the DMD itself. PMID:28003989

  11. 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.

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

    Science.gov (United States)

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

    2013-03-01

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

  13. Resident surgeon efficiency in femtosecond laser-assisted cataract surgery

    Science.gov (United States)

    Pittner, Andrew C; Sullivan, Brian R

    2017-01-01

    Purpose Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification. Patients and methods A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications. Review of digital video records provided quantitative interval measurements of core steps of the procedures, including completion of incisions, anterior capsulotomy, nucleus removal, cortical removal, and intraocular lens implantation. Results Total room time, operation time, and corneal incision completion time were found to be significantly longer in the femtosecond laser group versus the traditional phacoemulsification group (each Pcataract surgery is generally less efficient when trainees have more experience with traditional phacoemulsification. FLACS was found to have a significant advantage in completion of capsulotomy, but subsequent surgical steps were not shorter or longer. Resident learning curve for the FLACS technology may partially explain the disparities of performance. Educators should be cognizant of a potential for lower procedural efficiency when introducing FLACS into resident training. PMID:28203055

  14. Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty

    Institute of Scientific and Technical Information of China (English)

    Hong-Wei Zhou; Li-Xin Xie

    2016-01-01

    Background:The endothelium should be carefully evaluated when choosing a surgical technique for cataract removal.Therefore,we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted comeal grafts.Methods:A total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included,and clinical records were reviewed.Baseline demographic details,clinical characteristics,endothelial cell density (ECD),and best-corrected visual acuity (BCVA) were recorded.Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians.A regression model was constructed to compare the reduced rate of ECD.Results:Of the 54 eyes included in this study,extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group).There was no significant difference in the median age (P =0.081) or preoperative ECD (P =0.585) between the two groups.At 6 months after cataract surgery,ECD in ECCE group was significantly higher than that in phacoemulsification group (P =0.043).In addition,the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P =0.018),4 months (P < 0.001),and 6 months (P < 0.001) after cataract surgery.Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group (P < 0.00 l) and phacoemulsification group (P < 0.001),but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts (P < 0.001).There was no significant difference in postoperative BCVA between the two groups (P =0.065).Conclusion:ECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.

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

    Science.gov (United States)

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

    2015-01-01

    AIM To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. METHODS We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. Student’s paired t-test was carried out to compare continuous variables, and P-values <0.05 were considered statistically significant. RESULTS Twenty patients were included in the study, 13 males (65%) and seven females (35%). The mean age was 46.3 ± 13.6 years (range 22–70 years). The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS (P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well (P < 0.001). CONCLUSION Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time. PMID:26604848

  16. Cataract surgery outcomes in a Tertiary Hospital, Riyadh

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    Bader Al-Qahtani

    2016-01-01

    Conclusion: Cataract removal is a safe and effective surgery which can improve the quality of life. It has some complications that can be minimised with good pre-operative evaluation and post-operative rehabilitation.

  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...... after 5 and 10 years, respectively. Use of silicone oil increased the risk of cataract surgery (p = 0.009, log-rank test). CONCLUSIONS: Most diabetic vitrectomy patients stand to gain visual acuity ≥0.3 after surgery and a stable long-term visual acuity after 1 year. The only consistent long......-term predictor of low vision after surgery is use of silicone oil for endotamponade. About 2/3 of phakic patients will subsequently have cataract surgery the first 10 years after diabetic vitrectomy....

  18. 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

  19. Prevention and Control of Perioperative Incision Infection in Patients Undergoing Day Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    Chunyan Yang; Aihuan Chen; Yinghuan Wang; Xiaoqun Fang; Ronghua Ye; Jingyi Lin

    2014-01-01

    Purpose:.To explore the effects of the prevention and control of perioperative incision infection on the quality of day cataract surgery.Methods:.The nursing care and efficacy of 5087 patients un-dergoing day cataract surgery between October 2012 and Oc-tober 2013 were retrospectively reviewed. The disinfection and isolation guidance was established for perioperative prevention and control of infection,.topical administration of ocular a-gents, reexamination and healthcare instruction, and alterna-tive measures were taken.Results: All 5087 patients successfully underwent day surgery of phacoemulsification combined with intraocular lens im-plantation. All cases recovered without incision infection.Conclusion: Preoperative preparation, and intraoperative and postoperative prevention and control of infection serve as vital measures for effectively avoiding the incidence of incision in-fection in patients undergoing day cataract surgery. (Eye Science 2014; 29:182-185)

  20. 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

    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...

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

    Institute of Scientific and Technical Information of China (English)

    Ming; Chen; Christian; Swinney; Mindy; Chen

    2015-01-01

    AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery(FLACS) and traditional phacoemulsification for the first 18 mo of FLACS use at a private surgical center in Hawaii.METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined.All surgeries were performed at a single surgical center in Hawaii. The presence of intraoperative complications was used as the main outcome measure. Approval was obtained from the institutional review board of the University of Hawaii.RESULTS: The overall complication rate for FLACS was 1.8%, while that of the traditional procedure was5.8%(P <0.05). A majority of the surgeons(80%) had a lower complication rate while using FLACS.CONCLUSION: FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients.

  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. 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

  4. 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

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

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    Arelys Caraballo Díaz

    2012-03-01

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

  6. Corneoscleral abscess resulting from a broken suture after cataract surgery.

    Science.gov (United States)

    Cameron, J A; Huaman, A

    1994-01-01

    An 82-year-old man had pain and decreased vision in his right eye 15 months after uncomplicated cataract surgery. Examination revealed a large corneoscleral abscess with a 2 mm x 1 mm area of fluorescein staining at the base of a broken protruding 10-0 nylon suture. Streptococcus pneumoniae was isolated from both the suture and base of the ulcer. Despite intensive topical, subconjunctival, and systemic antibiotics, a large corneal perforation developed, necessitating a 10 mm tectonic penetrating keratoplasty. Long-term follow-up of patients after cataract surgery is important and should include an inspection of the limbal wound and removal of loose or broken exposed sutures. Suture-related complications will be eliminated if clinical studies prove the safety and efficacy of sutureless cataract surgery.

  7. 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

  8. The Gender Issue in Congenital and Developmental Cataract Surgery

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    Marzieh Katibeh

    2013-01-01

    Full Text Available Purpose: To describe the demographic pattern of congenital cataract surgery at a referral ophthalmology center in Iran and to evaluate any possible difference between the genders. Methods: Subjects aged 15 years or less scheduled for cataract surgery were enrolled in this cross-sectional study. Data was retrieved from the electronic medical records according to the ICD-10 coding system. Age and proportion of operations by sex were the main parameters of interest. We employed analysis of covariance to compare age at surgery and logistic regression to obtain the trend for the number of cataract procedures in boys and girls. Results: Overall, 314 congenital cataract procedures were performed during the study period, 55 (17.5% of which were related to second eye surgery. Operated eyes belonged to male subjects in 172 (54.8% cases and female subjects in 142 (45.2% cases. Mean age at operation for both first and second eyes was 3.2±3.0 years overall, and 3.1±2.9 versus 3.4±3.0 years in girls and boys, respectively (P= 0.62. Surgery was performed before one year of age in 33.2% and before 5 years in 75% of cases. Among patients undergoing second eye surgery, girls presented significantly later than boys (at 4.2±3.3 vs. 2.6±1.7 years, P= 0.012. Conclusion: The rate of congenital/infantile cataract surgery in boys was almost 10% higher than girls. We observed a significant difference only regarding age at second eye surgery which comprised 17.5% of all operations. One third and two thirds of the procedures were performed under the age of one and five years, respectively.

  9. Pros and cons of immediately sequential bilateral cataract surgery (ISBCS).

    Science.gov (United States)

    Grzybowski, Andrzej; Wasinska-Borowiec, Weronika; Claoué, Charles

    2016-01-01

    Immediately sequential bilateral cataract surgery (ISBCS) is currently a "hot topic" in ophthalmology. There are well-documented advantages in terms of quicker visual rehabilitation and reduced costs. The risk of bilateral simultaneous endophthalmitis and bilateral blindness is now recognized to be minuscule with the advent of intracameral antibiotics and modern management of endophthalmitis. Refractive surprises are rare for normal eyes and with the use of optical biometry. Where a general anesthetic is indicated for cataract surgery, the risk of death from a second anesthetic is much higher than the risk of blindness. A widely recognized protocol from the International Society of Bilateral Cataract Surgeons needs to be adhered to if surgeons wish to start practicing ISBCS.

  10. Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery

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    Lav Kochgaway

    2013-01-01

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

  11. 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.

  12. Simultaneous Penetrating Keratoplasty and Cataract Surgery

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    Mohammad-Ali Javadi

    2013-01-01

    Full Text Available Purpose: To determine the clinical outcomes of simultaneous penetrating keratoplasty (PK, cataract removal and intraocular lens implantation (triple procedure, and to compare the safety and efficacy of two different cataract extraction techniques during the course of PK. Methods: This retrospective comparative study was conducted on patients who had undergone a triple procedure. The technique of cataract extraction was either opensky extracapsular cataract extraction (ECCE or phacoemulsification (PE. In the ECCE group, the posterior chamber intraocular lens (PCIOL was implanted in the ciliary sulcus, while in the PE group PCIOLs were fixated within the capsular bag. Outcome measures included best spectacle corrected visual acuity (BSCVA, refractive results, graft clarity and complications. Results: Seventy-six eyes of 69 consecutive patients with mean age of 61.4±14.2 years were enrolled. Mean follow-up period was 61.4±37.2 months over which mean BSCVA was significantly improved from 1.40±0.68 to 0.44±0.33 LogMAR (P<0.001. Mean postoperative spherical equivalent refractive error was -2.13±3.02 D, which significantly differed from the target refraction (-0.73±0.29 D, P=0.004. At final follow-up, 89.5% of the corneal grafts remained clear. Conclusion: The triple procedure is a safe and effective approach to restore vision in patients with coexisting corneal pathologies and cataracts. However, unacceptable postoperative refractive error can be anticipated.

  13. 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.

  14. 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.

  15. 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.

  16. 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).

  17. 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.

  18. 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.

  19. 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

  20. Conjunctival inclusion cysts following small incision cataract surgery

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    Narayanappa Shylaja

    2010-01-01

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

  1. 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.

  2. Cataract surgery in patients with neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Kessel, Line; Koefoed Theil, Pernille; Lykke Sørensen, Torben;

    2016-01-01

    being treated with a median of 10 (range 3-36) anti-VEGF injections for neovascular AMD. Visual acuity improved by a mean of 7.1 [95% confidence interval (CI) 4.6-9.6] ETDRS letters in the first 6 months after cataract surgery. The need of anti-VEGF injections did not change after cataract surgery...... in electronic databases managing anti-VEGF injections and cataract surgery. We compared Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity and frequency of anti-VEGF injections before and after cataract surgery. RESULTS: We identified 89 eyes from 89 patients who had cataract surgery after...... AMD. Cataract surgery was not associated with an increased need for anti-VEGF treatment and patients who were in active anti-VEGF treatment had better visual outcomes than patients who had cataract surgery after long injection-free periods....

  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. 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.

  5. 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.

  6. 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...... literature search in the Embase, PubMed, and CENTRAL databases within the Cochrane Library. We included randomized clinical trials (RCTs) if they compared toric with non-toric IOL implantation (± relaxing incision) in patients with regular corneal astigmatism and age-related cataracts. We assessed the risk...

  7. Results of cataract surgery in the very elderly population

    Directory of Open Access Journals (Sweden)

    Michalska-Małecka K

    2013-08-01

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

  8. A COMPARATIVE STUDY OF THE AMOUNT OF ASTIGMATISM FOLLOWING CONVENTIONAL EXTRACAPSULAR CATARACT EXTRACTION AND MANUAL SMALL INCISION CATARACT SURGERY

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    Rajkumari Bigyabati

    2016-06-01

    Full Text Available BACKGROUND Cataract is the principal cause of avoidable blindness in India and throughout the world. Surgical removal of the cataractous lens remains the only effective treatment for management of cataract blindness. The success of cataract surgery is determined by best and earliest visual recovery. But the occurrence of postoperative astigmatism has become a major hurdle in achieving this goal. AIMS The study was designed to compare the amount of astigmatism following conventional extracapsular cataract extraction (ECCE and manual small incision cataract surgery (SICS. MATERIALS AND METHODS The study was carried out in 100 eyes of 75 patients aged between 50 and 80 years admitted for cataract surgery. Out of these, 50 eyes were operated by conventional extracapsular cataract extraction and 50 eyes by manual small incision cataract surgery. The patients were followed up at 2 nd , 4 th , 6 th and 8 th weeks. At each follow-up visual acuity, refraction and acceptance and keratometry were recorded and the findings analysed for astigmatism. RESULTS In the current study, the mean (SD astigmatism developed at the end of the 2 nd , 4 th and 6 th of follow-up was significantly lower in the SICS group as compared to the ECCE group (P<0.000. At the end of 8 weeks of follow-up, the mean (SD astigmatism of the SICS group was 0.64±0.56 D as compared to the mean (SD of the ECCE group of 1.39±86 D and the difference was found to be significant (p<0.014. CONCLUSION The current study concludes that manual small incision cataract surgery is a better technique to control postoperative astigmatism than conventional extracapsular cataract extraction.

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

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    Udaya Kumar

    2015-11-01

    Full Text Available The aim of study was to achieve complete cortical cleanup and avoid problems related with sideport during Small Incision Cataract Surgery (SICS so as to have a good visual out come with minimal recovery period, and a better quality of life. After nucleus delivery, cortical cleanup is an important step in any cataract surgical procedure. Cortex especially subincisional area (11 to 1 o’clock is difficult to manage intraoperatively. Bimanual irrigation aspiration through two side ports, aspiration by J cannula, iris massage manoeuver, ice cream scoop manoeuver are various techniques of cortical matter aspiration. We acquired the technique of aspiration of subincisional cortex without using side port in all cases by paying attention on type of cataract, status of pupil, use of Adrenalin mixed BSS intraoperatively, Tunnel construction, Capsulorhexis size and capsular rim size at 12 o’clock. MATERIAL AND METHODS In this retrospective study of 1 year from 2013 to 2014, 60 patients (60 eyes aged 40 years or older attending the General Ophthalmic Department were included in the study group with another group of 60 patients (60 eyes as controls. The study was on age related cataracts which are basically. 1 Cortical cataract 2 Nuclear cataract 3 Subcapsular cataract. Proper assessment of cortical cataract based on its maturity such as a Immature b Mature c Hyper mature and d Morgagnian cataract, nucleus for its opalescence and color, size of posterior subcapsular opacity and pupillary status (Dilating well or not with mydriatics were taken into consideration. Eyes with pseudoexfoliation having poor pupillary dilation were also included. Eyes with congenital anomalies, congenital cataract, gross corneal and retinal pathologies, and glaucoma were excluded. RESULTS Among 60 study eyes in the study group 35 presented with cortical, 20 with nuclear cataract and 5 with posterior subcapsular cataracts. In 58(96.6% cases, sideport was not required; 3(5% eyes

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

    Science.gov (United States)

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

    2012-09-01

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

  11. Argon laser photocoagulation of cyclodialysis clefts after cataract surgery

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-06-01

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

  12. The impact of cataract surgery on vision-related quality of life for bilateral cataract patients in Ho Chi Minh City, Vietnam: a prospective study

    OpenAIRE

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

    2014-01-01

    Background To determine the impact of cataract surgery on vision-related quality of life (VRQOL) and examine the association between objective visual measures and change in VRQOL after surgery among bilateral cataract patients in Ho Chi Minh City, Vietnam. Methods A cohort of older patients with bilateral cataract was assessed one week before and one to three months after first eye or both eye cataract surgery. Visual measures including visual acuity, contrast sensitivity and stereopsis were ...

  13. 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.

  14. 白内障手术中激光的应用%The Application of Laser in Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    李新

    2011-01-01

    白内障手术是眼科最常见的手术之一.最近20多年来,为了追求白内障手术切口更小、术中热损伤更小、安全性更高,不同波长的激光开始应用于白内障晶体核的乳化.近年来已经广泛用于角膜屈光手术的飞秒激光开始应用于白内障手术的各个环节,如隧道切口的制作、前囊的切开、白内障晶体核的乳化等.在此就白内障手术中激光的应用予以综述.%Cataract surgery is one of the most common surgery in Ophthahnology. In the past twenty years, different wavelength of laser has begun to be used in emulsify lens in cataract surgery in order to pursue the smaller incision, the less energy use, and make the surgery more security and stability. The femtosecond laser what has been widely used in corneal refractive surgery begin to be used in different step of cataract surgery in recent years, such as tunnel incision make, capsulorrhexis, emulsification of cataract lens, and so on. This article reviewed the applications of laser in cataract surgery.

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

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    Marcelo Carvalho Ventura

    2013-08-01

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

  16. [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

  17. Irrigation dynamic pressure-assisted hydrodissection during cataract surgery

    Science.gov (United States)

    Masuda, Yoichiro; Iwaki, Hisaharu; Kato, Noriko; Takahashi, Genichiro; Oki, Kotaro; Tsuneoka, Hiroshi

    2017-01-01

    The irrigation dynamic pressure-assisted hydrodissection technique (irrigation-hydro [iH]) does not require performing manual hydrodissection using a syringe and cannula to achieve cortical-capsular cleavage during cataract surgery. Since the iH technique uses the phaco tip to intentionally vacuum the intraocular fluid in order to induce the irrigation dynamic pressure for cortical-capsular cleavage, there is a reduction in the intraocular pressure (IOP) from the bottle-height-dependent hydrostatic pressure. Thus, since the peak irrigation pressure derived from the phaco tip sleeve will be limited by the height of the irrigation fluid bottle, this is advantageous in helping to avoid excessively high IOP during cortical-capsular hydrodissection. Using this technique, we were able to effectively perform phacoemulsification without complications in 607 of 609 cataract eyes. Our findings show that utilization of the iH technique would be of benefit to patients, as it prevents high-pressure hydrodissection-related complications, such as capsular block syndrome and tears in the anterior hyaloid membrane during cataract surgery. PMID:28243054

  18. Trypan blue-assisted posterior capsulorhexis in pediatric cataract surgery

    Science.gov (United States)

    Lotfy, Ayman; Abdelrahman, Ayman

    2017-01-01

    Purpose To evaluate the safety and efficacy of staining the posterior capsule with trypan blue during capsulorhexis in pediatric cataract surgery. Patients and methods This was a prospective randomized comparative study carried out at Alpha Vision Center, Zagazig, Egypt. This study included 2 groups of children with pediatric cataract randomly allocated to undergo irrigation and aspiration. In the trypan group, which included 11 eyes, trypan blue was used to stain the posterior capsule during posterior capsulorhexis. In the control group, which included 10 eyes, no staining was performed. All surgeries were performed by the same surgeon. The 2 groups were compared for criteria such as completion of capsulorhexis, disruption of vitreous face and in-the-bag intraocular lens implantation. Results This study included 21 eyes of 16 patients (age range: 6 months–4 years). A statistically significant difference was observed for the following parameters between the 2 groups: capsulorhexis completion (P=0.04), vitreous face disruption (P=0.01) and in-the-bag intraocular lens implantation (P=0.022). Conclusion This study suggests that staining of the posterior capsule during capsulorhexis in pediatric cataract operation gives better results than capsulorhexis without staining. The stain changes the capsule texture making capsulorhexis easier with fewer complications. PMID:28182152

  19. Keratitis by Aspergillus flavus infection after cataract surgery

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    João Luiz Pacini Costa

    Full Text Available ABSTRACT We report a case of keratis infection after cataract phacoemulsification with intraocular lens implantation in a 65-year-old female patient. The patient initially underwent cataract surgery on the right eye. Intraocular inflammation appeared on the second post-operative day and was initially treated as Toxic Anterior Segment Syndrome (TASS. The inflammation was reduced and vision improved initially but very aggressive and progressive keratitis destroyed the cornea due to the delay in correct diagnosis. Aspergillus flavus was isolated from a biopsy.The infection was treated with antifungal agents and loss of the eye was avoided by total corneal transplantation associated with Gundersen conjunctiva cover. To restore the lost vision, a second penetrating corneal graft with removal of the conjunctiva cover was performed 17 months later. The final best-corrected vision was 20/40 but prognosis for long-term graft survival is poor.

  20. The effect of blue-blocking and neutral intraocular lenses on circadian photoentrainment and sleep one year after cataract surgery

    DEFF Research Database (Denmark)

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

    2017-01-01

    PURPOSE: To compare the long-term effect on circadian photoentrainment and sleep in patients implanted with neutral and blue-blocking intraocular lenses 1 year after cataract surgery. METHODS: Randomized, controlled trial involving 67 patients with age-related cataract. Intervention was cataract...... compared with neutral IOLs. Cataract surgery improved the response of ipRGCs and sleep quality. However, the effect of cataract surgery on sleep quality may be unrelated to circadian photoentrainment....

  1. 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

  2. Iris recognition as a biometric method after cataract surgery

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    Roizenblatt Jaime

    2004-01-01

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

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

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    Cannon Paul S

    2005-06-01

    Full Text Available Abstract Background The management of diabetic patients with refractory macular oedema or patients with no adequate pre-operative view to administer laser treatment provide a challenge to the ophthalmologist. We wished to assess the use, safety and effect of intravitreal triamcinolone injection at the time of cataract surgery in patients with diabetic foveal oedema and sight limiting lens opacities. Method This was a longitudinal non-randomised prospective pilot study in 18 eyes (12 patients. All patients had visually significant lens opacities and either persistent diabetic foveal oedema unresponsive to laser treatment-group A, or foveal oedema with no adequate pre-operative view for laser treatment- group B. The cataract surgery was carried out under full aseptic technique using a self-sealing temporal incision and a foldable acrylic lens. Intravitreal triamcinolone was given infratemporally pars plana at the completion of the cataract surgery. The patients were reviewed at day 5, 2 weeks, 2 months and then every 3 months as required. The Wilcoxin matched-pairs test was used to assess the significance of the improvement in visual acuity at 2 months. Results Twelve patients with a total of 18 eyes were included in the study. There were 10 patients (15 eyes in group A and 3 patients (3 eyes in group B. Preoperatively 16 of the 18 eyes had a visual acuity of 6/24 or worse. Postoperatively 83% of patients had completely dry foveae at 2 weeks. Best-corrected visual acuities at two months review ranged from 6/6 to CF with 9 eyes (50% achieving 6/12 or better (7 eyes (47% in group A and 2 eyes (67% in group B. Three eyes had no recorded improvement in visual acuity, but no eyes had deterioration in acuity. The improvement in visual acuity was significant at p = 0.001. There were no significant sight threatening complications. Conclusion Intravitreal triamcinolone has been shown to lead to an improvement in macular oedema and visual improvement in

  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. 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

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

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    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.

  7. 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.

  8. 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.

  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. Ten-year Etiologic Review of Chinese Children Hospitalized for Pediatric Cataracts

    Institute of Scientific and Technical Information of China (English)

    Zixun Song; Daixin Zhao; Cancan Lv; Wei Pu; Wei Xiao

    2014-01-01

    Purpose:.Our aim was to obtain a better understanding of the etiologies and characteristics of pediatric cataracts treated at a single facility in China.Methods:.Medical records accrued over a 10-year period (from August, 2003 to July, 2013) at Shengjing Hospital of China Medical University were reviewed retrospectively , ide ntifying all patients treated for various subtypes of pediatric cataract..A database with 367 subjects under 14 years of age (598, including second-round surgeries) was generated.Results:.Of this cohort (n =367; males: 232, 63.2% ; fe-males: 135, 36.8%), 200 patients (54.5%) had bilateral cataracts, and 258 (70.3%) were under 3 years of age. In all age groups and in all subtypes of pediatric cataract,.males were most commonly affected..Congenital cataract was the most prevalent subtype, accounting for 296 patients (80.7%). Most congeni-tal cataracts were associated with other ocular or systemic ab-normalities;.and in 48 patients (16.22%),.they were heredi-tary..Traumatic cataract was the most common subtype (85.92%) of acquired cataract. The few instances of cataracts due to steroids (n=3) or to metabolic disorders (n=2) occurred in males and involved both eyes.Conclusion: The majority of pediatric cataracts in this patient population were congenital in nature. A significant lag in oph-thalmologic evaluation of Chinese infants was evident and should be addressed by educating both children and parents on risk factors for cataract development. Regular assessments are especially important in children subjected to long-term sys-temic steroid treatments. (Eye Science 2014; 29:138-142)

  11. 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....

  12. 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.

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

    Science.gov (United States)

    Zhu, J; Li, Z H

    2015-06-18

    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.

  14. 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.

  15. Perioperative prophylaxis for endophthalmitis after cataract surgery in Iran

    Directory of Open Access Journals (Sweden)

    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.

  16. Cataract surgery causes biomechanical alterations to the eye detectable by Corvis ST tonometry

    Science.gov (United States)

    Kato, Yoshitake; Nakakura, Shunsuke; Asaoka, Ryo; Matsuya, Kanae; Fujio, Yuki; Kiuchi, Yoshiaki

    2017-01-01

    Purpose Modern cataract surgery is generally considered to bring about modest and sustained intraocular pressure (IOP) reduction. However, the pathophysiological mechanism for this remains unclear. Moreover, a change in ocular biomechanical properties after surgery can affect the measurement of IOP. The aim of the study is to investigate ocular biomechanics, before and following cataract surgery, using Corvis ST tonometry (CST). Patients and methods Fifty-nine eyes of 59 patients with cataract were analyzed. IOP with Goldmann applanation tonometry (IOP-G), axial length, corneal curvature and CST parameters were measured before cataract surgery and, up to 3 months, following surgery. Since CST parameters are closely related to IOP-G, linear modeling was carried out to investigate whether there was a change in CST measurements following cataract surgery, adjusted for a change in IOP-G. Results IOP-G significantly decreased after surgery (mean±standard deviation: 11.8±3.1 mmHg) compared to pre-surgery (15.2±4.3 mmHg, Pcataract surgery (Pcataract surgery (Pcataract surgery. Conclusion Corneal biomechanical properties, as measured with CST, were observed to change significantly following cataract surgery. Trial registration Japan Clinical Trials Registry UMIN000014370 PMID:28222145

  17. 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.

  18. Conjunctival sac bacterial flora isolated prior to cataract surgery

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    Suto C

    2012-01-01

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

  19. Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

    DEFF Research Database (Denmark)

    Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi

    2017-01-01

    PURPOSE: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. DESIGN: Multicenter masked clinical trial. PARTICIPANTS: Eighteen cataract...... surgeons with different levels of experience. METHODS: Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. MAIN OUTCOME MEASURES: Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated...... task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. RESULTS: Novices (non...

  20. 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

    preoperatively, 1-3 days postoperatively and 3 months postoperatively. RESULTS: Three days postoperatively, mean ECL was 249 cells/mm(2) (SD ± 744) (9.1%) by FLACS and 235 cells/mm(2) (SD ± 681) (8.2%) by CPS (p = 0.87). Three months postoperatively, mean ECL was 274 cells/mm(2) (SD ± 358) (11.4%) by FLACS......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...... compared with 333 cells/mm(2) (SD ± 422) (13.9%) by CPS, (p = 0.30) 3 months postoperatively, hexagonality was decreased by 1.8% (SD ± 30) by FLACS and by 1.4% (SD ± 13) by CPS, (p = 0.84). The mean absolute difference from the attempted refraction was 0.37 dioptres (D) (SD ± 0.33) by FLACS and 0.41 D (SD...

  1. 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.

  2. WHEN TO POSTPONE CATARACT SURGERY: TAKING IN CONSIDERATION PATIENTS' QUALITY OF LIFE

    Directory of Open Access Journals (Sweden)

    Jovanović Miloš

    2015-12-01

    Full Text Available Purpose: Assessment of complication in surgery of complicated cataracts and option of postponement of surgery. Setting: Clinic for eye diseases, Clinical Centre of Serbia Methods: This was a retrospective observational case series. Results: In 16 patients subjected to cataract surgery by method of phacoemulsification, three experienced complications during surgery. Two experienced rupture of posterior lens capsule and prolapse of the vitreous body, and one, expulsive hemorrhage. The visual acuity in all three patients was lesser than the preoperative visual acuity. In the second group of 16 patients, after having been acquainted with the survey, the cataract surgery was postponed and the patients were controlled after one year. The cataract progressed just partially in certain patients and all the patients were satisfied with the status of their vision and did not demand surgery. Conclusions: Cataract surgery in complicated cases may be accompanied by complications with uncertain postoperative visual results. Therefore, in patients with complicated cataracts and relatively preserved visual acuity, it is necessary to be careful with proposing surgery and often obey their wish to postpone surgery. This should be done particularly with patients of advanced age, patients with poor general status of life and in monoculuses

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

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    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.

  4. Morphological features in eyes with endophthalmitis after cataract surgery

    DEFF Research Database (Denmark)

    Solborg Bjerrum, Søren; Prause, Jan Ulrik; Fuchs, Helle Josefine

    2016-01-01

    PURPOSE: To assess the ocular damage that occurs in eyes with postoperative endophthalmitis after cataract surgery (PE) based on optical coherence tomography (OCT) retinal scans of PE eyes and histological specimens of eyes removed due to PE. METHODS: Case-control study and case series. Fifty......-one patients who had previously developed PE were clinically examined with OCT scans of the retina of both eyes. Histological specimens of 10 removed PE eyes were studied. RESULTS: The OCT scans showed that PE eyes had a statistically significantly higher frequency of hyperdense elements on the internal...... limiting membrane (ILM) of the retina (14 eyes versus 3 eyes, p = 0.015) and a higher degree of retinal atrophy temporal to the fovea (13 eyes versus 1 eye, p = 0.013) compared to fellow eyes. The histopathological analyses showed the formation of epiretinal membranes, derangement of all retinal layers...

  5. Correction of low corneal astigmatism in cataract surgery

    Institute of Scientific and Technical Information of China (English)

    Pia; Leon; Marco; Rocco; Pastore; Andrea; Zanei; Ingrid; Umari; Meriem; Messai; Corrado; Negro; Daniele; Tognetto

    2015-01-01

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

  6. Post-cataract surgery visual disturbance in a retinitis pigmentosa patient with asteroid hyalosis.

    Science.gov (United States)

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

    2011-05-01

    A patient with retinitis pigmentosa showed visual disturbances following successful cataract surgery. He had a dense asteroid hyalosis in the eye before cataract surgery. After the surgery he noticed that his vision became worse. The visual disturbance was explained as being caused by the progression of retinal degeneration. Although the electroretinogram was non-recordable, the degeneration of macular area appeared relatively small. We considered that dense asteroid hyalosis was responsible for his visual disturbances, and pars plana vitrectomy (PPV) was performed to remove the asteroid hyalosis. After the PPV, rapid improvement of his visual acuity was observed. Cataract surgery may affect the status of asteroid hyalosis and cause rapid visual loss. PPV should be considered for retinitis pigmentosa patients with dense asteroid hyalosis, especially when a large decrease in visual acuity is noted shortly after cataract surgery.

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

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    Yoko Jingami

    2011-08-01

    Full Text Available A patient with retinitis pigmentosa showed visual disturbances following successful cataract surgery. He had a dense asteroid hyalosis in the eye before cataract surgery. After the surgery he noticed that his vision became worse. The visual disturbance was explained as being caused by the progression of retinal degeneration. Although the electroretinogram was non-recordable, the degeneration of macular area appeared relatively small. We considered that dense asteroid hyalosis was responsible for his visual disturbances, and pars plana vitrectomy (PPV was performed to remove the asteroid hyalosis. After the PPV, rapid improvement of his visual acuity was observed. Cataract surgery may affect the status of asteroid hyalosis and cause rapid visual loss. PPV should be considered for retinitis pigmentosa patients with dense asteroid hyalosis, especially when a large decrease in visual acuity is noted shortly after cataract surgery.

  8. 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.

  9. Increasing access to cataract surgery in a rural area--a support strategy.

    Science.gov (United States)

    Malhotra, R; Uppal, Y; Misra, A; Taneja, D K; Gupta, V K; Ingle, G K

    2005-01-01

    The objectives of the study were to elicit the reasons for not undergoing cataract surgery from those having cataract, aged 50 years and above, in a village community and, develop, implement and assess a support strategy for getting cataract surgery done. The leading reasons identified were monetary constraints (18.8%), transport difficulty (17.4%), lack of awareness about cataract in the eyes (17.4%) and lack of escort (14.5%). Based on the identified reasons, patients were transported in groups to a government eye hospital for free surgery after completion of required pre operative formalities at the village health center itself. Out of 65 eligible individuals, 66.2% underwent surgery. The success of the approach was evident by perceived improvement in vision in 88.4% operated patients, occurrence of only few minor complications and a satisfactory hospital experience being reported by all.

  10. Efficacy of 2% Lidocaine Injection as a Topical Agent in Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    Wenyong Huang; Bin Liu; Jiewei Liu; Jinxing Xu; Zhende Lin

    2003-01-01

    Purpose: To determine whether 2% Lidocaine injection is an effective topical anesthetic agent for non-phaco small incision cataract surgery.Setting: Charity eye clinic supported by Hellen Keller International.Methods:One hundred and twenty-five consecutive cataract surgery patients received topical anesthesia with 2% Lidocaine injection solution just 1 and 0.5 minutes prior to non-phaco small incision cataract extraction and intraocular lens implantation. Each patient was asked about pain or piessure sensation during the operation.Results: The surgeon felt ease in the operations. Many patients (93/125) were comfort during the whole surgery. Only 9 patients′ score was above level 3,mostly complained during the nucleus extraction; Among those whose score was level 1~2, 82.6%(19/23)claimed discomfort at middle of the operation (nucleus extraction) or the beginning (creating the conjunctival flap).Conclusion: Lidocaine injection solution(2%) was an effective topical anesthesia agent in cataract surgery.

  11. 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.

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

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    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.

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

    Science.gov (United States)

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

    2012-01-01

    Purpose. To compare the feasibility of cataract surgery with implantation of endocapsular supporting devices and intraocular lens (IOL) in subluxated cataract in phacoemulsification and manual small incision cataract surgery (MSICS). Design. Prospective randomized intervention case series consisting of 60 eyes with visually significant subluxated cataract. Method. The patients were randomly distributed between the two groups equally. The main outcome measure was implantation of in-the-bag IOL, 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 (P = 0.16). Both groups, achieved similar best corrected visual acuity (P = 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. PMID:22523646

  14. 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.

  15. Dealings between Cataract and Retinal Reattachment Surgery in PVR

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    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.

  16. 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.

  17. 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

  18. 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

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

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    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.

  20. Visual outcome and impact on quality of life after surgeries differ in children operated for unilateral and bilateral cataract (Pune study 2011

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    Mukesh Paryani

    2012-01-01

    Conclusion: Vision and VQL improved in children with unilateral and bilateral cataract. However, it was better 6 months following surgery in children with bilateral cataract than in children with unilateral cataract.

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

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    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.

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

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    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. 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

    surgery induces a regional increase in grey matter in areas V1 and V2 of the visual cortex. Results:  In all patients, cataract surgery immediately improved visual acuity, contrast sensitivity and mean sensitivity in the visual field of the operated eye. The improvement in vision was stable throughout...... the 6 weeks after operation. VBM revealed a regional expansion of grey matter volume in area V2 contralateral to the operated eye during the 6-week period after surgery. Individual increases in grey matter were predicted by the symmetry in visual acuity between the operated eye and nonoperated eye....... The more symmetrical visual acuity became after unilateral cataract surgery, the more pronounced was the grey matter increase in visual cortex. Conclusion:  The data suggest that cataract surgery triggered a use-dependent structural plasticity in V2 presumably through improved binocular integration...

  4. 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 ...

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

    Science.gov (United States)

    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.

  6. Effect of cataract surgery volume constraints on recently graduated ophthalmologists: a population-based cohort study

    Science.gov (United States)

    Campbell, Robert J.; El-Defrawy, Sherif R.; Bell, Chaim M.; Gill, Sudeep S.; Hooper, Philip L.; Whitehead, Marlo; Campbell, Erica de L.P.; Nesdole, Robert; Warder, Daniel; ten Hove, Martin

    2017-01-01

    BACKGROUND: Across Canada, graduates from several medical and surgical specialties have recently had difficulty securing practice opportunities, especially in specialties dependent on limited resources such as ophthalmology. We aimed to investigate whether resource constraints in the health care system have a greater impact on the volume of cataract surgery performed by recent graduates than on established physicians. METHODS: We used population-based administrative data from Ontario for the period Jan. 1, 1994, to June 30, 2013, to compare health services provided by recent graduates and established ophthalmologists. The primary outcome was volume of cataract surgery, a resource-intensive service for which volume is controlled by the province. RESULTS: When cataract surgery volume in Ontario entered a period of government-mandated zero growth in 2007, the mean number of cataract operations performed by recent graduates dropped significantly (−46.37 operations/quarter, 95% confidence interval [CI] −62.73 to −30.00 operations/quarter), whereas the mean rate for established ophthalmologists remained stable (+5.89 operations/quarter, 95% CI 95% CI −1.47 to +13.24 operations/quarter). Decreases in service provision among recent graduates did not occur for services without volume control. The proportion of recent graduates providing exclusively cataract surgery increased over the study period, and recent graduates in this group were 5.24 times (95% CI 2.15 to 12.76 times) more likely to fall within the lowest quartile for cataract surgical volume during the period of zero growth in provincial cataract volume (2007–2013) than in the preceding period (1996–2006). INTERPRETATION: Recent ophthalmology graduates performed many fewer cataract surgery procedures after volume controls were implemented in Ontario. Integrated initiatives involving multiple stakeholders are needed to address the issues facing recently graduated physicians in Canada. PMID:27920012

  7. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  9. 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.

  10. 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.

  11. 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.

  12. Congenital cataract: prevalence and surgery age at Zhongshan Ophthalmic Center (ZOC.

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    Haotian Lin

    Full Text Available Congenital cataract (CC is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22% of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47% of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93% of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%, nystagmus (6.16%, and refractive error (3.65%. In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.

  13. Congenital cataract: prevalence and surgery age at Zhongshan Ophthalmic Center (ZOC).

    Science.gov (United States)

    Lin, Haotian; Yang, Ye; Chen, Jingjing; Zhong, Xiaojian; Liu, Zhaochuan; Lin, Zhuoling; Chen, Wan; Luo, Lixia; Qu, Bo; Zhang, Xinyu; Zheng, Danying; Zhan, Jiao; Wu, Hanfu; Wang, Zhirong; Geng, Yu; Xiang, Wu; Chen, Weirong; Liu, Yizhi

    2014-01-01

    Congenital cataract (CC) is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22%) of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47%) of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old) became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93%) of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%), nystagmus (6.16%), and refractive error (3.65%). In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.

  14. 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.

  15. Cataract surgery in a patient with severe chronic iritis and corneal endothelial damage.

    Science.gov (United States)

    Yasukawa, T; Suga, K; Yokoo, N; Asada, S

    1998-07-01

    We report a patient with broad anterior synechias and corneal endothelial damage. The patient had chronic iritis and cataracts secondary to chronic iritis in both eyes. Because the right eye had broad anterior synechias and severe corneal endothelial damage, extracapsular cataract extraction and intraocular lens implantation were performed through the basal iris. Good postoperative visual acuity was obtained. The cornea showed little trauma from the surgery and remained clear 36 months postoperatively.

  16. [Post-operative residual astigmatism after cataract surgery: Current surgical methods of treatment].

    Science.gov (United States)

    Pisella, P-J

    2012-03-01

    Residual astigmatism after cataract surgery can be corrected by three different techniques: classic limbal relaxing incisions, easy to perform but with limited precision; laser refractive surgery (PRK or Lasik), additionally allowing for correction of spherical equivalent; and more recently the use of a piggyback toric intraocular lens in the ciliary sulcus.

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

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    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.

  18. 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.

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

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    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.

  20. Incidence and pattern of dry eye after cataract surgery.

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    Ngamjit Kasetsuwan

    Full Text Available PURPOSE: To evaluate the incidence and severity pattern of dry eye after phacoemulsification. SETTING: King Chulalongkorn Memorial Hospital, Bangkok, Thailand. DESIGN: Prospective descriptive study. METHODS: Samples were collected from ninety-two uncomplicated cataract patients who were 18 years old or older. Dry eye incidence and pattern were analyzed at days 0, 7, 30 and 90 after phacoemulsification using (1 Ocular Surface Disease Index (OSDI questionnaire, (2 tear break up time (TBUT, (3 Oxford ocular surface staining system, and (4 Schirmer I test without anesthesia. RESULTS: Seven days after phacoemulsification, the incidence of dry eye was 9.8% (95% confidence interval; 3.6-16.0%. The severity of dry eye peaked seven days post-phacoemulsification and was measured by OSDI questionnaire and all three clinical tests. Within thirty days and 3 months post-surgery, both the symptoms and signs showed rapid and gradual improvements, respectively. However, dry eye post-phacoemulsification was not significantly associated with sex and systemic hypertension (P = 0.26, 0.17 and 0.73, respectively. CONCLUSIONS: The incidence of dry eye after phacoemulsification was 9.8%. Symptoms and signs of dry eye occurred as early as seven days post-phacoemulsification and the severity pattern improved over time. We recommend that ophthalmologists should evaluate patients both before and after phacoemulsification to prevent further damage to the ocular surface and able to manage the patient promptly and effectively so the patient will not have a poor quality of life and vision due to dry eye syndrome.

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

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    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

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

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    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.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

  5. 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.

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

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    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.

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

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    Thomas R

    2000-01-01

    Full Text Available A surgical approach designed to reliably attain the modern goal of small incision cataract surgery 99.8% of the time is described. Phacoemulsification as well as a manual small incision technique is utilised to achieve the desired outcome as often as possible and for all types of cataracts. The logic, and required surgical steps are described and illustrated. This surgical technique allows the advantages of small incision surgery to be reliably achieved. The method is flexible and allows decisions and steps to be modified depending on the skill and comfort zone of the individual surgeon.

  8. 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

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

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    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.

  10. 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.

  11. 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 ...

  12. Quality of life after first- and second- eye cataract surgery on community project in Lombok Island, West Nusa Tenggara, Indonesia

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    Tjahjono D. Gondhowiardjo

    2013-05-01

    Full Text Available Background: This study aims to assess the quality of life and the time trade off-utility value of the first eye cataract surgery and the second eye cataract surgery in Lombok Island-Indonesia. Methods: This was an epidemiologic survey study on community of cataract surgery. Evaluations of quality of life (QoL and time trade-off (TTO were performed using questionnaire prior and three weeks after cataract surgeries who had either first (group A or second eye cataract surgery (group B. Personal data was noted especially on self-care, mobility, socially, and mentally status. Data was analyzed by chi-square test for categorical data and unpaired t-test or Mann-Whitney test for numeric data. Results: A total of 77 subjects was included in this study, there were 50 subjects in group A and 27 subjects in group B. Elements of QoL were improved after surgeries including self care, mobility, social, and mental status in both groups (p < 0.001. The modified TTO was accepted in 35 subjects in group A and 22 subjects in group B. Quality of life was improved in 46 patients in group A, there was further improvement in 22 patients in group B. The degree of patient’s expectation was good in 87% of all subjects. Conclusion: Second- eye cataract surgery showed further improvement in QoL despite better outcome of the first- eye cataract surgery. The outcome of cataract surgery conducted was relevant to the patient’s expectation. (Med J Indones. 2013;22:107-13Keywords: First and second cataract surgery, quality of life, senile cataract, time trade-off

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

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    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.

  14. Induced astigmatism after cataract surgery - a retrospective analysis of cases from the University of Port Harcourt Teaching Hospital, Nigeria

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    A. O. Adio

    2011-12-01

    Full Text Available Visual rehabilitation after cataract surgery may often be disappointing due to induction of corneal astigmatism following issues in realigning, point to point, the corneal wound margin in the process of surgery despite biometry and use of the appropriateintraocular lens. The purpose of this study is to determine the amount of surgically induced astigmatism after sutured cataract extraction-extracapsular cataract extraction (ECCE and intracapsular cataract extraction (ICCE and intraocular lens (IOLimplantation in the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Folders of all cataract patients operated on in the eye theatre of the aforenamed tertiary facility between2002 and 2006 were considered.  Relevant patient details and intraoperative and postoperative management were examined and reported upon. One hundred and fourteen eyes (114 of one hundred patients who had cataract surgeries done within the five-year period of this study were examined. ECCE + IOL implantation were examined in the period under review. The post-operative refraction objectively and subjectively was retrieved from the records of each patient. The post-operative cylinderpower (total astigmatism was recorded.Of 114 eyes, only 83 eyes (72.8% had refraction results postoperatively due to loss of fol-low-up. The total number with astigmatism was 57(68.7%. Forty-two had against-the-rule (73.7%, twelve (21.1% with-the-rule, while five (0.09% were oblique. The mean post-operative astigmatism was 1.85 D. The surgically induced corneal astigmatism was highest with ECCE with PCIOL. Astigmatism less than 2 D was highest in this group (ECCE with IOL while ICCE with ACIOL had the highest number with astigmatism in the range between 2 D and 4 D. The total astigmatism which was mainly with-the-rule (vertical plus cylinder did not seem to impair severely the post-operative visual acuity of the patients.In conclusion, surgically induced astigmatism affected almost

  15. 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.

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

    OpenAIRE

    2012-01-01

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

  17. High correlation between performance on a virtual-reality simulator and real-life cataract surgery

    DEFF Research Database (Denmark)

    Thomsen, Ann Sofia Skou; Smith, Phillip; Subhi, Yousif

    2017-01-01

    -tracking software of cataract surgical videos with a Pearson correlation coefficient of -0.70 (p = 0.017). CONCLUSION: Performance on the EyeSi simulator is significantly and highly correlated to real-life surgical performance. However, it is recommended that performance assessments are made using multiple data......PURPOSE: To investigate the correlation in performance of cataract surgery between a virtual-reality simulator and real-life surgery using two objective assessment tools with evidence of validity. METHODS: Cataract surgeons with varying levels of experience were included in the study. All...... antitremor training, forceps training, bimanual training, capsulorhexis and phaco divide and conquer. RESULTS: Eleven surgeons were enrolled. After a designated warm-up period, the proficiency-based test on the EyeSi simulator was strongly correlated to real-life performance measured by motion...

  18. Cataract Surgery after Retinal Detachment Surgery with Arruga’s Suture: Case Report

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    Erkan Ünsal

    2016-12-01

    Full Text Available A 56-year old female patient presented to our clinic with a complaint of low vision in her right eye. Twenty-two years earlier she had undergone a scleral buckling operation in her right eye because of retinal detachment. She indicated that vision in her right eye was good after the surgery but had recently been gradually declining. Best-corrected vision acuity was counting fingers at 1 meter in the right eye and 8/10 in the left eye. Anterior segment examination revealed stage 3 nuclear cataract in the right eye. Examination of the right eye was blurred and revealed an area of chorioretinal atrophy posterior to the equator, approximately 3 disc diameters in the peripapillary zone and about 2 disc diameters in the nasal papilla zone. Anteriorly of the equator there was an area of chorioretinal atrophy as well as a narrow, sharply demarcated, shiny 360⁰ suture with high buckling pressure, situated intraretinally but extending into the vitreous in some places. The structure was thought to be made of polyethylene. Around the suture there were retinal atrophic changes. After detailed explanation of the possible surgical complications and after obtaining informed consent, the right eye cataract was removed by phacoemulsification and a foldable intraocular lens was placed into the capsule. During the operation, we worked under low fluid pressure and as atraumatically as possible due to the possibility of intraocular pressure changes and the risk of the suture causing retinal and blood vessel tears or passing completely into the eye and causing intravitreal hemorrhage. A month after an uncomplicated surgery, the posterior segment examination demonstrated a reattached retina and the patient’s best corrected visual acuity was 6/10.

  19. 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.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Bernal-Delgado Enrique

    2007-04-01

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

  2. 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.

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

    DEFF Research Database (Denmark)

    Kessel, Line; Erngaard, Ditte; Flesner, Per

    2015-01-01

    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...

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

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

    2015-01-01

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

  5. 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

  6. 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.

  7. Video-Assisted Informed Consent for Cataract Surgery: A Randomized Controlled Trial

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    Ruan, Xiangcai; Tang, Haoying; Yang, Weizhong; Xian, Zhuanhua; Lu, Min

    2017-01-01

    Purpose. To investigate whether adding video assistance to traditional verbal informed consent advisement improved satisfaction among cataract surgery patients. Methods. This trial enrolled 80 Chinese patients with age-related cataracts scheduled to undergo unilateral phacoemulsification surgery. Patients were randomized into two groups: the video group watched video explaining cataract-related consent information and rewatched specific segments of the video at their own discretion, before receiving traditional verbal consent advisement; the control group did not watch the video. Outcomes included patient satisfaction, refusal to consent, time to complete the consent process, and comprehension measured by a ten-item questionnaire. Results. All 80 enrolled patients signed informed consent forms. Compared with the control group, members of the video group exhibited greater satisfaction (65% versus 86%, p = 0.035) and required less time to complete the consent process (12.3 ± 6.7 min versus 5.6 ± 5.4 min, p < 0.001), while also evincing levels of comprehension commensurate with those reported for patients who did not watch the video (accuracy rate, 77.5% versus 80.2%, p = 0.386). Conclusion. The video-assisted informed consent process had a positive impact on patients' cataract surgery experiences. Additional research is needed to optimize patients' comprehension of the video. PMID:28191349

  8. [A case report of a recurrence of Mooren's ulcer after cataract surgery].

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    Schweitzer, C; Touboul, D; Ghiringhelli, C; Colin, J

    2007-03-01

    We report the case of Mooren's ulcer recurrence after uncomplicated cataract surgery in a 61-year-old woman. This cataract developed because of repetitive inflammation of the anterior chamber and corticotherapy. Local and general corticotherapy with cyclosporin 2% drops was started in association with an anterior lamellar graft and a conjunctival recession due to a preperforation condition. Secondarily cyclophosphamide was necessary to control recurrence with a good anatomic result and an increase in visual acuity. The case updates physiopathologic and diagnostic data on this rare limbic autoimmune ulcerative disease. The diagnosis was made by histology and the dosage of specific autoantibodies against cornea. The prevention of recurrence after surgery requires a long clinical quiescent period, minimally invasive surgery long after inflammation has subsided, and a gradual tapering of corticotherapy over several weeks.

  9. 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

  10. Using qualitative methods to understand the determinants of patients' willingness to pay for cataract surgery: a study in Tanzania.

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    Geneau, Robert; Massae, Patrick; Courtright, Paul; Lewallen, Susan

    2008-02-01

    Cataract is the leading cause of avoidable blindness in Africa. There are various documented barriers to the uptake of cataract surgery, cost being one of them. There is, however, little evidence regarding patients' willingness to pay (WTP) for cataract surgery in Africa and the best way to measure it. We conducted a grounded theory study in order to understand better cataract patients' WTP for surgery in Tanzania. A total of 47 cataract patients from three regions of Tanzania were interviewed. The interviews were tape-recorded and transcribed verbatim. The coding process involved identifying emerging themes and categories and their interconnection. Our study reveals that the main factors behind patients' WTP for cataract surgery are (1) the level of perceived need for sight and cataract surgery; (2) the decision-making processes at the family level and (3) the characteristics of local eye care programs. Our study shows that WTP concerns not only the patients but also their relatives. For most patients and families, the amount of $20-$30 is deemed reasonable for a sight-restoring procedure. It does not appear realistic for eye care program managers to charge the real cost of cataract surgery at present (about US $70-in Kilimanjaro). However, eye care programs can influence WTP for cataract surgery by providing quality services and by offering adequate counseling about the procedure. The qualitative findings enriched the interpretation of a previously reported quantitative survey and yield implications for both researchers and decision-makers using or relying on WTP methodologies in developing countries.

  11. 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.

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

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    Al-Shaer Mutahar

    2010-01-01

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

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

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    Elsawy MF

    2013-06-01

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

  14. 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

  15. A COMPARISON OF PERIBULBAR WITH PARABULBAR ANAESTHESIA IN PATIENTS UNDERGOING MANUAL SMALL INCISION CATARACT SURGERY

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    Prakash

    2014-08-01

    Full Text Available PURPOSE: To study and compare the efficacy of peri bulbar anaesthesia with para bulbar anaesthesia in patients undergoing manual small incision cataract surgery (MSICS. METHODS: Two hundred patients were randomized to peri bulbar and para bulbar groups. All surgeries were performed by same surgeons. Pain during administration of anaesthesia, 1 hour after surgery and 6 hours after surgery was graded on a visual analogue pain scale and compared for both the techniques. The ocular akinesia after anaesthesia was compared for both the techniques. RESULTS: There was no significant difference in pain between both the groups during anaesthesia, 1hour after anaesthesia and 6 hours after anaesthesia. There was no significant difference in the ocular akinesia between both the groups. CONCLUSION: Subtenon's technique for administration of anaesthesia during MSICS is as safe and effective as the peri bulbar technique giving equally good analgesia during and after the surgery.

  16. Lens Epithelial Cell Death Secondary to Acanthamoeba Keratitis: Absence of Capsular Bag Opacification Six Years after Cataract Surgery

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    Javier Moreno-Montañés

    2011-12-01

    Full Text Available Purpose: To show the evolution of anterior chamber structures 6 years after cataract surgery in a case with Acanthamoeba keratitis (AK. Methods: A 37-year-old woman with AK receiving long-term treatment with chlorhexidine, propamidine isethionate and steroids developed a white cataract and iris atrophy. Penetrating keratoplasty and cataract surgery were performed with subsequent intraocular pressure elevation requiring Molteno shunt implantation. Two years after the last surgery, endothelial decompensation developed and another penetrating keratoplasty was performed. Intraoperatively, the anterior and posterior capsules were completely transparent. Results: Six years after cataract surgery, the intraocular lens was centered with clear anterior and posterior capsules without lens epithelial cells proliferation. No Soemmering’s ring formation or posterior capsule opacification was found. Also, no zonular damage or pseudophacodonesis was observed. Conclusions: This case suggests that AK infection and AK treatment not only cause white progressive cataract but also lens epithelial cell death. The capsules may be completely clear 6 years after cataract surgery, with a good quality of vision regardless of intraocular lens material or design.

  17. Prevalence of Corneal Astigmatism and Anterior Segmental Biometry Characteristics Before Surgery in Chinese Congenital Cataract Patients.

    Science.gov (United States)

    Lin, Duoru; Chen, Jingjing; Liu, Zhenzhen; Wu, Xiaohang; Long, Erping; Luo, Lixia; Lin, Zhuoling; Li, Xiaoyan; Zhang, Li; Chen, Hui; Liu, Jinchao; Chen, Weirong; Lin, Haotian; Liu, Yizhi

    2016-02-25

    The prevalence and the distribution characteristics of corneal astigmatism (CA) and anterior segment biometry before surgery in Chinese congenital cataract (CC) patients are not completely understood. This study involved 400 CC patients from the Zhongshan Ophthalmic Center enrolled from February 2011 to August 2015. Data on CA, keratometry, central corneal thickness (CCT) and anterior chamber depth (ACD) were measured by the Pentacam Scheimpflug System. The mean age of patients was 54.27 months, and the ratio of boys to girls was 1.53:1. The mean CA was 2.03 diopters (D), and 39.25% of subjects had CA values ≥2 D. The most frequent (71.8%) diagnosis was with-the-rule astigmatism. Oblique astigmatism was present in 16.2% of cases, and 12% of cases had against-the-rule astigmatism. The mean keratometry measurement of cataractous eyes in bilateral patients was significantly larger than that in unilateral patients. Girls had a larger mean keratometry but a thinner CCT than did boys. The CA, CCT, and ACD of cataractous eyes were significantly larger than those of non-cataractous eyes in unilateral patients. The CA, mean keratometry, CCT, and ACD in CC patients varied with age, gender, and laterality. Fully understanding these characteristics may help inform guidelines and treatment decisions in CC patients.

  18. Significant improvement in dynamic visual acuity after cataract surgery: a promising potential parameter for functional vision.

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    Mingxin Ao

    Full Text Available PURPOSE: Dynamic visual acuity (DVA is a relatively independent parameter for evaluating the ability to distinguish details of a moving target. The present study has been designed to discuss the extent to which age-related cataract impacts DVA in elderly individuals and to determine whether it could be restored after bilateral phacoemulsification combined with intraocular lens implantation surgery. METHODS: Twenty-six elderly cataract patients scheduled for binocular cataract surgery and 30 elderly volunteers without cataract were enrolled in the study. DVA at 15, 30, 60 and 90 degree per second (dps was assessed, and velocity-dependent visual acuity decreases between consecutive speed levels were calculated. RESULTS: Compared with the control group, the patient group exhibited significantly worse DVA performance at all speed levels (p<0.001, and the decreases in velocity-dependent visual acuity were more serious in the patient group at the intervals of 0-15 dps (p<0.001, 15-30 dps (p = 0.007 and 30-60 dps (p = 0.008. Postoperatively, DVA performance at every speed level in the patient group clearly improved (p<0.001 and recovered to levels compatible to the control group. The decrease in visual acuity with increasing speed was less pronounced than during the preoperative phase (p0-15 dps = 0.001, p15-30 dps<0.001 and p30-60 dps = 0.001 and became similar to that of the control group. The postoperative visual benefit regarding DVA was more pronounced than the improvement in static visual acuity (p15 dps = 0.001 and p<0.001 at 30 dps, 60 dps and 90 dps. CONCLUSIONS: The impact of age-related cataract on DVA was more severe than its effects on static visual acuity. After cataract surgery, not only static vision of the patients was restored markedly, but also the dynamic vision. DVA could be an important adjunct to the current evaluation system of functional vision, thereby meriting additional attention in clinical assessment.

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

    Science.gov (United States)

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

    2012-02-23

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

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

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    Parikshit Gogate

    2014-01-01

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

  1. 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.

  2. Incidence of and Risk Factors for Postoperative Glaucoma and Its Treatment in Paediatric Cataract Surgery.

    Science.gov (United States)

    Mataftsi, Asimina

    2016-01-01

    Postoperative glaucoma is perhaps the most feared complication after paediatric cataract surgery, as it is difficult to control. Paediatric glaucoma is also challenging to diagnose, and different definitions of glaucoma have led to a rather big range of reported incidences of this disease. It can occur soon after surgery, in which case it is usually closed-angle glaucoma, or it can have a late onset, even more than a decade after surgery, and its aetiopathogenesis remains unclear to this day. There is significant controversy as to what the risk factors are for developing it, especially regarding intraocular lens implantation. The vast majority of studies show that an earlier age at surgery confers a higher risk. Medical and surgical treatment of aphakic/pseudophakic glaucoma can be successful; however, management often requires repeated procedures with or without multiple medications, and the prognosis is guarded. The visual outcome depends on sufficient intraocular pressure control and management of concurrent amblyopia.

  3. The Effect of Cataract Surgery on Circadian Photoentrainment

    DEFF Research Database (Denmark)

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

    2015-01-01

    -illumination pupil response (PIPR) to blue light from 10 to 30 seconds after light exposure as a surrogate measure. Secondary outcomes were circadian rhythm analysis using actigraphy and 24-hour salivary melatonin measurements. Finally, objective and subjective sleep quality were determined by actigraphy...... and the Pittsburgh Sleep Quality Index. RESULTS: The blue light PIPR increased 2 days (17%) and 3 weeks (24%) after surgery (P

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

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    Glišić Selimir

    2015-12-01

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

  5. 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.

  6. 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

  7. Application of Pentacam in the cataract surgery%Pentacam在白内障手术中的应用

    Institute of Scientific and Technical Information of China (English)

    周琳; 张健

    2015-01-01

    目前白内障手术已日趋成熟,人们对白内障术后视觉质量的要求越来越高,屈光性质的白内障手术已经日渐成为主流。利用Pentacam在术前对患者进行详细的角膜疾病排查、晶状体密度测量、角膜地形图的采集,利用角膜地形图进行人工晶状体的优选以及人工晶状体度数的计算等,可以帮助我们更好地明确患者术前情况,从而更好地提高白内障患者术后的视觉质量。%With the improvement of cataract operation, the cataract surgery has become increasingly perfect. The cataract patients show greater expectation for the result of cataract operation. As a result, refractive cataract surgery has become the main trend. Detailed investigations of corneal diseases, lens density, corneal topography, preferable intraocular lens ( IOL ) choice, and IOL power calculation can help us get a better knowledge of preoperative conditions on patients, which can be conducted with pentacam. So we can have a better forecast of post - operative outcome and improve the quality of vision for cataract patients after surgery.

  8. Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications.

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    Giles, Kagmeni; Christelle, Domngang; Yannick, Bilong; Fricke, Otto Herrmann; Wiedemann, Peter

    2016-01-01

    The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia.

  9. Choroidal and macular thickness changes induced by cataract surgery

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    Falcão MS

    2013-12-01

    Full Text Available Manuel S Falcão,1,2 Nuno M Gonçalves,2 Paulo Freitas-Costa,1,3 João B Beato,2 Amândio Rocha-Sousa,1,2 Ângela Carneiro,1,2 Elisete M Brandão,2 Fernando M Falcão-Reis1,21Department of Sense Organs, Faculty of Medicine, University of Porto, 2Department of Ophthalmology of Hospital de São João, 3Department of Anatomy, Faculty of Medicine, University of Porto, Porto, PortugalBackground: The aim of this study was to evaluate the effect of uneventful phacoemulsification on the morphology and thickness of the macula, the submacular choroid, and the peripapillary choroid.Methods: In 14 eyes from 14 patients, retinal macular thickness, choroidal submacular thickness, and choroidal peripapillary thickness were measured preoperatively and at one week and one month after phacoemulsification using enhanced depth imaging spectral domain optical coherence tomography. Changes in thickness of the different ocular tissues were evaluated.Results: There was a statistically significant increase in mean retinal macular thickness at one month. In horizontal scans, the mean increase was +8.67±6.75 µm (P<0.001, and in vertical scans, the mean increase was +8.80±7.07 µm (P=0.001. However, there were no significant changes in choroidal morphology in the submacular and peripapillary areas one month after surgery. In vertical scans, there was a nonsignificant increase in choroidal thickness (+4.21±20.2 µm; P=0.47 whilst in horizontal scans a nonsignificant decrease was recorded (−9.11±39.59 µm; P=0.41. In peripapillary scans, a nonsignificant increase in mean choroidal thickness was registered (+3.25±11.80 µm; P=0.36.Conclusion: Uncomplicated phacoemulsification induces nonpathologic increases in retinal macular thickness probably due to the inflammatory insult of the surgery; however these changes are not accompanied by significant changes in choroidal thickness. In the posterior segment, the morphologic response to the inflammatory insult of

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

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    Jatin

    2015-05-01

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

  11. 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.

  12. 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

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

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    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.

  14. Two rare cases of Acremonium acute endophthalmitis after cataract surgery in a tertiary care hospital.

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    Calderaro, Adriana; Motta, Federica; Larini, Sandra; Gorrini, Chiara; Martinelli, Monica; Piscopo, Giovanni; Benecchi, Magda; Arcangeletti, Maria Cristina; Medici, Maria Cristina; De Conto, Flora; Montecchini, Sara; Neri, Alberto; Scaroni, Patrizia; Gandolfi, Stefano; Chezzi, Carlo

    2013-10-01

    This report describes two cases of Acremonium sp. endophthalmitis, occurring in two patients who underwent cataract surgery on the same day in the same operating room of our hospital ophthalmology clinic. Diagnosis of fungal endophthalmitis was established by the repeated isolation of the same fungal agent from vitreous washing, acqueous fluid and intraocular lens samples and by its identification on the basis of morphological and molecular features. The cases reported in this study emphasize the need for clinical microbiology laboratories to be prepared to face the diagnosis of uncommon infectious diseases such as exogenous fungal endophthalmitis by Acremonium, and to enhance the awareness of surgeons and clinicians of this occurrence.

  15. 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.

  16. 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

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

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

    2012-07-01

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

  18. Clinical observation on the small incision non phacoemusification cataract surgery performed by China medical team in Africa

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    En-Hui Yi

    2017-02-01

    Full Text Available AIM:To observe the clinical effects of the small incision non phacoemusification cataract surgery in 462 Sudanese cataract cases(536 eyes. METHODS:From September 2013 to August 2015, we analyzed the 462 Sudanese cataract cases(536 eyesperformed cataract surgery by the way of the small incision non phacoemusification with intraocular lens(IOLimplantation and summarized the intraoperative and postoperative complications, the eyesight and intraocular pressure(IOPof the eyes in 1d, 1wk and 1mo after operation. RESULTS: Intraoperative complications: posterior capsular ruptured and vitreous prolapsed in 18 eyes(3.4%, iris prolapsed in 10 eyes(1.9%, suspensory ligament of the lens ruptured in 7 eyes(1.3%, not implanted IOL in 5 eyes(0.9%, descent's membrane detachment in 3 eyes(0.6%, iridodialysis in 1 eye(0.2%. Postoperative complications: corneal edema in 47 eyes(8.8%, anterior chamber inflammatory reaction in 32 eyes(6.0%, pupil oval or slightly upward in 12 eyes(2.2%, the upper iris incarcerated in the tunnel incision in 3 eyes(0.6%,hyphema in 2 eyes(0.4%, infective endophthalmitis in 1 eye(0.2%. Visual acuity: uncorrected visual acuity were ≤0.1 in 52 eyes(9.7%, >0.1-0.1-CONCLUSION:The small incision non phacoemusification cataract surgery with IOL implantation has the advantages of small incision, short operation time, relatively safe, easy to mastered, no-suture, quick visual function recovery and low cost. And, the operation equipments are simple and do not need many expensive medical equipments, supplies and professional staffs. So, the small incision non phacoemusification cataract surgery with IOL implantation is suitable for the anti-blind work of cataract in the foreign aid and remote areas.

  19. Cardiac surgery 2015 reviewed.

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    Doenst, Torsten; Strüning, Constanze; Moschovas, Alexandros; Gonzalez-Lopez, David; Essa, Yasin; Kirov, Hristo; Diab, Mahmoud; Faerber, Gloria

    2016-10-01

    For the year 2015, almost 19,000 published references can be found in PubMed when entering the search term "cardiac surgery". The last year has been again characterized by lively discussions in the fields where classic cardiac surgery and modern interventional techniques overlap. Lacking evidence in the field of coronary revascularization with either percutaneous coronary intervention or bypass surgery has been added. As in the years before, CABG remains the gold standard for the revascularization of complex stable triple-vessel disease. Plenty of new information has been presented comparing the conventional to transcatheter aortic valve implantation (TAVI) demonstrating similar short- and mid-term outcomes at high and low risk, but even a survival advantage with transfemoral TAVI at intermediate risk. In addition, there were many relevant and interesting other contributions from the purely operative arena. This review article will summarize the most pertinent publications in the fields of coronary revascularization, surgical treatment of valve disease, heart failure (i.e., transplantation and ventricular assist devices), and aortic surgery. While the article does not have the expectation of being complete and cannot be free of individual interpretation, it provides a condensed summary that is intended to give the reader "solid ground" for up-to-date decision-making in cardiac surgery.

  20. Visual Outcome of Phacoemulsification versus Small Incision Cataract Surgery in Pseudoexfoliation Syndrome – A Pilot Study

    Science.gov (United States)

    Gadewar, Shveta Bhimashankar

    2017-01-01

    Introduction Available data has highlighted the efficacy of both Phacoemulsification (PHACO) and Small Incision Cataract Surgery (SICS) in the presence of Pseudoexfoliation (PEX) syndrome. In developing countries, both are commonly performed procedures for cataract extraction. But, no direct comparison between these two procedures is available in the setting of PEX syndrome. With this lacuna in mind, this pilot study decided to compare the visual outcomes of both these techniques in the setting of PEX syndrome. Aim To compare and analyze the efficacy and safety of PHACO versus SICS in patients of PEX syndrome who underwent cataract surgery. Materials and Methods A prospective, conveniently sampled, observational, pilot study was conducted over six months in ophthalmology department of a tertiary eye institute in India. A total of 200 eyes of 100 patients conforming to pre-defined criteria were conveniently sampled and allotted to two groups of 50 patients each. First group underwent PHACO and second underwent SICS. The demographic profile, pre-operative, intra-operative and post-operative details and complications as well as visual acuity were recorded. Data obtained was analyzed using chi-square test. Statistical significance was set at 95% Confidence Intervals (CI), i.e., at a p-value of <0.05. Results Of 76 males and 24 females, the mean age was 67.95 years. No statistically significant differences were observed between PHACO and SICS groups with regards to intra-operative complications {overall n=13 in PHACO versus n=21 in SICS, p=0.13}. Controlled sphincterotomy was required in a significantly higher number of SICS cases (p=0.03). No statistically significant differences were observed in terms of post-operative complications (overall n=5 in PHACO versus n=10 in SICS, p=0.26). Conclusion With careful pre-operative assessment, due to intra-operative modifications and surgical expertise, both PHACO and SICS are apparently safe procedures in PEX syndrome.

  1. PREVALENCE OF GLAUCOMA IN PATIENTS UNDERGOING CATARACT SURGERY IN RURAL SET UP IN SOUTHERN INDIA

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    Bharathi

    2015-05-01

    Full Text Available PURPOSE: To determine the prevalence and types of glaucoma in rural patients posted for cataract surgery under eye camps at a tertiary care hospital . BACKGROUND: Glaucoma is the second leading cause of blindness in the adult pop ulation in India. The global prevalence of glaucoma for population aged 40 to 80 years is estimated to be 3.54% and the projected number of people with glaucoma worldwide will increase to 111.8 million in 2040. This creates a need for early diagnosis and p rompt management of glaucomas especially in the underprivileged rural areas that lack awareness and facilities. METHODOLOGY: A cross - sectional study was conducted at a regional ophthalmic center for all the patients posted for cataract surgery under eye ca mps. Study was carried out for duration of one year and included 1400 patients. The patients underwent detailed workup to detect the presence of glaucomas and were treated accordingly if the disease was detected. RESULTS: The overall prevalence of glaucoma in our study population was 2.14%. Amongst them, 0.78% had primary open angle glaucoma, 0.14% had primary angle closure glaucoma and 1.21% of them had pseudoexfoliative glaucoma. The prevalence of glaucomas increased with increasing age. CONCLUSION: With increasing life expectancy the number of glaucoma patients is constantly growing large in our country. Early case detection rate is of utmost importance to reduce the disease burden in the rural population where awareness in terms of routine eye screening is very low

  2. 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.

  3. 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

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

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    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.

  5. 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.

  6. The Effect of Therapeutic Touch Performed During Cataract Surgery on Anxiety and Patient Satisfaction

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    Emel Yılmaz

    2016-03-01

    Full Text Available Objective: The aim of the study was to determine the ef­fect of therapeutic touch (TT on anxiety and patient satis­faction when performed during a cataract surgery. Methods: A randomized controlled trial sample consisted of 114 individuals, 57 in the intervention group and 57 controls, who were hospitalized for cataract surgery and who conformed to the study criteria. Prior to the study approval was obtained from the ethics committee and informed consent was given by the patients. Data was collected using a personal information form, a visual analogue scale (VAS to measure anxiety, the Spielberg State/Trait Anxiety Inventory (STAI and the Newcastle Satisfaction with Nursing Care Scale (NSNCS. During the surgery, patients in the intervention group received a 15-minute session of TT. Results: In the intervention group, patients’ mean VAS anxiety score after TT was 3.56±1.85, while that of the control group in the 15th minute of the operation was 8,88±1,50. It was found that anxiety levels were reduced in the intervention group after TT compared with the con­trol group, and that vital signs were affected positively. NSNCS scores of patients in the intervention group were higher than those in the control group. Conclusion: It was observed that TT applied during sur­gery reduced anxiety, affected vital signs positively and increased patent satisfaction. The application of TT dur­ing surgery is recommended. J Clin Exp Invest 2016; 7 (1: 52-62

  7. 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.

  8. 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

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

  9. 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

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

  10. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

    AIM: To evaluate the visual outcome and factors influencing visual outcome of manual small incision cataract surgery(MSICS) in the rural area in the Xianfeng County.METHODS: Eighty-two eyes of 82 patients who underwent cataract surgery performed by using MSICS technique were identified. Data collected included each patient’s age, gender, the level of education. Uncorrected and corrected distance visual acuity(UDVA and CDVA) at presentation and at 1, 6, 8wk postoperatively, pre-existing eye disease, operative findings and complications, the risk factors were evaluated.RESULTS: In 82 patients, the average age was 69.6±0.6y, illiterate were 52(63.4%). Of 82 eyes, pseudophakia was present in 77 eyes(93.9%). At 1wk postoperatively,47 eyes(57.3%) had the UDVA of ≥6/18, and 52 eyes(63.4%) had the CDVA of ≥6/18. At 6 to 8wk postoperatively, 50 eyes(61.0%) had UDVA of ≥6/18, and57 eyes(69.5%) had the CDVA of ≥6/18. Postoperative visual status was significantly related to the co-morbidities, such as corneal pathology, glaucoma(P <0.001).Operative complications, such as posterior capsule opacity and cystoid macular edema were main operative cause for the poor visual outcome.CONCLUSION: MSICS provides a good visual recovery in our study but the vision outcome did not fulfill the standards proposed by WHO, which highlights the need for an improvement in local socioeconomic understanding, population education and surgery quality.

  12. 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.

  13. 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

  14. Effects of clonidine on recovery after sevoflurane anaesthesia in children undergoing cataract surgery.

    Science.gov (United States)

    Ghai, B; Ram, J; Chauhan, S; Wig, J

    2010-05-01

    This trial assessed the effects of two doses of clonidine compared with placebo on the quality and speed of recovery in children premedicated with oral midazolam and anaesthetised with sevoflurane for cataract surgery. One hundred and twenty American Society of Anesthesiologists physical status I to II children (aged one to six years), premedicated with oral midazolam 0.5 mg/kg and undergoing elective unilateral cataract surgery with sevoflurane anaesthesia were studied. Children were randomised to intravenous clonidine 1 microg/kg (group C1, n=39), 2 microg/kg (group C2, n=41) or normal saline (group NS, n=40). Clinically successful sub-Tenon local anaesthesia block was required for a patient to be included in the analysis. The primary outcome was the incidence of postoperative agitation. Postoperative agitation was defined as a Pain Discomfort Score of -3 using items 3 to 5 only, which was assessed 15 minutely until discharge. Agitation was observed in 11/40 (27.5%) children in the NS group compared to 2/39 (5.1%) in group Cl and none in group C2 (P < 0.001). Rescue medication to treat severe agitation was required in 5/40 (12.5%) in the NS group, 1/39 (2.6%) in group C1 and none in group C2 (P = 0.025). Time to meet discharge criteria was significantly shorter in group C1 compared to the other two groups (48.4 +/- 14.0 minutes compared to C2 79.5 +/- 12.8 minutes and NS 73.1 +/- 20.4 minutes, P < 0.001). There were no significant effects on blood pressure and heart rate. Intravenous clonidine 1 microg/kg is effective for reducing agitation after sevoflurane anaesthesia and midazolam premedication in children undergoing cataract surgery. Intravenous clonidine 2 microg/kg was also effective and for a longer period, but was associated with a longer time to discharge.

  15. Is the Memory Effect of the Blind Spot Involved in Negative Dysphotopsia after Cataract Surgery?

    Science.gov (United States)

    Wenzel, Martin; Menapace, Rupert; Eppig, Timo; Langenbucher, Achim

    2015-01-01

    We present novel clinical observations on negative dysphotopsia (ND) in eyes that have undergone cataract surgery. In the past, shadow effects were alleged to be located in the far peripheral temporal visual field 50° to 100° away from the optical axis. In a small series of eight patients we found evidence of photic effects, described by the patients as shadows in the periphery that were objectively located much more centrally. In all cases, we could find an association of these phenomena with the blind spot. We hypothesize that the memory effect of the blind spot which is dislocated and changed in magnification due to replacement of the crystalline lens could be one determinant for pseudophakic ND. The scotoma of the optic nerve head and the main arteries and veins of the phakic eye are displaced in the pseudophakic eye depending on the specific characteristics and position of the intraocular lens within the eye. PMID:26425353

  16. Is the Memory Effect of the Blind Spot Involved in Negative Dysphotopsia after Cataract Surgery?

    Directory of Open Access Journals (Sweden)

    Martin Wenzel

    2015-01-01

    Full Text Available We present novel clinical observations on negative dysphotopsia (ND in eyes that have undergone cataract surgery. In the past, shadow effects were alleged to be located in the far peripheral temporal visual field 50° to 100° away from the optical axis. In a small series of eight patients we found evidence of photic effects, described by the patients as shadows in the periphery that were objectively located much more centrally. In all cases, we could find an association of these phenomena with the blind spot. We hypothesize that the memory effect of the blind spot which is dislocated and changed in magnification due to replacement of the crystalline lens could be one determinant for pseudophakic ND. The scotoma of the optic nerve head and the main arteries and veins of the phakic eye are displaced in the pseudophakic eye depending on the specific characteristics and position of the intraocular lens within the eye.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Wei Ching-Kuo

    2012-10-01

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

  19. Comparison of midazolam sedation with or without fentanyl in cataract surgery.

    Science.gov (United States)

    Cok, O Yalcin; Ertan, A; Bahadir, M

    2008-01-01

    We compared the effect of midazolam sedation with or without fentanyl on the hemodynamic parameters, sedation, and pain and satisfaction profile in cataract surgery. Two hundred and ten patients were randomly allocated to receive either midazolam 1 mg i.v. (Group M, n = 101) alone or with fentanyl 25 microg (Group MF, n = 100) before retrobulbar injection. Hemodynamic parameters, observer's assessment of alertness/sedation (OAA/S) scores, pain during block and surgery, satisfaction of patient and surgeons were assessed. Heart rate and diastolic arterial pressure decreased after retrobulbar injection in comparison to baseline whereas systolic arterial pressure values increased in both groups. The majority of patients in both groups experienced mild pain during retrobulbar injection but no pain during surgery. There was a significant decrease in OAA/S scores in both groups (p = 0.001) and this decline was more significant in Group MF (p = 0.038). We suggest that midazolam alone may produce optimal block conditions for the patient and it is satisfactory during the procedure while the addition of fentanyl has not improved the effect on the examined parameters.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Sniatecki JJ

    2015-09-01

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

  2. 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.

  3. 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.

  4. 先天性白内障的手术治疗及其进展%Recent advances in congenital cataract surgery

    Institute of Scientific and Technical Information of China (English)

    周舟; 李莉

    2014-01-01

    先天性白内障是一种常见眼病,该病严重影响儿童视觉发育和视力。手术是其主要治疗方法。由于儿童的术前评估、术中操作和术后管理都较成年人困难,使得手术效果往往不甚理想。因此,我们对近年来先天性白内障手术治疗的相关研究做一综述,以探讨该领域存在的问题和进一步发展的方向。%Congenital cataract is a common eye disease which leads to children low vision. Surgery is the main treatment. Because of children's preoperative evaluation, operation, postoperative management is more difficult than adult, the outcome of surgery is not so well. Therefore, we review the relevant congenital cataract surgery researches in recent years in order to discuss the problems and further developments in this area.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Rodrigo Pessoa Cavalcanti Lira

    2001-10-01

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

  7. Does cataract surgery alleviate poverty? Evidence from a multi-centre intervention study conducted in Kenya, the Philippines and Bangladesh.

    Directory of Open Access Journals (Sweden)

    Hannah Kuper

    Full Text Available BACKGROUND: Poverty and blindness are believed to be intimately linked, but empirical data supporting this purported relationship are sparse. The objective of this study is to assess whether there is a reduction in poverty after cataract surgery among visually impaired cases. METHODOLOGY/PRINCIPAL FINDINGS: A multi-centre intervention study was conducted in three countries (Kenya, Philippines, Bangladesh. Poverty data (household per capita expenditure--PCE, asset ownership and self-rated wealth were collected from cases aged ≥50 years who were visually impaired due to cataract (visual acuity<6/24 in the better eye and age-sex matched controls with normal vision. Cases were offered free/subsidised cataract surgery. Approximately one year later participants were re-interviewed about poverty. 466 cases and 436 controls were examined at both baseline and follow-up (Follow up rate: 78% for cases, 81% for controls, of which 263 cases had undergone cataract surgery ("operated cases". At baseline, operated cases were poorer compared to controls in terms of PCE (Kenya: $22 versus £35 p = 0.02, Bangladesh: $16 vs $24 p = 0.004, Philippines: $24 vs 32 p = 0.0007, assets and self-rated wealth. By follow-up PCE had increased significantly among operated cases in each of the three settings to the level of controls (Kenya: $30 versus £36 p = 0.49, Bangladesh: $23 vs $23 p = 0.20, Philippines: $45 vs $36 p = 0.68. There were smaller increases in self-rated wealth and no changes in assets. Changes in PCE were apparent in different socio-demographic and ocular groups. The largest PCE increases were apparent among the cases that were poorest at baseline. CONCLUSIONS/SIGNIFICANCE: This study showed that cataract surgery can contribute to poverty alleviation, particularly among the most vulnerable members of society. This study highlights the need for increased provision of cataract surgery to poor people and shows that a focus on blindness may help to alleviate

  8. 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.

  9. 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.

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

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    Naveed Nilforushan

    2008-11-01

    Full Text Available

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

  11. Prevalence of Cataract Surgery and Visual Outcomes in Indian Immigrants in Singapore: The Singapore Indian Eye Study

    OpenAIRE

    Preeti Gupta; Yingfeng Zheng; Tay Wan Ting; Ecosse L Lamoureux; Ching-Yu Cheng; Tien-Yin Wong

    2013-01-01

    OBJECTIVE: To determine the prevalence of cataract surgery and factors associated with post-surgical visual outcomes in migrant Indians living in Singapore. RESEARCH DESIGN AND METHODS: We conducted a population-based study in 3,400 Indian immigrants residing in Singapore-the Singapore Indian Eye Study (SINDI). All participants underwent comprehensive medical eye examination and a standardized interview. Post-operative visual impairment (VI) was defined as best-corrected or presenting visual ...

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

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    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

  13. Corneal astigmatism change and wavefront aberration evaluation after cataract surgery: "Single" versus "paired opposite" clear corneal incisions

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    Hasan Razmjoo

    2014-01-01

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

  14. Improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery

    OpenAIRE

    Elliott, D; Patla, A.; Bullimore, M.

    1997-01-01

    AIMS—To determine the improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery.
METHODS—Clinical vision (monocular and binocular high and low contrast visual acuity, contrast sensitivity, and disability glare), functional vision (face identity and expression recognition, reading speed, word acuity, and mobility orientation), and perceived visual disability (Activities of Daily Vision Scale) were measured in 25 subjects before a...

  15. 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

  16. The long-term anterior segment configuration after pediatric cataract surgery and the association with secondary glaucoma

    Science.gov (United States)

    Chen, Ding; Gong, Xian-hui; Xie, He; Zhu, Xue-ning; Li, Jin; Zhao, Yun-e

    2017-01-01

    Secondary glaucoma constitutes major sight-threatening complication of pediatric cataract surgery, yet the etiology remains unclear. The purpose of this study was to investigate the long-term anterior segment configuration and the association with secondary glaucoma in pediatric pseudophakia. Ultrasound biomicroscopy (UBM) was performed on 40 eyes of 26 children underwent pediatric cataract surgery and intraocular lens (IOL) implantation. The anterior chamber depth (ACD), angle-opening distance at 500 μm (AOD500), trabecular-iris angle (TIA), central corneal thickness (CCT), structural abnormities, IOL position, IOP, and incidence of glaucoma were evaluated. High insertion of iris, in which the iris root is attached more anteriorly than normal, was seen in 13 eyes (32.50%). IOL was located in the capsular bag in 19 eyes and in the ciliary sulcus in 21 eyes. Logistic regression analysis identified high insertion of iris (OR 3.40, 95% CI 1.03–11.17, p = 0.03) and IOL implantation in sulcus (OR 1.39, 95% CI 1.07–4.85, p = 0.04) as independent risk factors for glaucoma. The presence of high insertion of iris and IOL implantation in ciliary sulcus may increase the long-term risk of the development of secondary glaucoma after pediatric cataract surgery. PMID:28220849

  17. 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.

  18. 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.

  19. 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

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

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    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.

  1. Cataract Surgery after Retinal Detachment Surgery with Arruga’s Sutures: Case Report

    OpenAIRE

    Erkan Ünsal; Kadir Eltutar; Osman Kızılay; Belma Karini

    2016-01-01

    A 56-year old female patient presented to our clinic with a complaint of low vision in her right eye. Twenty-two years earlier she had undergone a scleral buckling operation in her right eye because of retinal detachment. She indicated that vision in her right eye was good after the surgery but had recently been gradually declining. Best-corrected vision acuity was counting fingers at 1 meter in the right eye and 8/10 in the left eye. Anterior segment examination revealed stage 3 nuclear cata...

  2. 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

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

    Science.gov (United States)

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

    2013-02-22

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

  4. The Prevalence of Age-Related Eye Diseases and Cataract Surgery among Older Adults in the City of Lodz, Poland

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    Michal Szymon Nowak

    2015-01-01

    Full Text Available Purpose. To determine the prevalence of age-related eye diseases and cataract surgery among older adults in the city of Lodz, in central Poland. Material and Methods. The study design was cross-sectional and observational study. A total of 1107 women and men of predominantly Caucasian origin were successfully enumerated and recruited for the study. All selected subjects were interviewed and underwent detailed ophthalmic examinations. Results. Overall 8.04% (95% CI 6.44–9.64 subjects had cataract surgery in either eye. After excluding subjects with bilateral cataract surgery, the prevalence of cataract was 12.10% (95% CI 10.18–14.03. AMD was found in 4.33% (95% CI 3.14–5.54 of all subjects. Of them 3.25% (95% CI 2.21–4.30 had early AMD and 1.08% (95% CI 0.47–1.69 had late AMD. Various types of glaucoma were diagnosed in 5.51% (95% CI 4.17–6.85 of subjects and 2.62% (95% CI 1.68–3.56 had OHT. The prevalence rates of DR and myopic macular degeneration were 1.72% (95% CI 0.95–2.48 and 0.45% (95% CI 0.06–0.85, respectively. All multiple logistic regression models were only significantly associated with older age. The highest rate of visual impairment was observed among subjects with retinal diseases. Conclusions. The study revealed high prevalence of age-related eye diseases in this older population.

  5. 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.

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

    Science.gov (United States)

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

    2012-04-01

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

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

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    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.

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

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    To KG

    2014-04-01

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

  9. 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

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

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    Md Shafiqul Alam

    2014-01-01

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

  11. 发展中国家教学医院的白内障手术服务%Cataract surgery services in a teaching hospital in a developing country

    Institute of Scientific and Technical Information of China (English)

    Ifeoma R Ezegwui

    2009-01-01

    目的:总结发展中国家教学医院的白内障手术现状,探讨怎样在减少白内障致盲率方面达到视觉2020计划的目标.方法:通过计算机化白内障手术病例表收集从2006-01/12期间在我院手术的成人白内障病例资料.不包括外伤性白内障.应用SSPS 11.0版本分析数据.结果:在研究期间,3名眼科医生对67眼实施白内障手术.囊外白内障摘除联合后房人工晶状体植入术占95.5%.12wk随访期间,74.5%患者的最好视力为6/6-6/18,13.7%<6/18- 6/60,11.8%<6/60.结论:在尼日利亚这样的发展中国家的教学医院中,白内障手术的比率很低.这就需要提高大多数眼科医生工作的教学医院的白内障手术服务.在教学医院中实施的白内障手术应该是低成本或免费的.大量的手术是很好的锻炼,将带来好的效果.%AIM: To review the cataract surgery services in a teaching hospital in a developing country with a view to assessing how a teaching hospital can contribute to achieving the goals of the Vision 2020 programme with respect to decreasing cataract blindness.METHODS: The computerised cataract surgery record form was used to collect data on adult cataract surgery performed at Enugu State University of Sciences and Technology (ESUT) Teaching Hospital Parklane, Enugu, Nigeria over a 12 month-period (from January 2006 to December 2006). Traumatic cataracts were excluded. Data was analyzed using SSPS version 11.0.RESULTS: A total of 67 eyes had cataract operation during the study period. Three ophthalmologists did these. Majority (95.5%) had ab-externo extracapsular cataract extraction with posterior chamber intraocular lens implanted (ECCE + PC-IOL). At 12 weeks of follow up post operatively, 74.5% had best corrected vision of 6/6-6/18, 13.7% had <6/18-6/60 while 11.8% had <6/60. CONCLUSION: The volume of cataract surgeries performed in a teaching hospital in a developing country like Nigeria is low. There is need for improved service

  12. Training a cataract surgeon

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    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.

  13. 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.

  14. Sudden corneal edema due to retained lens nuclear fragment presenting 8.5 years after cataract surgery.

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    Pandit, Rahul T; Coburn, Amy G

    2011-06-01

    A 79-year-old woman presented with a 1-week history of sudden onset of decreased vision, pain, and redness in the right eye. Ocular history included uneventful cataract surgery in both eyes more than 8 years prior to presentation. Slitlamp examination revealed significant corneal edema and mild iritis. Gonioscopy revealed a retained lens nuclear fragment in the inferior angle. Surgical removal of the fragment improved the patient's condition. The retained nuclear fragment presumably lodged behind the iris at the time of the initial surgery and spontaneously moved forward more than 8 years later. To our knowledge, this is the longest reported delay between phacoemulsification and presentation of a retained nuclear fragment. Before this case, retained nuclear fragments had been associated with complications within a year of surgery only. We recommend gonioscopy in cases of sudden-onset corneal edema extending to the inferior limbus in patients with a history of phacoemulsification.

  15. Comparative analysis on manual small incision cataract surgery and pha-coemulsification cataract surgery for treatment of hard nucleus cataract%手法碎核小切口白内障摘除术与超声乳化白内障摘除术治疗硬核性白内障的对比分析

    Institute of Scientific and Technical Information of China (English)

    尹丽婷; 赵萍

    2014-01-01

    目的:分析手法碎核小切口白内障摘除术与超声乳化白内障摘除术治疗硬核性白内障的应用价值。方法随机将95例硬核性白内障患者进行分组,对照组予超声乳化白内障摘除术治疗,实验组予手法碎核小切口白内障摘除术治疗,观察两组手术效果和安全性。结果实验组术后3个月矫正视力达到0.5~1.0患者(93.75%)明显高于对照组(81.01%)(P<0.05);实验组术后1d、1周角膜散光情况高于对照组(P<0.01);实验组术中并发后囊膜破裂发生率、角膜水肿发生率分别低于对照组(P<0.01)。结论手法碎核小切口白内障摘除术具有切口小、创伤少和并发症发生率低等优势,在治疗硬核性白内障方面优于超声乳化白内障摘除术。%Objective To analyze the value of applying manual small incision cataract surgery and phacoemulsification cataract surgery for treatment of hard nucleus cataract. Methods A total of 95 cases of hard nucleus cataract were ran-domly assigned to the control group given phacoemulsification cataract surgery and the experimental group given manu-al small incision cataract surgery. The surgical effect and safety were observed. Results At the end of the third month the surgery, 93.75%of the patients in the experimental group had corrected visual acuity of 0.5~1.0, significantly high-er than 81.01% of the control group (P<0.05). At the end of first day and first week after surgery, the experimental group had greater corneal astigmatism than the control group (P<0.01). The experimental group had lower incidence rate of posterior capsular rupture and corneal edema during surgery than the control group (P<0.01). Conclusion With the advantage of smaller incision, less trauma and lower incidence of complications, manual small incision cataract surgery has better efficacy for treatment of hard nucleus cataract than phacoemulsification cataract surgery.

  16. 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.

  17. 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.

  18. 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.

  19. Inadvertent Trypan Blue Staining of Posterior Capsule during Cataract Surgery Associated with “Argentinian Flag” Event

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    Robert A. Prinzi

    2016-01-01

    Full Text Available Trypan blue is common in visualizing the anterior capsule during cataract surgery. Inadvertent staining of the posterior capsule during phacoemulsification is a rare complication and there are few reports in the literature. The proposed mechanism of posterior capsule staining in previous reports includes a compromised zonular apparatus or iris retractors facilitating the posterior flow of trypan blue. We report the first case of trypan blue staining of the posterior capsule associated with the “Argentinian flag” sign. In our case, the “Argentinian flag” allowed the trypan blue to seep between the posterior capsule and the lens, staining the anterior surface of the posterior capsule.

  20. Long-Term Observation of Triplex Surgery for Cataract after Phakic 6H Implantation for Super High Myopia

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    Xin Liu

    2016-01-01

    Full Text Available Purpose. To analyze the safety, effectiveness, and stability of triplex surgery for phakic 6H anterior chamber phakic intraocular lens explantation and phacoemulsification with in-the-bag IOL implantation for super high myopia in long-term observations. Methods. This retrospective case series evaluated 16 eyes of 10 patients who underwent triplex surgery. Best corrected visual acuity (BCVA, endothelial cell density (ECD, and associated adverse events were evaluated. Results. The mean follow-up time after the triplex surgery was 46 ± 14 months. The mean logMAR BCVA was significantly improved after triplex surgery (P = 0.047. One eye developed endophthalmitis five days postoperatively and underwent pars plana vitrectomy (PPV. Five eyes with preoperative severe endothelial cell loss developed corneal decompensation and underwent keratoplasty at a mean time of 9.4 ± 2.6 months after the triplex surgery. One eye had graft failure and underwent a second keratoplasty. The eye developed rhegmatogenous retinal detachment and underwent PPV with silicone oil 18 months later. ECD before the triplex surgery was not significantly different compared with that at last follow-up (P = 0.495 apart from these five eyes. Three eyes (18.8% developed posterior capsule opacification. Conclusions. Triplex surgery was safe and effective for phakic 6H related complicated cataracts. Early extraction before severe ECD loss is recommended.

  1. 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

  2. 手法小切口白内障手术临床效果分析%The efficacy of manual small incision cataract surgery

    Institute of Scientific and Technical Information of China (English)

    史银娟; 胡竹林; 欧燕华; 王红林

    2014-01-01

    目的 探讨手法小切口白内障手术的手术技巧、效果及影响因素.方法 321例(356眼)手法小切口白内障手术联合人工晶状体植入术,观察视力恢复情况及并发症的情况.结果 术后视力恢复良好,最佳矫正视力,术后1周≥0.6者182眼(51.1%);术后1月≥0.6者248眼(69.7%);术后半年≥0.6者为288眼(80.9%),术中、术后并发症很少.结论 手法小切口白内障手术是有效、安全、经济的白内障手术方法.%Objective To analyse the efficacy of manual small incision cataract surgery for senile cataract.Methods 356 eyes of 321 cases of senile cataract were treated by manual small incision cataract surgery combined with intraoclar lens implantation.The visual acuity and surgical complications were observed.Results The corrected visual acuities of ≥0.6 were found in 182 eyes(51.1%) 1 week after surgery,in 248 eyes (69.7%) 1 month after surgery,and in 288 eyes (80.9%) 6 months after surgery.There were few complications during or after operation.Conclusion Manual small incision cataract surgery is an efficacious and safe approach for senile cataract.

  3. The long term impact of cataract surgery on quality of life, activities and poverty: results from a six year longitudinal study in Bangladesh and the Philippines.

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    Lisa Danquah

    Full Text Available BACKGROUND: Cataract surgery has been shown to improve quality of life and household economy in the short term. However, it is unclear whether these benefits are sustained over time. This study aims to assess the six year impact of cataract surgery on health related quality of life (HRQoL, daily activities and economic poverty in Bangladesh and The Philippines. METHODS AND FINDINGS: This was a longitudinal study. At baseline people aged ≥50 years with visual impairment due to cataract ('cases' and age-, sex-matched controls without visual impairment were interviewed about vision specific and generic HRQoL, daily activities and economic indicators (household per capita expenditure, assets and self-rated wealth. Cases were offered free or subsidised cataract surgery. Cases and controls were re-interviewed approximately one and six years later. At baseline across the two countries there were 455 cases and 443 controls. Fifty percent of cases attended for surgery. Response rates at six years were 47% for operated cases and 53% for controls. At baseline cases had poorer health and vision related QoL, were less likely to undertake productive activities, more likely to receive assistance with activities and were poorer compared to controls (p<0.05. One year after surgery there were significant increases in HRQoL, participation and time spent in productive activities and per capita expenditure and reduction in assistance with activities so that the operated cases were similar to controls. These increases were still evident after six years with the exception that time spent on productive activities decreased among both cases and controls. CONCLUSION: Cataract causing visual loss is associated with reduced HRQoL and economic poverty among older adults in low-income countries. Cataract surgery improves the HRQoL of the individual and economy of the household. The findings of this study suggest these benefits are sustained in the long term.

  4. 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

  5. Influence on ocular surface after cataract surgery and effect of topical diquafosol on postoperative dry eye: a multicenter prospective randomized study

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    Miyake K

    2017-03-01

    Full Text Available Kensaku Miyake,1 Norihiko Yokoi2 On behalf of Dry Eye After Cataract Surgery Investigational Study Group (DASIS group 1Miyake Eye Hospital, Nagoya, 2Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Purpose: To investigate influences of 3% diquafosol sodium ophthalmic solution (DQS on ocular surface after cataract surgery and effects on postoperative dry eye. Design: This study had two consecutive prospective study phases. The former was an observational study from before cataract surgery to 4 weeks after surgery and the latter was a randomized open-label study from 4 to 8 weeks after surgery. Methods: Subjects were 433 eyes of 433 patients undergoing cataract surgery with intraocular lens implantation. Dry eye examination of tear breakup time (BUT, corneal and conjunctival fluorescein staining scores, total subjective symptom score (12 symptoms, and Schirmer I test were conducted before surgery and 4 weeks after surgery. Patient demographics and these examination results were used to analyze risk factors to predict postoperative dry eye. In a randomized study, 154 eyes diagnosed with dry eye postoperatively were applied either DQS or artificial tears (AT six times daily for 4 weeks. The data of the examinations were compared. Results: At 4 weeks after surgery, BUT was shortened significantly (P=0.036, fluorescein staining score increased significantly (P=0.012, but total subjective symptom score was significantly improved (P<0.001. The majority of postoperative dry eye was shortened BUT type (53.1%. The dry eye prevalence after surgery decreased (55.7% compared with before surgery (69.7%. Females and the patient with dry eye symptoms before surgery had significant risk factors for postoperative dry eye. In a randomized study, BUT was significantly prolonged in the DQS group (P=0.015, but not in the AT group. Fluorescein staining score was significantly improved in both groups (P<0.001. Total subjective symptom

  6. 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.

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

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    Ebiakpo-aboere Sonron

    2015-09-01

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

  8. Corneal toxicity secondary to inadvertent use of benzalkonium chloride preserved viscoelastic material in cataract surgery

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    Eleftheriadis, H; Cheong, M; Sandeman, S; Syam, P P; Brittain, P; Klintworth, G K; Lloyd, A; Liu, C

    2002-01-01

    Aims: To study the long term toxic effects of intraocular benzalkonium chloride (BAC). Methods: 19 patients exposed to intraocular BAC preserved viscoelastic during cataract surgery in February 1999 developed severe striate keratopathy immediately postoperatively. 16 patients, including two who underwent penetrating keratoplasty, were studied in the period April to June 2000. Ocular symptoms, visual acuity, biomicroscopy, intraocular pressure, dilated funduscopy, specular endothelial microscopy, and corneal pachymetry findings were recorded. The corneal and iris specimens of the two patients who underwent keratoplasty were studied by light, transmission, and scanning electron microscopy. Results: Six males and 10 females, aged 64–98 years, were studied 14–16 months postoperatively. All patients were symptomatic. 12 patients had best corrected visual acuity of 6/12 or better and four patients of between 6/18 and 6/60. Five patients had corneal epithelial oedema and 11 had Descemet's membrane folds. The central corneal thickness, 620 (SD 71) μm, in affected eyes was significantly higher (p<0.005, two tailed paired t test) than that of the contralateral eyes, 563 (SD 48) μm. The endothelial cell density was significantly lower (p<0.0001, two tailed paired t test) in affected eyes: 830 (SD 280) cells/mm2v 2017 (SD 446) cells/mm2. The mean average cell area was significantly higher in the BAC treated eyes: 1317 (SD 385) μm2v 521 (SD 132) μm2. There was no significant difference in the coefficient of variation of cell size between the two eyes (p=0.3, two tailed paired t test). Two corneal specimens displayed morphological features of bullous keratopathy and other non-specific abnormalities. Extracellular melanosomes were present in a portion of the iris of one case. Conclusion: BAC is toxic to the corneal endothelium when used intraocularly, leading to severe striate keratopathy. This cleared in most cases but left varying degrees of residual stromal thickening

  9. Results of Cataract Outreach Services in a State of Nigeria

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    Abdu Lawan

    2010-06-01

    Full Text Available AIM: A blindness prevalence survey in 1996 indicated that estimates of 40000 are blind from cataracts in Kano state, northwestern Nigeria. Many more were severely visually impaired. Eye care personnel and other resources for eye care delivery are located at the state capital. The state Ministry of Health organized an outreach program. The aim was to operate on 750 cataract patients and measure the visual acuity at two weeks follow up. METHOD: Patients were registered and examined. Cataract patients with accurate four quadrant light projection, briskly reacting pupils and normal intra ocular pressures were selected and had manual extra capsular cataract extraction with posterior chamber intra ocular lens implantation. Post operative medications were administered. Patients were reviewed at 2 weeks follow up after discharge during which their visual acuity was measured and recorded. RESULTS: 868 cataract patients were operated. Thirty two percent of the patients were blind before surgery and 77% of these had bilateral cataracts. The proportion of those who had posterior chamber intra ocular lens (PC IOL was 85%. The proportion of patients who regained normal vision was 43% and overall, 94% had vision of 6/60 or, better after surgery compared with 20% in this category before surgery, (WHO vision category 0 and 1. CONCLUSION: Cataract outreach service is essential in reducing cataract blindness. There is need to follow up patients although the vision recorded for this study was obtained at two weeks follow up. [TAF Prev Med Bull 2010; 9(3.000: 225-228

  10. Visual Acuity, Retinal Sensitivity, and Macular Thickness Changes in Diabetic Patients without Diabetic Retinopathy after Cataract Surgery

    Science.gov (United States)

    Irman Grčar, Irena; Grčar, Rok; Pfeifer, Vladimir

    2017-01-01

    Aim. Functional and morphological macular study after cataract surgery in a group of diabetics without diabetic retinopathy compared to nondiabetics to evaluate the effect of surgical oxidative stress on diabetic retina. Methods. Prospective, comparative study. Preoperative eye exam, best corrected visual acuity (BCVA) measured by ETDRS letters, and optical coherence tomography (OCT) were followed by standard cataract surgery. The follow-up visits at 1, 3, and 6 months postoperatively included BCVA, OCT, and microperimetry, to analyze changes within and between the groups. Results. The BCVA improved significantly in diabetics and controls: 64.2 to 81.0 and 61.9 to 82.1 ETDRS at 6 months, respectively. The central macula at OCT significantly thickened in both groups, while the central 5 fields, corresponding to the microperimetry area, subclinically thickened from 284.20 to 291.18 μm at 6 months only in diabetics (p = 0.026). A matching slight decrease in the microperimetry sensitivity from 1 to 6 months was found also only in diabetics, with mean average difference −0.75 dB (p = 0.04). Conclusion. Underlying diabetes does not influence the surgical outcome in diabetics without diabetic retinopathy. However, slight thickening of wider macula and corresponding decrease in retinal sensitivity observed in diabetics 6 months postoperatively might influence visual function on long term. PMID:28243608

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

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    Mansoori Tarannum

    2005-12-01

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

  12. [Rehabilitation methods for children with complicated cataract].

    Science.gov (United States)

    Ivanov, G; Cuşnir, V; Septichina, Natalia; Cuşnir, Vitalie

    2010-01-01

    The work deals with the results of surgical treatment of 155 patients, who had uveal cataract, by method of facoemulsification with artificial crystalline lens transplanting. The age of the sick varied from 3 to 15 as a result of a complex treatment, involving determination of ethnic factor in the development of uveal cataract, before- and after-operation conservative medical treatment, surgical treatment of abscuration ambliopia 78.1% children and the keenness of sight 0.4 and 68.7% got binocularious sight. The study lot of posttraumatic cataract affected children included 189 patients, from them 68 with stationary cataract, 87 with intumescent cataract and 34 with postoperatorial aphakia. Age from 2 to 15 years. 76.3% cases of evolution without postoperatorial complications, in 13.7% intraoperatorial were observed different complications. The work presents the results of surgical treatment 196 of children, who had innate cataract, by the method of facoasoriation with soft intra-eyepiece lens transplanting from 133 patients who had two-sided cataract, 63 had monolateral cataract. All children underwent laser simulation and videocomputer auto-training in post-operation period. As a result of the treatment, 66.8% patients got the amelioration of sight with 0.4, and 58% got binocular sight. The children's age varied between 6 months and 15 years. This article presents a review of the treatment results of 213 children with posttraumatic, congenital and complicated cataracts. The rehabilitation of the patients with the lens pathology includes a complex of measures of early diagnosis, surgery, optimal correction, medical treatment before and after surgery, the prophilaxis and treatment of complications. This approach permits to increase the visual acuity in 83.8% and to restore the binocular vision in 71.4% patients.

  13. 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

  14. Influence on ocular surface after cataract surgery and effect of topical diquafosol on postoperative dry eye: a multicenter prospective randomized study

    Science.gov (United States)

    Miyake, Kensaku; Yokoi, Norihiko

    2017-01-01

    Purpose To investigate influences of 3% diquafosol sodium ophthalmic solution (DQS) on ocular surface after cataract surgery and effects on postoperative dry eye. Design This study had two consecutive prospective study phases. The former was an observational study from before cataract surgery to 4 weeks after surgery and the latter was a randomized open-label study from 4 to 8 weeks after surgery. Methods Subjects were 433 eyes of 433 patients undergoing cataract surgery with intraocular lens implantation. Dry eye examination of tear breakup time (BUT), corneal and conjunctival fluorescein staining scores, total subjective symptom score (12 symptoms), and Schirmer I test were conducted before surgery and 4 weeks after surgery. Patient demographics and these examination results were used to analyze risk factors to predict postoperative dry eye. In a randomized study, 154 eyes diagnosed with dry eye postoperatively were applied either DQS or artificial tears (AT) six times daily for 4 weeks. The data of the examinations were compared. Results At 4 weeks after surgery, BUT was shortened significantly (P=0.036), fluorescein staining score increased significantly (P=0.012), but total subjective symptom score was significantly improved (Pscore was significantly improved in both groups (Pscore was significantly decreased in the AT group (Pfilm stability and ocular surface, and DQS has a capability to improve them. PMID:28360509

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

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    Devalina Goswami

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  17. Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study

    Science.gov (United States)

    Martinez-de-la-Casa, Jose Maria; Diaz-Valle, David; Morales-Fernandez, Laura; Fernandez-Perez, Cristina; Garcia-Feijoo, Julian

    2016-01-01

    Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA). Results. 20 patients were enrolled. Mean follow-up was 47.4 ± 18.46 months. Mean baseline IOP was 19.95 ± 3.71 mmHg with medication and 26 ± 3.11 mmHg after washout. Mean end-follow-up IOP was 16.25 ± 1.99 mmHg, representing an IOP decrease of 36.92%, 9.74 ± 3.14 mmHg (P < 0.001), from baseline washout IOP. The mean number of medications was significantly reduced from 1.3 ± 0.66 to 0.75 ± 0.79 (P = 0.017). 45% of patients were medication-free by the end of follow-up. Mean log⁡MAR BCVA improved significantly from 0.42 ± 0.16 to 0.18 ± 0.16 (P < 0.001). No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract. PMID:27882243

  18. Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study

    Directory of Open Access Journals (Sweden)

    Pedro Arriola-Villalobos

    2016-01-01

    Full Text Available Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT. Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP, topical hypotensive medications required, and best-corrected visual acuity (BCVA. Results. 20 patients were enrolled. Mean follow-up was 47.4±18.46 months. Mean baseline IOP was 19.95±3.71 mmHg with medication and 26±3.11 mmHg after washout. Mean end-follow-up IOP was 16.25±1.99 mmHg, representing an IOP decrease of 36.92%, 9.74±3.14 mmHg (P<0.001, from baseline washout IOP. The mean number of medications was significantly reduced from 1.3±0.66 to 0.75±0.79 (P=0.017. 45% of patients were medication-free by the end of follow-up. Mean log⁡MAR BCVA improved significantly from 0.42±0.16 to 0.18±0.16 (P<0.001. No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT and cataract.

  19. Effective dose 50 of desflurane for laryngeal mask airway removal in anaesthetized children in cataract surgeries with subtenon block

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    Sameer Sethi

    2015-01-01

    Full Text Available Background: Quantification of the depth of desflurane anesthesia required for laryngeal mask airway (LMA removal in children has been done with the use of intravenous fentanyl or caudal anesthesia. This study aimed to determine the end-tidal concentration of desflurane required for LMA removal in children without the use of caudal or opioid analgesia in children undergoing elective cataract surgery. Materials and Methods: Our study enrolled 25 American Society of Anesthesiologists I and II children aged 2-10 years, undergoing elective cataract surgery. Anesthesia was induced with sevoflurane and oxygen/nitrous oxide using face mask and a size 2 LMA inserted. A subtenon block was administered in all children before surgical incision. Desflurane was used for maintenance of anesthesia. Predetermined end tidal concentration of desflurane was maintained for 10 min at the end of surgery before LMA removal was attempted. End tidal concentrations were increased/decreased using the Dixon up-down method (with 0.5% as a step size in the next patient depending on the previous patient′s response. Patient responses to LMA removal were classified as "movement" or "no movement." Results: 50% effective dose (ED 50 for successful removal of the LMA with desflurane in the presence of subtenon block was 3.6% (3.20-3.97% and that the 95% ED 95 was 4.648% (4.15-6.47%. Conclusion: Laryngeal mask airway removal can be successfully accomplished in 50% and 95% anesthetized children at 3.6% and 4.65% end-tidal desflurane concentration.

  20. Comparison of safety of loteprednol 0.5%/ difluprednate 0.05%/ prednisolone1% eye drops in the post cataract surgery patients

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    Preet Sood

    2016-12-01

    Conclusions: Both the newer drugs are much safer as compared to prednisolone for intraocular pressure. As they are equiefficacious to prednisolone their use in post cataract surgery inflammation is recommended. [Int J Basic Clin Pharmacol 2016; 5(6.000: 2368-2370

  1. 小切口手法白内障摘出术的历史和现状%History and current situation in manual small incision cataract surgery

    Institute of Scientific and Technical Information of China (English)

    李一壮

    2010-01-01

    @@ 小切口手法白内障摘出术(manual small incisioncataract surgery,MSICS)是相对于传统白内障囊外摘出术(extracapsular cataract extraction,ECCE)而言的,是切口较小的一种手法白内障囊外摘出术.

  2. Immediate Postoperative Intraocular Pressure Adjustment Reduces Risk of Cystoid Macular Edema after Uncomplicated Micro Incision Coaxial Phacoemulsification Cataract Surgery

    Science.gov (United States)

    Jarstad, Allison R.; Chung, Gary W.; Tester, Robert A.; Day, Linda E.

    2017-01-01

    Purpose To determine the accuracy of visual estimation of immediate postoperative intraocular pressure (IOP) following microincision cataract surgery (MICS) and the effect of immediate postoperative IOP adjustment on prevention of cystoid macular edema (CME). Setting Ambulatory surgical center. Methods Prospective, randomized analysis of 170 eyes in 135 patients with MICS, performed in a Medicare approved outpatient ambulatory surgery center. Surgical parameters included a keratome incision of 1.5 mm to 2.8 mm, topical anesthetic, case completion IOP estimation by palpation and patient visualization of light, and IOP adjustment before exiting the operating theater. IOPs were classified into three groups: low (21 to 30 mmHg). IOP measurements were repeated 1 day after surgery. Optical coherence tomography (Stratus OCT, Zeiss) was measured at 2 weeks. An increase in foveal thickness greater than 15 µm was used to indicate CME. Statistical analysis was performed using one- and two-tailed Student's t-tests. Results Mean minimal foveal thickness averaged 207.15 µm in the low pressure group, 205.14 µm in the normal IOP group, and 210.48 µm in the elevated IOP group 2 weeks following surgery. CME occurred in 14 of 170 eyes (8.2%) at 2 weeks (low IOP, 35.7%; normal IOP, 14.2%; elevated IOP, 50.0%). Change in IOP from the operating theater to 1 day after surgery was within +/−5 mmHg in 54 eyes (31.7%), elevated by 6 to 15 mmHg in 22 eyes (12.9%), and elevated more than 15 mmHg in four eyes (2.3%). IOP was reduced by 6 mmHg to 15 mmHg in 39 eyes (22.9%) and reduced by more than 15 mmHg in nine eyes (5.3%). Conclusions Immediate postoperative adjustment of IOP may prevent CME in MICS. Physicians can improve their ability to estimate postoperative IOP with experience in tonometry to verify immediate postoperative IOP. There are patient safety and economic benefits to immediate IOP adjustment in the operating theater. Synopsis Immediate postoperative IOP adjustment

  3. 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...

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

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    Colin Cook

    2002-01-01

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

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

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    Phuc Huynh

    2011-09-01

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

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

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    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.

  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. Dexmedetomidine as an additive to local anesthetics compared with intravenous dexmedetomidine in peribulbar block for cataract surgery

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    A M Abdelhamid

    2016-01-01

    Full Text Available Background: No studies compared parenteral dexmedetomidine with its use as an adjuvant to ophthalmic block. We compared between adding dexmedetomidine to bupivacaine in peribulbar block and intravenous (IV dexmedetomidine during peribulbar block for cataract surgery. Materials and Methods: A prospective, randomized, double-blind study on 90 patients for cataract surgery under peribulbar anesthesia. Study included three groups; all patients received 10 ml of peribulbar anesthesia and IV infusion of drugs as follows: Group I: Received a mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + normal saline (1 ml + 150 IU hyaluronidase + IV infusion of normal saline, Group II: Received mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + dexmedetomidine 50 μg (1 ml +150 IU hyaluronidase + IV infusion of normal saline and Group III: Received mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + normal saline (1 ml +150 IU hyaluronidase + IV dexmedetomidine 1 μg/kg over 10 min; followed by 0.4 μg/kg/h IV infusion. We recorded onset, duration of block, Ramsay Sedation Score, intra-ocular pressure (IOP, hemodynamics, and adverse effects. Results: There was a significant decrease in the onset of action and increase in the duration of block in Group II as compared with the Group I and Group III. Mean Ramsay Sedation Score was higher in Group III. The IOP showed a significant decrease in Group II and Group III 10 min after injection (P < 0.01. Heart rate showed a significant decrease in Group III in comparison with the two other groups (P < 0.05. Only two patients in Group III developed bradycardia. Conclusion: Dexmedetomidine as an additive shortens onset time, prolong block durations and significantly decreases the IOP with minimal side effects. IV dexmedetomidine, in addition, produces intra-operative sedation with hemodynamic stability.

  10. Effect of Low Dose Dexmedetomidine on Emergence Delirium and Recovery Profile following Sevoflurane Induction in Pediatric Cataract Surgeries

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    Babita Ghai

    2015-01-01

    Full Text Available This randomized trial was conducted to assess the efficacy and recovery profile of low dose intravenous dexmedetomidine in prevention of post-sevoflurane emergence delirium in children undergoing cataract surgery. Sixty-three children aged 1–6 years were included. Anesthesia was induced with sevoflurane and airway was maintained with LMA. They were randomized to group D 0.15 (received intravenous dexmedetomidine 0.15 μg/kg, group D 0.3 (received dexmedetomidine 0.3 μg/kg, or group NS (received normal saline. The incidence of emergence delirium, intraoperative haemodynamic variables, Aldrete scoring, pain scoring, rescue medication, and discharge time were recorded. Emergence delirium was significantly reduced in dexmedetomidine treated groups with incidence being 10% in group D 0.15, none in group D 0.3, and 35% in the NS group (p=0.002. Significantly lower PAED scores were observed in D 0.15 and D 0.3 group compared to the NS group (p=0.004. Discharge time was significantly prolonged in the NS group compared to D 0.15 and D 0.3 (45.1 min ± 4.4 versus 36.8 min ± 3.8 versus 34.4 min ± 4.6, p<0.02. Intravenous dexmedetomidine in low doses (0.3 and 0.15 μg/kg was found to be effective in reducing emergence delirium in children undergoing unilateral cataract surgery.

  11. 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.

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

    Science.gov (United States)

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

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

  13. 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

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

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    Bagnis A

    2011-04-01

    cataract surgery should be considered in such cases in order to prevent potentially sight-threatening conditions.Keywords: cystoid macular edema, inflammation, laser surgery, plateau iris configuration

  15. Relevant factors analysis of poor vision after cataract surgery%白内障术后视力低下的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张秀

    2011-01-01

    目的:了解白内障复明术后效果,探讨引起白内障患者术后视力低下的主要因素.方法:186例(208眼)白内障患者采用超声乳化白内障囊外摘除加人工晶体植入术,术后行直接、间接眼底镜检查,对眼底镜所见无法确诊的病例,则予以眼底荧光血管造影检查.结果:208眼,术后153眼视力恢复,占73.55%,53眼视力低下,占26.45%.其中与手术有关致视力低下32眼,占15.38%,原有眼病所致视力低下21眼,占10.09%.结论:白内障术后视力低下与手术效果、术前原有的眼病和各种各样的病变均有很大的关系.%Objective: To know the effect of the cataract surgery, and to explore the main reason of visual acuity after cataract surgery. Methods: 186 cases of cataract patients (208 eyes) were treated by cataract phaeoemuIsification and ex tracapsular cataract extraction plus intraocular lens implantation, direct, indirect ophthalmoscopy were used alter operation, ophthalmoscopy findings could not be confirmed cases used fundus fluorescein angiography. Results: 153 eyes were visual acuity after surgery (73.55%), 53 eyes were with poor vision (26.45%). 32 eyes were related with the cause of poor vision with surgery (15.38%), 21 eyes were due to low vision of the original eye disease (10.09%). Conclusion: Poor vision after cataract surgery have a great relationship with the surgery, preoperalive eye disease and a variety of existing lesions.

  16. Refractive changes and correction after congenital cataract surgery%先天性白内障术后屈光变化及矫正

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    王锐; 张浩润; 黄旭东; 付梦军; 赵静静

    2015-01-01

    对先天性白内障的患儿实施白内障摘除手术已经基本达成共识,但先天性白内障手术后是否植入晶状体、植入晶状体的年龄及植入的人工晶状体度数仍是一个很有争议的问题。本文就先天性白内障患儿术后的屈光变化及残余屈光度的矫正进行综述。%Abstract• For the children with congenital cataract, cataract surgery is the consensus. But after congenital cataract surgery, it is still controversial that whether to implant intraocular lenses, the age of the implantation and the degree of lenses. ln this paper, both refractive changes in the children with congenital cataract and correction on residual refraction postoperatively were summarized.

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

    Directory of Open Access Journals (Sweden)

    Lee Teak Tan

    2008-08-01

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

  18. 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.

  19. Outcomes of cataract surgeries over 16 years in camps held by Al Basar International Foundation in 38 underdeveloped countries

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    Adel A Rushood

    2011-01-01

    Full Text Available Purpose : To evaluate the outcomes of 16 years of eye campaigns in 38 countries in Africa, Asia and the Middle East Materials and Methods : A descriptive, retrospective study using the Al-Basar International Foundation (BIF records. BIF is a non-governmental, non-religious philanthropic organization working in the field of the prevention of blindness since 1989. Having its base in Saudi Arabia and working mainly in Asia and Africa. Study variables included the causes of diminished vision, outcomes of eye surgeries, number of camps, patients assessed, surgeries performed, intraocular lenses (IOLs implanted, spectacles distributed, general outcomes of campaigns, and other variables. Results : Between the periods of November 1989 and June 2006, BIF conducted 620 eye camps. These camps were conducted by ophthalmologists with expertise of working in eye camps with limited resources and harsh environmental conditions. Over two million people were examined and/or treated, and 186, 765 surgeries were performed. Nearly 100,000 IOLs were implanted and more than 140,000 spectacles were prescribed and distributed. The majority of these activities (74% took place in Asia and the Middle East. The best corrected visual acuity achieved (BCVA was ranked good (6/6 -6/18 in 59% of patients and borderline (BCVA 6/18 - 6/60 in 35% and poor (BCVA <6/60 in less than 6% of patients based on World Health Organization (WHO criteria. Conclusion : Quality assured eye campaigns held by BIF helped the most needy countries and people. Intensive volunteer cataract programs and surgeries such as those provided by the BIF add significant support to the efforts of the WHO and International Agency for the Prevention of Blindness in fighting blindness.

  20. 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

  1. 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

  2. 婴幼儿先天性白内障术后无晶状体性青光眼的临床分析%Clinical analysis of aphakic glaucoma following infantile congenital cataract surgery

    Institute of Scientific and Technical Information of China (English)

    马成霞; 吕勇; 吕建; 杨琳; 谭凤玲; 李彬彬

    2016-01-01

    Objective To investigate the incidence,occurrence time and types of aphakic glaucoma following infantile congenital cataract surgery.Methods The records of children who underwent surgery for congenital cataract within the first 24 months of life between January 2010 and January 2014 at the First Affiliated Hospital of Zhengzhou University were retrospectively reviewed.Children with preoperative conditions associated with glaucoma were excluded.The following parameters were ascertained:age received cataract surgery,operation method,the incidence,occurrence time and types of glaucoma.Results A total of 205 patients (324 eyes) with an average surgery age of 13.9 months were included,and the mean follow-up time was 47.6 months.The operation method was cataract extraction combined with posterior continuous circular capsulorhexis and anterior vitrectomy.Twenty-nine patients (37 eyes,11.42%) had subsequent development of aphakic glaucoma,9 eyes of which (2.78%) developed early onset angle closed glaucoma,and the occurrence time was (4.2 ±2.6) months after cataract surgery;28 eyes (8.64%) developed late onset open angle glaucoma,26 of which was angle open glaucoma,and the rest two was angle closed glaucoma.The occurrence time was (37.5 ± 11.0) months after cataract surgery.Twenty-nine patients (37 eyes) developed aphakic glaucoma had cataract surgery within 2 to 12 months (6.8 months on average).The rest 176 patients (287 eyes) who did not develop glaucoma had cataract surgery at 10 to 24 months (14.1 months on average).Conclusions The incidence of aphakic glaucoma following infantile congenital cataract surgery is 11.42%.Aphakic glaucoma is divided into two types of early onset angle closed glaucoma and late onset open angle glaucoma.The occurence time of glaucoma was 2 months to 64 months after cataract surgery.Late onset open angle glaucoma is the most common type.%目的 分析婴幼儿先天性白内障术后无晶状体性青光眼的发生率

  3. 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.

  4. 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.

  5. [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.

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

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    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

  7. Normal flora of conjunctiva and lid margin, as well as its antibiotic sensitivity, in patients undergoing cataract surgery at Phramongkutklao Hospital

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    Ratnumnoi R

    2017-01-01

    Full Text Available Ravee Ratnumnoi, Narumon Keorochana, Chavalit Sontisombat Department of Ophthalmology, Phramongkutklao Hospital, Bangkok, Thailand Objective: This study aimed to evaluate the normal flora of conjunctiva and lid margin, as well as its antibiotic sensitivity. Design: This was a prospective cross-sectional study. Patients and methods: A prospective study was conducted on 120 patients who underwent cataract surgery at the Phramongkutklao Hospital from September 2014 to October 2014. Conjunctival and lid margin swabs were obtained from patients before they underwent cataract surgery. These swabs were used to inoculate blood agar and chocolate agar plates for culturing. After growth of the normal flora, the antibiotic sensitivity method using tobramycin, moxifloxacin, levofloxacin, and cefazolin was applied. Main outcome measures: Normal flora of conjunctiva and lid margin, along with its antibiotic sensitivity, from patients who underwent cataract surgery was assessed. Results: A total of 120 eyes were included in this study, and bacterial isolation rates were identified. Five bacteria from the lid margin were cultured, namely, coagulase-negative staphylococcus (58.33%, Streptococcus spp. (2.5%, Corynebacterium (1.67%, Micrococcus spp. (1.67%, and Staphylococcus aureus (0.83%. Two bacteria from the conjunctiva were cultured, namely, coagulase-negative staphylococcus (30% and Streptococcus spp. (0.83%. Results of antibiotic sensitivity test showed that all isolated bacteria are sensitive to cefazolin 100%, tobramycin 98.67%, levofloxacin 100%, and moxifloxacin 100%. Conclusion: Coagulase-negative staphylococci are the most common bacteria isolated from conjunctiva and lid margin. Keywords: conjunctival flora, lid margin flora, cataract surgery, sensitivity, antibiotics

  8. 超高龄白内障人工晶状体手术的临床效果%Clinical efficacy of cataract surgery in the super elderly patients

    Institute of Scientific and Technical Information of China (English)

    郝黎; 李媛; 侯习武

    2012-01-01

    目的 总结基层医院对扶贫90岁以上高龄患者白内障复明手术的安全性、临床效果及体会.方法 回顾性分析近3年对白内障患者中90岁以上超高龄老人28例(32眼)进行小切口白内障手术,对术中麻醉效果、安全性及临床效果进行分析.结果 28例(32眼)白内障成功顺利完成手术,术后视力恢复快.随访无严重的并发症.结论 高龄老人白内障在基层医院开展扶贫高龄白内障复明手术,安全、实用、效果良好,同样可取得好效果.%Objective To summarize the safety,clinical efficacy and experiences of the cataract surgery in patients over the age of 90 in primary hospital.Methods The effects,anesthesia,and postoperative clinical safety of small incision cataract surgery for patients over the age of 90 of 28 cases( 32 eyes)were retrospective analysised nearly three years.Results All patients were performed a successful cataract surgery with fast visual recovery after surgery and with no serious complications.Conclusion The operations for super elderly cataract patients in the primary hospital were safe and practical,the results were satisfactory.

  9. 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.

  10. Functional visual improvement after cataract surgery in eyes with age-related macular degeneration; Results of the Ophthalmic Surgical Outcomes Data (OSOD) Project.

    Science.gov (United States)

    Stock, Michael V; Vollman, David E; Baze, Elizabeth F; Chomsky, Amy S; Daly, Mary K; Lawrence, Mary

    2015-03-03

    Purpose: To determine if cataract surgery on eyes with age-related macular degeneration (AMD) confers as much functional visual improvement as on eyes without retinal pathology. Methods: This is a retrospective analysis of 4,924 cataract surgeries from the VA Ophthalmic Surgical Outcomes Data Project. We included cases of eyes with AMD which had both preoperative and postoperative NEI-VFQ-25 questionnaires submitted and compared their outcomes to controls without retinal pathology. We excluded patients with other retinal pathologies. The analyses compared changes in visual acuity and overall functional visual improvement and its subscales. Results: Preoperative and postoperative questionnaires were submitted by 58.3% of AMD and 63.8% of controls. Analysis of overall score showed that cataract surgery on eyes with AMD led to increased visual function (13.8± 2.4 NEI-VFQ units, PNEI-VFQ units, PAMD was predictive of postoperative visual function (r=-0.38, PAMD patients with vision of 20/40 or better had overall outcomes similar to controls (-2.2± 4.7 NEI-VFQ units, P=0.37). Conclusions: Cataract surgery on eyes with AMD offers an increase in functional visual improvement; however, the amount of benefit is associated with the eye's preBCVA. For eyes with preBCVA ≥20/40, the improvement is similar to that of patients without retinal pathology. However, if preBCVA is <20/40, the amount of improvement was shown to be significantly less and decreased with decreasing preBCVA.

  11. Effects of 3% diquafosol sodium ophthalmic solution on higher-order aberrations in patients diagnosed with dry eye after cataract surgery

    Science.gov (United States)

    Inoue, Yasushi; Ochi, Shintarou

    2017-01-01

    Purpose To evaluate the effects of diquafosol sodium ophthalmic solution 3% (DQS) and artificial tears (AT) on higher-order aberrations (HOAs) in patients with dry eye after cataract surgery. Design This was a post hoc analysis of a previously conducted randomized clinical study. Methods Fifty-nine eyes from 42 patients (17 males and 25 females, aged 72.6±8.0 years) with verified or suspected dry eye at 4 weeks after cataract surgery were evaluated. The dry eye patients were randomly assigned to receive DQS or AT for 4 weeks. Tear breakup time (BUT), corneal and conjunctival fluorescein staining scores, and HOAs were analyzed before and after instillation. HOAs were measured consecutively for 10 seconds with a wavefront analyzer. Average HOAs, HOA fluctuations (fluctuation index [FI]) and changes in HOAs (stability index [SI]) were compared within and between the two groups. Results After 4 weeks of instillation, BUT significantly increased (P=0.001) compared with preinstillation values in the DQS group, but not in the AT group. This increase in BUT in the DQS group was significantly greater than in the AT group (P=0.014). Corneal and conjunctival fluorescein staining scores after instillation significantly improved compared with preinstillation values in the DQS group (P=0.018). In HOAs, the cornea aberration changed from an upward curve (a sawtooth pattern) to an almost constant value (a stable pattern) in the DQS group, but not in the AT group. In FI and SI, there were no significant changes in either group; however, FI and SI were significantly lower in the DQS group than in the AT group (both, P=0.004). Conclusion The dry eye patients after cataract surgery had a visual dysfunction in HOAs. DQS is effective to treat dry eye disease after cataract surgery with improvement of visual function. PMID:28096651

  12. Normal flora of conjunctiva and lid margin, as well as its antibiotic sensitivity, in patients undergoing cataract surgery at Phramongkutklao Hospital

    Science.gov (United States)

    Ratnumnoi, Ravee; Keorochana, Narumon; Sontisombat, Chavalit

    2017-01-01

    Objective This study aimed to evaluate the normal flora of conjunctiva and lid margin, as well as its antibiotic sensitivity. Design This was a prospective cross-sectional study. Patients and methods A prospective study was conducted on 120 patients who underwent cataract surgery at the Phramongkutklao Hospital from September 2014 to October 2014. Conjunctival and lid margin swabs were obtained from patients before they underwent cataract surgery. These swabs were used to inoculate blood agar and chocolate agar plates for culturing. After growth of the normal flora, the antibiotic sensitivity method using tobramycin, moxifloxacin, levofloxacin, and cefazolin was applied. Main outcome measures Normal flora of conjunctiva and lid margin, along with its antibiotic sensitivity, from patients who underwent cataract surgery was assessed. Results A total of 120 eyes were included in this study, and bacterial isolation rates were identified. Five bacteria from the lid margin were cultured, namely, coagulase-negative staphylococcus (58.33%), Streptococcus spp. (2.5%), Corynebacterium (1.67%), Micrococcus spp. (1.67%), and Staphylococcus aureus (0.83%). Two bacteria from the conjunctiva were cultured, namely, coagulase-negative staphylococcus (30%) and Streptococcus spp. (0.83%). Results of antibiotic sensitivity test showed that all isolated bacteria are sensitive to cefazolin 100%, tobramycin 98.67%, levofloxacin 100%, and moxifloxacin 100%. Conclusion Coagulase-negative staphylococci are the most common bacteria isolated from conjunctiva and lid margin. PMID:28203050

  13. 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

  14. Effectiveness and Optical Quality of Topical 3.0% Diquafosol versus 0.05% Cyclosporine A in Dry Eye Patients following Cataract Surgery

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    Jang Hoon Lee

    2016-01-01

    Full Text Available Purpose. To evaluate the effectiveness and optical quality of 3.0% topical diquafosol versus 0.05% cyclosporine A in dry eye patients following cataract surgery. Methods. In total, 40 eyes of 40 patients newly diagnosed with dry eye syndrome 1 week after cataract surgery were randomized to receive either 3.0% diquafosol ophthalmic solution six times daily or 0.05% cyclosporine A twice daily for 3 months. Outcome measures were tear film break-up time (TBUT, results on Schirmer 1 test, ocular surface staining score, the ocular surface disease index (OSDI score, and higher-order aberrations (HOAs. Measurements were taken at baseline and at 1, 2, and 3 months. Results. In the diquafosol group, TBUT showed higher outcomes than the cyclosporine A group at 1 and 3 months. Both groups showed increased scores on Schirmer 1 test. The ocular surface staining score decreased in all periods in both groups. Vertical coma and total HOAs decreased more in the cyclosporine A group than in the diquafosol group at 3 months. Conclusion. Both 3.0% diquafosol and 0.05% cyclosporine A were effective in treating dry eye after cataract surgery. Diquafosol was more effective in increasing the tear secretion, but cyclosporine A was more effective in improving optical aberrations.

  15. Developing cross-sectoral quality assurance for cataract surgery in the statutory quality assurance program of the German health care system: Experiences and lessons learned.

    Science.gov (United States)

    Bramesfeld, Anke; Pauletzki, Jürgen; Behrenz, Lars; Szecsenyi, Joachim; Willms, Gerald; Broge, Björn

    2015-08-01

    Since 2001, statutory external quality assurance (QA) for hospital care has been in place in the German health system. In 2009, the decision was taken to expand it to cross-sectoral procedures. This novel and unprecedented form of national QA aims at (1) making the quality procedures comparable that are provided both in inpatient and outpatient care, (2) following-up outcomes of hospital care after patients' discharge and (3) measuring the quality of complex treatment chains across interfaces. As a pioneer procedure a QA procedure in cataract surgery QA was developed. Using this as an example, challenges of cross-sectoral QA are highlighted. These challenges relate, in particular, to three technical problems: triggering cases for documentation, following-up patients' after hospital discharge, and the burden of documentation in outpatient care. These problems resulted finally in the haltering of the development of the QA procedure. However, the experiences gained with this first development of cross-sectoral QA inspired the reorientation and further development of the field in Germany. Future cross-sectoral QA will rigorously aim at keeping burden of documentation small. It will draw data for QA mainly at three sources: routine data, patient surveys and peer reviews using indicators. Policy implications of this reorientation are discussed.

  16. 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

  17. 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

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

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    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.

  19. Pattern of refractive correction and timing of stage II IOL implantation after congenital cataract extraction.

    Science.gov (United States)

    Li, Yan; Lin, Haotian

    2014-12-01

    Congenital cataract occurs during infancy when the axial length and corneal and visual function are in the sensitive stages of rapid development. Inappropriate surgical intervention 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 during 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 implantation. 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.

  20. Subperiosteal hematoma from peribulbar block during cataract surgery leading to optic nerve compression in a patient with parahemophilia

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    Khokhar S

    2015-12-01

    Full Text Available Sudarshan Khokhar,1 Bhagabat Nayak,1 Bharat Patil,1 Milind Devidas Changole,1 Gautam Sinha,1 Reetika Sharma,1 Lipika Nayak2 1Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Department of Pediatrics, Loknayak Hospital, Maulana Azad Medical College, Delhi, India Abstract: A 17-year-old male presented with gradual painless diminution of vision since childhood. Slit lamp examination revealed both eyes having congenital cataract. Right eye lens aspiration was performed but was uneventful, and he prepared for left eye surgery after 7 days. Immediately after giving a peribulbar block, a complete akinesia, tight eyelids, and stony hard eyeball was noted. An abaxial proptosis of 7 mm was noted. Lateral canthotomy and inferior cantholysis were done and proptosis reduced to 5 mm. Bleeding time–clotting time was normal. Proptosis worsened to 8 mm the next day. Contrast-enhanced computed tomography scan showed inferolateral subperiosteal hematoma, but drainage could not be performed due to prolonged prothrombin time and activated prothrombin time. Fresh frozen plasma was transfused. Tarsorrhaphy was performed for exposure keratopathy after his coagulation profile became normal. Hematology evaluation after 2 weeks detected factor V deficiency, and was diagnosed as Owren's disease or parahemophilia. Keywords: peribulbar block, hematoma, subperiosteal, parahemophilia, optic nerve compression

  1. 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

  2. Effects of 3% diquafosol sodium ophthalmic solution on higher-order aberrations in patients diagnosed with dry eye after cataract surgery

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    Inoue Y

    2016-12-01

    Full Text Available Yasushi Inoue, Shintarou Ochi Inoue Eye Clinic, Tamano, Okayama, Japan Purpose: To evaluate the effects of diquafosol sodium ophthalmic solution 3% (DQS and artificial tears (AT on higher-order aberrations (HOAs in patients with dry eye after cataract surgery. Design: This was a post hoc analysis of a previously conducted randomized clinical study. Methods: Fifty-nine eyes from 42 patients (17 males and 25 females, aged 72.6±8.0 years with verified or suspected dry eye at 4 weeks after cataract surgery were evaluated. The dry eye patients were randomly assigned to receive DQS or AT for 4 weeks. Tear breakup time (BUT, corneal and conjunctival fluorescein staining scores, and HOAs were analyzed before and after instillation. HOAs were measured consecutively for 10 seconds with a wavefront analyzer. Average HOAs, HOA fluctuations (fluctuation index [FI] and changes in HOAs (stability index [SI] were compared within and between the two groups. Results: After 4 weeks of instillation, BUT significantly increased (P=0.001 compared with preinstillation values in the DQS group, but not in the AT group. This increase in BUT in the DQS group was significantly greater than in the AT group (P=0.014. Corneal and conjunctival fluorescein staining scores after instillation significantly improved compared with preinstillation values in the DQS group (P=0.018. In HOAs, the cornea aberration changed from an upward curve (a sawtooth pattern to an almost constant value (a stable pattern in the DQS group, but not in the AT group. In FI and SI, there were no significant changes in either group; however, FI and SI were significantly lower in the DQS group than in the AT group (both, P=0.004. Conclusion: The dry eye patients after cataract surgery had a visual dysfunction in HOAs. DQS is effective to treat dry eye disease after cataract surgery with improvement of visual function. Keywords: cataract surgery, dry eye, tear film breakup time, higher-order aberrations

  3. 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.

  4. 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.

  5. Clinical Analysis of Non-phacoemulsification Cataract Operation Using Small Incision Cataract Surgery in the Treatment of Hard Nuclear Cataract%小切口非超声乳化白内障手术治疗硬核白内障的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨震雷; 陈蕾; 李婧媛

    2016-01-01

    目的:探讨小切口非超声乳化白内障术治疗硬核白内障的效果。方法随机将120例硬核白内障患者平均分为两组,观察组行小切口非超声乳化白内障术,对照组行常规术式治疗。比较两组临床疗效。结果两组视力差异无统计学意义(P >0.05)。观察组角膜散光、并发症发生率优于对照组(P <0.05)。结论小切口非超声乳化白内障术疗效理想。%Objective To observe the effect of small incision cataract surgery. Methods 120 patients were divided into two groups, observation group used small incision cataract surgery, and control group used conventional therapy. comparing efficacy of two groups. Results The vision had no difference between two groups (P>0.05). the corneal astigmatism and the incidence rate of complications of observation group were significantly better than control group (P<0.05). Conclusion The effect of small incision cataract surgery is ideal.

  6. Three cases of extracapsular cataract extraction for radiation cataract

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

    1996-02-01

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

  7. Identification of a novel missense mutation of MAF in a Japanese family with congenital cataract by whole exome sequencing: a clinical report and review of literature.

    Science.gov (United States)

    Narumi, Yoko; Nishina, Sachiko; Tokimitsu, Motoharu; Aoki, Yoko; Kosaki, Rika; Wakui, Keiko; Azuma, Noriyuki; Murata, Toshinori; Takada, Fumio; Fukushima, Yoshimitsu; Kosho, Tomoki

    2014-05-01

    Congenital cataracts are the most important cause of severe visual impairment in infants. Genetic factors contribute to the disease development and 29 genes are known to cause congenital cataracts. Identifying the genetic cause of congenital cataracts can be difficult because of genetic heterogeneity. V-maf avian musculoaponeurotic fibrosarcoma oncogene homolog (MAF) encodes a basic region/leucine zipper transcription factor that plays a key role as a regulator of embryonic lens fiber cell development. MAF mutations have been reported to cause juvenile-onset pulverulent cataract, microcornea, iris coloboma, and other anterior segment dysgenesis. We report on six patients in a family who have congenital cataracts were identified MAF mutation by whole exome sequencing (WES). The heterozygous MAF mutation Q303L detected in the present family occurs in a well conserved glutamine residue at the basic region of the DNA-binding domain. All affected members showed congenital cataracts. Three of the six members showed microcornea and one showed iris coloboma. Congenital cataracts with MAF mutation exhibited phenotypically variable cataracts within the family. Review of the patients with MAF mutations supports the notion that congenital cataracts caused by MAF mutations could be accompanied by microcornea and/or iris coloboma. WES is a useful tool for detecting disease-causing mutations in patients with genetically heterogeneous conditions.

  8. 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.

  9. A comparison of intraocular pressure and hemodynamic responses to insertion of laryngeal mask airway or endotracheal tube using anesthesia with propofol and remifentanil in cataract surgery

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    Mohsen Ziyaeifard

    2012-01-01

    Full Text Available Background: The aim of this study was to evaluate intraocular pressure (IOP and hemodynamic responses following insertion of laryngeal mask airway (LMA or endotracheal tube (ETT after anesthesia induction with propofol and remifentanil in cataract surgery. Materials and Methods: In a randomized controlled study, 50 adults scheduled for elective cataract extraction procedure under general anesthesia were allocated to LMA insertion (n = 25 or ETT (n = 25 groups. IOP, systolic blood pressure (SBP, diastolic blood pressure (DBP, and heart rate (HR were measured after insertion of the airway device every minute up to 5 min. Results: There were no significant differences between LMA and ETT groups in SBP, DBP, HR, and IOP immediately after airway instrumentation up to 5 min, except in 4th min in DBP, 2nd min in HR, and 5th min in IOP (7.9 ± 2.3 mmHg in LMA and 9.4 ± 2.5 mmHg in ETT group; P = 0.030. There was good surgeon satisfaction for providing acceptable surgical field in both groups (88% in LMA and 80% in ETT group; P = 0.702. Conclusion: Propofol combined with remifentanil provides good and excellent conditions for insertion of LMA or ETT with minimal hemodynamic disturbances in cataract surgery. Considering LMA insertion is less traumatic than ETT, using LMA may be better than ETT for airway securing in these patients.

  10. Cataracts and Dupuytren disease: a case report and review of the literature.

    Science.gov (United States)

    Cutolo, Carlo A; Lombardo, Sara; Verticchio Vercellin, Alice C; Bertone, Chiara; De Amici, Mara; Antoniazzi, Elena; Milano, Giovanni

    2012-11-08

    Purpose. Dupuytren disease is an inherited proliferative and progressive connective disease. Ectopic disease may, however, be located distant from the palmar fascia. 
Methods. Case report and review of the literature. 
Results. We describe a case of symmetric bilateral posterior subcapsular cataracts associated with symmetric bilateral Dupuytren disease and symmetric bilateral Ledderhose disease in a 56-year-old Caucasian man. His medical history was negative for glucocorticoids intake, diabetes, and exposure to radiation. Serum transforming growth factor β (TGF-β)1 concentration has been evaluated and was found to be almost double compared to the controls. 
Conclusions. We speculate that the TGF-β plays an important role for ocular and connective tissue disorders.

  11. 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

  12. 白内障超声乳化吸除联合小梁切除术治疗青光眼合并白内障59例临床观察%Clinical observation on treatment of 59 cases of glaucoma and cataract with ultrasonic phacoemulsification for cataract surgery combined with trabeculectomy.

    Institute of Scientific and Technical Information of China (English)

    刘欣; 高宗银; 张柳

    2011-01-01

    Objective To observe the clinical effect of treating glaucoma and cataract with ultrasonic phacoemulsification for cataract surgery combined with trabeculectomy. Methods Fifty nine patients with glaucoma and cataract were treated with ultrasonic phacoemusification for cataract surgery combined with trabeculectomy. Postoperative vision, intraocular pressure, filtering bleb and complications were observed. ResultsPostoperative vision of patients was significantly increased, postoperative intraocular pressure and complications were significantly decreased,and filtering bleb was seen. Conclusion The effect of treatment in cases of glaucoma and cataract with ultrasonic phacoemulsification for cataract surgery combined with trabeculectomy is excellent.%目的 观察白内障超声乳化吸除联合小梁切除术治疗青光眼合并白内障的临床疗效.方法 59例青光眼合并白内障患者,采用白内障超声乳化吸除联合小梁切除术治疗,观察病人的术后视力、眼压、滤过泡及并发症情况.结果 术后视力明显增高,眼压明显地降低,均有滤过泡形成.结论 采用白内障超声乳化吸除联合小梁切除术对青光眼合并白内障的治疗效果良好.

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

    Science.gov (United States)

    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

  14. 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.

  15. Paediatric cataract: challenges and complications

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    Dr P Vijayalakshmi

    2016-10-01

    Full Text Available Amblyopia should always be anticipated in children with unilateral cataract, asymmetrical bilateral cataracts (or where there is a delay between the first and second eye operation, or a delay of more than a year between diagnosis/ detection and surgery, cataracts with anisometropia or traumatic cataracts with corneal scars. When amblyopia is detected, occlusion therapy (eye patching must be instituted at the earliest opportunity. The patching regimen is the same with any strabismic amblyopia and sometimes needs to be aggressive at the start. It is crucial to explain the need for patching to the parents, since compliance is the greatest obstacle to the success of amblyopia treatment.

  16. 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.

  17. 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

  18. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Country-Wide Monitoring of Cataract Surgical Outcomes

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    Moses C Chirambo

    2002-01-01

    Full Text Available The Lions SightFirst Eye Hospital (LSFEH in Lilongwe, Malawi, participated in the initial study to develop monitoring systems for cataract outcome. The pilot study took place between 1 June and 31 December, 2000. All surgery was done at the Lions SightFirst Hospital, Lilongwe. The number of cataract operations recorded in the study was 454.However, the proportion of patients seen for review was 89%, mainly because of active follow-up of those patients who did not come for review on their own.

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

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    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

  2. 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.

  3. 非超声乳化小切口白内障手术与超声乳化白内障手术的临床对比分析%Clinical comparison analysis between non-phacoemulsification small incision cataract surgery and of phacoemulsification cataract surgery

    Institute of Scientific and Technical Information of China (English)

    李诗敏

    2015-01-01

    目的:观察探讨非超声乳化小切口白内障手术与超声乳化白内障手术的临床疗效。方法:选取2011年12月至2014年09月期间我院收治的白内障患者400例,将其随机分为观察组和对照组,每组200例,对照组患者给予超声乳化白内障手术治疗,观察组给予非超声乳化小切口白内障手术治疗,术后随访并对两组患者的临床疗效进行比较分析。结果:随访后发现,术后1天,在患者视力>0.5方面,对照组155例(77.50%),观察组125例(62.50%),对照组明显高于观察组,两组差异显著具有统计学意义(p0.05)。结论:非超声乳化小切口白内障手术与超声乳化白内障手术在治疗白内障方面均具有显著临床效果,临床中要根据患者的实际情况选取合适的方式,最大限度的减少并发症。%Objective:to explore the non-phacoemulsification small incision cataract surgery and clinical effect of phacoemulsi-fication cataract surgery. Methods:cataract patients in our hospital during the December 2011 to September 2014 400 cases, be randomly divided into two groups and the control group, each group of 200 cases, phacoemulsification cataract surgery in the treatment of patients with control groups, observation groups were given non-phacoemulsification small incision cataract surgery and postoperative follow-up and comparative analysis of the clinical effect of two groups of patients. Results: found that 1 day after surgery, in patients with Visual > 0. 5, 155 cases in the control group (77. 5%) , 125 patients in the observation group (62. 5%) , the Group was significantly higher than that observed in the control group, the two groups significant difference statis-tically significant (p0. 05) . Conclusion: non-phacoemulsification small incision cataract surgery with phacoemulsification cataract surgery are significant clinical effects in treating cataracts, clinical selection must be based on a

  4. Safety and efficacy of loteprednol etabonate ophthalmic ointment 0.5% for the treatment of inflammation and pain following cataract surgery

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    Timothy L Comstock

    2011-02-01

    Full Text Available Timothy L Comstock1 Michael R Paterno1 Angele Singh1 Tara Erb1 Elizabeth Davis21Bausch and Lomb Inc., Rochester, NY, USA; 2Minnesota Eye Consultants, Bloomington, MN, USABackground: To compare the safety and efficacy of loteprednol etabonate ophthalmic ointment 0.5% (LE ointment, a new topical ointment formulation, with vehicle for the treatment of inflammation and pain following cataract surgery.Methods: Two randomized, multicenter, double-masked, parallel-group, vehicle-controlled studies were conducted. Patients aged ≥18 years with a combined postoperative anterior chamber cells and flare (ACI ≥ Grade 3 following uncomplicated cataract surgery participated in seven study visits. Patients self-administered either topical LE ointment or vehicle four times daily for 14 days. Efficacy outcomes included the proportion of patients with complete resolution of ACI and the proportion of patients with no (Grade 0 pain at postoperative day 8. Safety outcomes included the incidence of adverse events, ocular symptoms, changes in intraocular pressure and visual acuity, and biomicroscopy and funduscopy findings.Results: Data from the two studies were combined. The integrated intent-to-treat population consisted of 805 patients (mean [standard deviation] age 69.0 [9.2] years; 58.0% female and 89.7% white. Significantly more LE ointment-treated patients than vehicle-treated patients had complete resolution of ACI (27.7% versus 12.5% and no pain (75.5% versus 43.1% at day 8 (P < 0.0001 for both. Fewer LE ointment-treated patients required rescue medication (27.7% versus 63.8%, and fewer had an ocular adverse event (47.2% versus 78.0%, P < 0.0001 while on study treatment. The most common ocular adverse events with LE ointment were anterior chamber inflammation, photophobia, corneal edema, conjunctival hyperemia, eye pain, and iritis. Mean intraocular pressure decreased in both treatment groups. Four patients had increased intraocular pressure ≥10 mm

  5. 基于流动医院的白内障超声乳化手术培训模式的探索%Exploration of cataract phacoemulsification surgery training models based upon mobile hospital

    Institute of Scientific and Technical Information of China (English)

    王凯; 鲍永珍; 李明武; 黎晓新

    2011-01-01

    In mobile hospitals, numerous cataract patients have recovered visual acuity after cataract surgeries, during which a lot of eligible cataract surgeons have been trained.During the process of training, Department of Ophthalmology, Peking University People' s Hospital explored two new cataract surgery training models and gained good training results.Combination of these two models has significantly elevated completion rate of independently performed cataract surgeries, and lowered incidence of surgery complications.%基于流动医院的白内障复明手术给无数白内障患者带来了光明,同时也培养了一批合格的白内障手术医师。在实施复明手术的过程中,北京大学人民医院眼科中心探索了2种新的白内障手术培训模式,取得了良好的手术培训效果。通过2种模式的有机结合,显著提高了受训眼科医师的白内障手术独立完成率,并降低了手术并发症的发生率。

  6. 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.

  7. Natural orifice transluminal endoscopy surgery: A review

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    Jo(a)o Moreira-Pinto; Estev(a)o Lima; Jorge Correia-Pinto; Carla Rolanda

    2011-01-01

    Minimally invasive surgery started spreading worldwide in 1987, when the first laparoscopic cholecystectomy was performed. Meanwhile, improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions, even beyond the wall barrier. The first transgastric peritoneoscopy, in 2004, brought to light the concept of natural orifice transluminal endoscopic surgery (NOTES). The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation. The authors present a review of all developments concerning NOTES, including animal studies and human experience.

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

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    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.

  9. Genetics of Congenital Cataract.

    Science.gov (United States)

    Pichi, Francesco; Lembo, Andrea; Serafino, Massimiliano; Nucci, Paolo

    2016-01-01

    Congenital cataract is a type of cataract that presents at birth or during early childhood, and it is one of the most easily treatable causes of visual impairment and blindness during infancy, with an estimated prevalence of 1-6 cases per 10,000 live births. Approximately 50% of all congenital cataract cases may have a genetic cause, and such cases are quite heterogeneous. Although congenital nuclear cataract can be caused by multiple factors, genetic mutation remains the most common cause. All three types of Mendelian inheritance have been reported for cataract; however, autosomal dominant transmission seems to be the most frequent. The transparency and high refractive index of the lens are achieved by the precise architecture of fiber cells and homeostasis of the lens proteins in terms of their concentrations, stabilities, and supramolecular organization. Research on hereditary congenital cataract has led to the identification of several classes of candidate genes that encode proteins such crystallins, lens-specific connexins, aquaporin, cytoskeletal structural proteins, and developmental regulators. In this review, we highlight the identified genetic mutations that account for congenital nuclear cataract.

  10. Small Incision Non-phacoemulsification Cataract Surgery Clinical Effect Analysis of Hard Nucleus Cataract%小切口非超声乳化白内障手术治疗硬核白内障的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    殷先第

    2015-01-01

    Objective To explore the clinical effect of smal incision non-phacoemulsification cataract surgery in the hard nuclear cataract treatment.Methods Choose 76 cases of our hospital's hard nuclear cataract patients,divided into control group and experimental group in lots of ways, control group treated by conventional incision cataract extracapsular extraction, and the experimental treated by smal incision non phacoemulsification cataract surgery, the treatment effects were analyzed.Results The experimental group after treatment in patients with corneal luminosity and the incidence of complications was better than the control group patients, the results were statisticaly significant (P<0.05).ConclusionSmal incision non-phacoemulsification cataract surgery in treatment of hard nuclear cataract ,the effect is remarkable.%目的:探究硬核白内障治疗中采用小切口非超声乳化白内障手术的临床效果。方法选择我院收治的硬核白内障患者76例,采用抽签的方式将其分为对照组和实验组,对照组治疗方式为常规切口白内障囊外摘除术,而实验组治疗方式为小切口非超声乳化白内障手术,将治疗效果进行对比分析。结果治疗后实验组患者的角膜散光度及并发症发生率明显优于对照组患者,差异P<0.05。结论在硬核白内障治疗中采用小切口非超声乳化白内障手术方式,效果显著。

  11. Tendências evolutivas dos cirurgiões de catarata presentes no IV Congresso Brasileiro de Catarata e Cirurgia Refrativa Evolutionary trends of cataract surgeons who attended the IV Brazilian Congress of Cataract and Refractive Surgery

    Directory of Open Access Journals (Sweden)

    Marcony Rodrigues de Santhiago

    2009-02-01

    Full Text Available OBJETIVO:Dar continuidade ao processo de atualização e aperfeiçoamento da cirurgia de catarata no Brasil, além de obter dados para uma análise comparativa das atuais tendências cirúrgicas nacionais e internacionais. MÉTODOS:Em maio de 2007, foram obtidos dados de 188 participantes de um congresso de Catarata e Cirurgia Refrativa através questionários autoaplicáveis, contendo perguntas objetivas a respeito da cirurgia de catarata. Análise estatística foi feita através teste T e Qui-quadrado. RESULTADOS: Observou-se que 95,8% dos participantes praticam a facoemulsificação, enquanto somente 4,2% preferem usar a técnica extracapsular convencional. Para 73,4% dos participantes, o bloqueio peribulbar é preferido em relação ao uso de anestésico tópico (20,2%. A técnica de facoemulsificação mais realizada é a de dividir e conquistar (32,0%. A hidroximetilcelulose foi o viscoelástico de escolha para 60,8% dos colaboradores. O aparelho de facoemulsificação mais usado pelos participantes foi o Infiniti® (24,0%, seguido pelo Legacy® (19,8%. CONCLUSÃO:Os resultados deste estudo foram consistentes com o que era esperado, tendo como base pesquisas semelhantes. Destaca-se um aumento considerável do número cirurgiões adeptos à facoemulsificação e tendências no sentido de maior utilização de incisões corneanas temporais e anestesia tópica.Purpose: To continue the updating and improving process of the cataract surgery in Brazil, through recently pulled out and documented registries. In addition, we want to obtain data for a comparative analysis of the current national and international surgical trends. METHODS:In May 2007, data were obtained from 188 participants of a Congress of Cataract and Refrative Surgery who answered simple and multiple-response questions about cataract surgery. Data were analyzed by statistic means of Chi-square test and T test. RESULTS:95.8% of respondents practice phacoemulsification, while only

  12. The Influence of Oral Ginger before Operation on Nausea and Vomiting after Cataract Surgery under General Anesthesia: A double-blind placebo-controlled randomized clinical trial

    Science.gov (United States)

    Seidi, Jamal; Ebnerasooli, Shahrokh; Shahsawari, Sirous; Nzarian, Simin

    2017-01-01

    Background According to Iranian traditional medicine, using safe ginger may contribute to taking less chemical medicines and result in fewer side effects. Objective To determine the influence of using ginger before operation on nausea and vomiting, after cataract surgery under general anesthesia. Methods This study was a double-blind placebo-controlled randomized clinical trial conducted at Kurdistan University of Medical Sciences in 2015. 122 candidates of cataract surgery were randomly allocated in three groups. The first group received a ginger capsule in a single 1 g dose, the second received two separate doses of ginger capsule each containing 500 mg and the third group received placebo capsule before operation. The patients were examined and studied for the level of nausea and occurrence of vomiting for 6 hours after the operation. The intensity of nausea was scored from zero to ten, based upon Visual Analog Scale. SPSS version 20 was used to analyze the data. We used Chi square and Kruskal-Wallis test for the analyses of outcomes. Results The frequency and intensity of nausea and the frequency of vomiting after operation among those who had taken the ginger capsule in 2 separate 500 mg doses was less than the other 2 groups. This difference was significant (pKurdistan University of Medical Sciences, Sanandaj, Iran. PMID:28243400

  13. Corneal topographic analysis of small incision in cataract surgery%小切口白内障术后的早期角膜地形图分析

    Institute of Scientific and Technical Information of China (English)

    郑海华; 陈峰; 韩真真

    2001-01-01

    目的:研究白内障小切口术后角膜形态变化特点。 方法:用角膜地形图对27例(34眼)白内障小切口手术患者进行检查,分析其术前,术后1周、1月、3月的角膜地形图变化。 结果:术后1周仅产生手术源性散光0.52D,术后1月角膜散光及CIM值(角膜不规则系数)趋向稳定,裸眼视力≥0.5占26眼(76.42%),SF值(角膜形状系数)术前术后无明显变化。结论:小切口具有早期角膜形态变化小、散光稳定、视力恢复快等优点,角膜地形图可准确全面反映白内障术后角膜形态变化。%Objective:To study corneal topographic changes after cataract surgery through small incision.Methods:Corneal topography of 34 eyes in 27 patients who had undergone small incision cataract surgery was analyzed preoperatively and at 1 week, 1 month, 3 months postoperatively. Results:Surgically induced astigmatic change of 0.52D was observed at 1 week postoperatively. Corneal astigmatism and CIM remained quite stable 1 month after surgery. 26 eyes(76.42%) obtained uncorrected visual acuity to 0.5 or better. Compared with preoperative statistics, no significant change of SF was found postoperatively.Conclusion:The results suggested that the small incision produces less astigmatism postoperatively, faster postoperative recovery, less corneal topographic change early after surgery. Computerized videokeratography system is an effective way to measure precisely the change of corneal topography after cataract surgery.

  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. Bariatric surgery and pregnancy: literature review

    Directory of Open Access Journals (Sweden)

    Pedro Ferrand Miranda

    2014-01-01

    Full Text Available Obesity has currently reached epidemic proportions, both in Chile and in the world. This condition is associated to a variety of maternal complications in all stages of the vital cycle and during pregnancy. Medical treatment has not proved successful thus resulting in an increase in bariatric surgery in recent years, even when it is not first line treatment. This literature review aims to report updated results of surgical treatment for obesity before and during pregnancy with respect to fertility, gestational diabetes, pre-eclampsia and pregnancy-induced hypertension. It also looks into the possible effects of surgery on fetal development, and its relation to premature delivery, fetal macrosomy, low birth weight and neural tube defects, as well as effects on maternal and fetal outcomes, mainly in nutrition. Lastly, we suggest some recommendations that arise from this review on the role of contraception, nutrition and time between surgery and pregnancy.

  16. Laparoscopic surgery for endometrial cancer: a review.

    Science.gov (United States)

    Hauspy, Jan; Jiménez, Waldo; Rosen, Barry; Gotlieb, Walter H; Fung-Kee-Fung, Michael; Plante, Marie

    2010-06-01

    Uterine cancer is the fourth most common cancer in Canadian women, with an estimated 4200 new cases and 790 disease-related deaths in 2008. We investigated the domains that are important for further implementation of minimally invasive surgery for the management of endometrial cancer by performing a literature review to assess the available data on overall and disease-free survival in laparoscopic versus open surgery. We also investigated the influence of patient- related factors, surgical factors, quality of life, and cost implications. Among the 23 articles reviewed, five were randomized controlled trials (RCTs), four were prospective reviews, and 14 were retrospective reviews. The RCTs showed no difference in overall and disease-free survival for patients with endometrial cancer who had undergone laparoscopic hysterectomy compared with open surgery. Morbid obesity is a limiting factor for the feasibility of complete laparoscopic staging. Laparoscopy seems to decrease complications and decrease blood loss. It also shortens hospital stay, with improved short-term quality of life and cosmesis, while yielding similar lymph node counts. Overall, laparoscopy is cost-effective, because the increased operation cost of laparoscopy is offset by the shorter hospital stay and faster return to work. On the basis of currently available data, patients with endometrial cancer should be offered minimally invasive surgery as part of their treatment for endometrial cancer whenever possible.

  17. 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

  18. 儿童先天性白内障手术年龄特点及其影响因素%THE AGE FEATURES AND THEIR INFLUENCING FACTORS OF CHILDREN UNDERGOING SURGERY FOR CONGENITAL CATARACT

    Institute of Scientific and Technical Information of China (English)

    由彩云; 应良; 吴晓明

    2011-01-01

    Objective To investigate the age features and related factors of children undergoing congenital cataract surgery.Methods Clinical data of 196 children with congenital cataract who were treated surgically, in 1995-2006, were analyzed retrospectively.Results The mean age at surgery was 68.3±40.0 months.A difference of ages at surgery was significant between bilateral and unilateral procedures (t=-3.70 ,P<0.05).Those with preoperative nystagmus,total cataract and nuclear cataract were much younger than others (t=4.04-4.64, P<0.05).Conclusion The age of the kids at surgery, in our hospital,for congenital cataract was correlated with single or both eyes involved, pre-existing nystagmus, and type of cataract.%目的 探讨先天性白内障病儿手术年龄特点及影响因素.方法 对1995-2006 年就诊的196例先天性白内障病儿进行回顾性分析.结果 病儿白内障总体手术年龄为(68.3±40.0)个月.双眼、单眼病儿手术年龄比较差异有显著性(t=-3.70,P<0.05).术前伴眼球震颤、全内障、核型白内障病儿的手术年龄均比总体手术年龄显著提前(t=4.04~4.64,P<0.05).结论 我院先天性白内障病儿手术年龄与单眼双眼发病、是否伴眼球震颤及白内障类型相关.

  19. 白内障患者手术后干眼不应忽视%Not to ignore the dry eye of cataract patients after surgery

    Institute of Scientific and Technical Information of China (English)

    孙旭光; 施玉英; 张琛

    2008-01-01

    白内障患者手术后发生干眼的问题已经引起了国内外学者的注意.白内障患者术后干眼可分为早期(可逆性)干眼和慢性(不可逆性)干眼,前者术前泪液分泌功能多为正常,由于手术及术后用药等因素的影响,术后泪液分泌暂时性减少,随着相关因素的去除,其功能可以恢复正常;后者术前已患有干眼,或泪液分泌功能处于"边界状态",手术及术后相关因素加剧了泪液分泌的异常,甚至造成眼表组织的异常.及时发现和正确处理术后干眼,对维持眼表稳定性和更好地恢复视力均有重要的临床意义.%Dry eye syndrome following carrot surgery W88 concerned about recently.Two kinds of dry eye were clinically observed after cataract surgery,early dry eye and chronic dry eye.Most cases of early dry eye,who usually had the normal lacrimal secretion before surgery,were reversible and involved in some of factors associated with surgery and pest-surgery medicatiotr But most cases of chronic dry eye,who have abnormal lacrimal secretion or"borderline state"of lacrimal secretion test before surgery,may suffer from the ocular surface diseases related to irreversible dry eye disease.It is significantly important for maintaining of the ocular surface stability and recovery of vision acuity after cataract surgery to do early diagnose and promptly manage the dry eye syndrome.

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

    Science.gov (United States)

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

    2010-01-01

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

  1. 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.

  2. A review of penile elongation surgery

    Science.gov (United States)

    Gillis, Joshua

    2017-01-01

    Penile elongation surgery is less commonly performed in the public sector, but involves a collaborative approach between urology and plastic surgery. Congenital and acquired micropenis are the classic surgical indications for penile elongation surgery. The goal of intervention in these patients is to restore a functional penis size in order to allow normal standing micturition, enable satisfying sexual intercourse and improve patient quality of life. Many men seeking elongation actually have normal length penises, but perceive themselves to be small, a psychologic condition termed ‘penile dysmorphophobia’. This paper will review the anatomy and embryology of congenital micropenis and discuss both conservative and surgical management options for men seeking penile elongation therapy. PMID:28217452

  3. 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

  4. Prevalence of second-eye cataract surgery and time interval after first-eye surgery in Iran: A clinic-based study

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    Marzieh Katibeh

    2013-01-01

    Conclusion: The number of cataract operations in this tertiary eye care setting increased 1.5 fold over the study period. The proportion of second-eye operations also rose from 1/4 to 1/3 during the same time.

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

    Directory of Open Access Journals (Sweden)

    Amaryllis Avakian

    2005-10-01

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

  6. Minimal invasive gastric surgery: A systematic review

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    Kirti Bushan

    2015-01-01

    Full Text Available Background: As an alternate to open surgery, laparoscopic gastrectomy (LG is currently being performed in many centers, and has gained a wide clinical acceptance. The aim of this review article is to compare oncologic adequacy and safety of LG with open surgery for gastric adenocarcinomas with respect to lymphadenectomy, short-term outcomes (postoperative morbidity and mortality and long-term outcome (5 years overall survival and disease-free survival. Materials and Methods: PubMed was searched using query “LG” for literature published in English from January 2000 to April 2014. A total of 875 entries were retrieved. These articles were screened and 59 manuscripts ultimately formed the basis of current review. Results: There is high-quality evidence to support short-term efficacy, safety and feasibility of LG for gastric adenocarcinomas, although accounts on long-term survivals are still infrequent.

  7. Closure of incision in cataract surgery in-vivo using a temperature controlled laser soldering system based on a 1.9μm semiconductor laser

    Science.gov (United States)

    Gabay, Ilan; Basov, Svetlana; Varssano, David; Barequet, Irina; Rosner, Mordechai; Rattunde, Marcel; Wagner, Joachim; Platkov, Max; Harlev, Mickey; Rossman, Uri; Katzir, Abraham

    2016-03-01

    In phacoemulsification-based cataract surgery, a corneal incision is made and is then closed by hydration of the wound lips, or by suturing. We developed a system for sealing such an incision by soldering with a semiconductor disk laser (λ=1.9μm), under close temperature control. The goal was to obtain stronger and more watertight adhesion. The system was tested on incisions in the corneas of 15 eyes of pigs, in-vivo. Optical Coherent Tomography (OCT) and histopathologic examination showed little thermal damage and good apposition. The measured average burst pressure was 1000+/-30mmHg. In the future, this method wound may replace suturing of corneal wounds, including in traumatic corneal laceration and corneal transplantation.

  8. Effect observation about eye movement training to cataract patients before surgery%白内障患者术前眼球运动训练的效果观察

    Institute of Scientific and Technical Information of China (English)

    马新荣

    2016-01-01

    目的:探讨术前眼球运动训练在白内障手术效果的支持。方法:对161名白内障患者进行有效的术前眼球运动训练。结果:161例患者经过术前眼球运动训练,手术效果良好未见明显并发症。结论:白内障患者手术前进行眼球运动训练,可使患者术中很好的配合手术,提高手术成功率。%Objective:Discuss the support of effects about eye movement training to cataract surgery.Method:By giving 161 preoperative cataract patients effective eye movement training.Result:after 161 cataract patients received preoperative eye movement training,they had good operation effects without apparent complications.Conclusion:If cataract patients receive eye movement training before surgery,they can cooperate more positively during operation,and the success rate of surgery will be improved greatly.

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

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    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.

  10. HEAD - TO - HEAD COMPARISON OF TOLERABILITY AND ACCEPTABILITY OF SINGLE DOSE OF FOUR TOPICAL NSAIDS IN PATIENTS UNDERGOING CATARACT SURGERY : A RANDOMIZED OPEN LABEL PARALLEL GROUP STUDY

    Directory of Open Access Journals (Sweden)

    Chandra Sekhar

    2015-07-01

    Full Text Available INTRODUCTION : Ophthalmic NSAIDs are used to control pain , discomfort and inflammation associated with ocular conditions and also , following ophthalmic cataract surgeries. These drugs can cause ocular discomfort following administration which lasts for a short duration. However , there exist differences in the intensity and duration of burning sensation among the c ommonly used ophthalmic NSAIDs. Hence , we evaluated the tolerability and acceptability of four topical NSAIDS i.e. , 0.3% nepafenac (N , 0.5% ketorolac (K , 0.4% ketorolac (K LS and 0.09% bromfenac (B after instilling a single drop. METHODS: This randomized , open label , parallel group study was conducted in the department of Ophthalmology in Narayana Medical College , Nellore. A total number of 80 patients participated in the study. Randomization list was computer generated in a ratio of 1:1:1:1 of N , K , K L Sand B. Each patient received one drop of the study drug either in right or left eye which was also decidedat random.Patients of either gender above21 years of age , having no ocular surface pathology and eligible for cataract surgery were include d in the study. Outcome variables included ocular burning intensity on VAS (0 - 100 mm at 0 min (immediately , 2 min and 6 min after administration of medications , time to complete pain relief and global medication performance rated by patient as 0 (bad , 1 (fair , 2(good or 3 (severe . RESULTS: The mean age of patients was 52.85±17.46 years. All groups were age matched , however there were more females than males (pN>K LS >K on global medication performance. CONCLUSION: Bromfenac had better tolerability and acceptability as compared to other tested topical NSAIDs , which was in the order of B>N> K LS >K.

  11. 云南省泸西县白内障患病率及手术覆盖率调查%Prevalence Rate and Surgery Status of Cataract in Luxi County of Yunnan Province

    Institute of Scientific and Technical Information of China (English)

    蔡宁; 陈苗苗; 袁援生; 蔡山

    2013-01-01

    目的 调查云南省泸西县白内障患病率、手术覆盖率和效果,评价近l0a来实施白内障手术的防盲治盲工作.方法 2011年11月至2012年4月采用整群随机抽样对泸西县抽取5 151例50岁及以上人群进行眼部调查,了解白内障及接受手术情况.结果 5 151例受检者中白内障患病率22.40%,手术负荷量9.3%.白内障盲手术覆盖率5.25%,社会负担率9.24%.接受手术的217人中只实施了右眼手术占77.42%.术后裸眼视力>0.5占39.9%,矫正视力>0.5占51.1%.结论 云南省泸西县人群中白内障造成的视力损伤是较严重的问题.该人群白内障盲的手术覆盖率较低,社会负担率很高,手术解决白内障盲效果明显但远未达到病人预期目标.%Objective To investigate the prevalence rate,surgical coverage rate and effect of surgery of cataract in Luxi county of Yunnan province,so as to evaluate the cataract status and the result of the blindness prevention and treatment program in the recent 10 years.Methods Cluster random sampling was used in selecting individuals aged over 50 from November 2011 to April 2012 in Luxi county.A total of 5151 individuals received eye examination,and their cataract operation status was evaluated.Results The prevalence rate of cataract was 22.40% among 5151 individuals,and the burden of cataract surgery was 9.3%.Cataract surgical coverage rate was 5.25%,and the cataract blindness burden was 9.24%.Among the 217 persons with cataract surgery,77.42% had the surgery in only the right eye.After surgery,the uncorrected visual acuity and the corrected visual acuity of 0.5 or better was accounted for 39.9% and 51.1%,respectively.Conclusion Vision impairment related to cataract is a serious problem in this population-based sample of Luxi county.Among the population,cataract surgical coverage rate is low,and the social burden rate is very high.The efficacy of cataract surgery is obvious but far from the

  12. Objective to Observe the Clinical Effects and Choose the Type of Cataract After Glaucoma Surgery%青光眼术后白内障术式选择及临床效果观察

    Institute of Scientific and Technical Information of China (English)

    冯宝娟

    2015-01-01

    目的:探讨青光眼术后白内障术式选择及效果。方法选取青光眼术后白内障术式患者60例,将其分为对照组和观察组各30例,对照组采用透明眼角膜切口超声入乳化术治疗,观察组采用经颞侧巩膜隧道小切口白内障摘出术治疗。结果对照组视力恢复率为65.73%,观察组视力恢复率为62.47%。结论透明眼角膜切口超声入乳化术和经颞侧巩膜隧道小切口白内障摘出术均是治疗青光眼术后白内障的有效方法。%Objective To investigate the cataract after glaucoma surgery operation selection and effect. Methods 60 cases of patients with cataract after glaucoma surgery type were selected and divided into control group and observation group with 30 cases in each group, the control group using transparent corneal incision in phacoemulsification ultrasound treatment, observation group were treated by the temporal scleral tunnel small incision cataract surgery treatment. Results In the control group, the visual recovery rate was 65.73%, the observation group vision recovery rate was 62.47%. Conclusion Transparent corneal incision phacoemulsification ultrasound into and through temporal scleral tunnel small incision cataract extraction are effective ways of treatment for cataract after glaucoma surgery.

  13. 婴幼儿白内障摘除术后青光眼的患病率及危险因素%The prevalence and risk factors of glaucoma following congenital and infantile cataract surgery

    Institute of Scientific and Technical Information of China (English)

    范媛媛; 杨新

    2013-01-01

    Glaucoma following cataract surgery in infant is a delayed complication of congenital and infantile cataract surgery.The incidence increased with duration of follow-up.There are many risk factors for the development of glaucoma have,including age at cataract surgery,microcornea,central corneal thickness,persistent fetal vasculature,cataract operating procedure and genetic factors.Primary intraocular lens implantation may be a protective factor.The treatment of glaucoma is difficult.Aqueous drainage devices are moderately successful.In order to reduce visual function damage,we emphasize the importance of a long follow-up after congenital cataract surgery.%婴幼儿白内障术后青光眼是一种迟发性白内障术后并发症,患病率依随访时间的延长而升高.其患病相关危险因素有:患儿接受白内障手术时的年龄、小角膜、中央角膜厚度、持续性胎儿血管化、白内障手术过程以及遗传因素等.一期后房植入人工晶状体可能是保护性因素.多数治疗方式效果欠佳,目前青光眼引流物植入术仍是治疗该病的较有效方式.为减少本病患儿视功能损害,应加强白内障患儿手术后随访.

  14. Objective to Observe the Clinical Effects and Selection of Cataract After Glaucoma Surgery%青光眼术后白内障术式选择及临床效果观察

    Institute of Scientific and Technical Information of China (English)

    王海峰

    2015-01-01

    目的:观察青光眼术后白内障术式选择及效果。方法随机将70例青光眼术后白内障术式患者分为两组,每组35例,对照组采用透明眼角膜切口超声入乳化术治疗,观察组采用经颞侧巩膜隧道小切口白内障摘出术治疗。结果对照组视力恢复率71.43%,观察组视力恢复率为70.85%。结论透明眼角膜切口超声入乳化术和经颞侧巩膜隧道小切口白内障摘出术均是治疗青光眼术后白内障的有效方法。%Objective To observe the selection with cataract after glaucoma surgery operation and effect.Methods Randomized 70 patients with cataract after glaucoma surgery operation in the two groups, each group of 35 cases, control group adopts transparent corneal incision, ultrasound into the phaco group through temporal sclera tunnel small incision cataract extraction and treatment.Results The control group vision recovery rate71.43%, observation group vision recovery rate was 70.85%.Conclusion Ultrasonic into the advantages and transparent cornea incision through temporal sclera tunnel small incision cataract extraction and surgery is an effective method for cataract after glaucoma surgery.

  15. Tricuspid surgery for tricuspid regurgitation: review.

    Science.gov (United States)

    Isomura, Tadashi; Fukada, Yasuhisa; Miyazaki, Takuya; Endo, Masahiro

    2016-10-01

    The tricuspid regurgitation (TR) is so-called 'functional' rather than organic. And therefore, it was originally thought that in most patients with secondary TR, surgical treatment of the left side heart valve would correct the problems of the TR. However, in recent study, the residual or recurrent TR showed poor prognosis after the surgery and the tricuspid valve is called 'forgotten' valve. The anatomy and pathophysiology of the tricuspid valve are shown as three-dimensional structure which is different from the "saddle-shaped" mitral annulus, and the finding suggests that an annuloplasty for TR is different from that for mitral regurgitation. The indication of tricuspid annuloplasty (TAP) for TR is not only the degree of TR but also annular dilatation without TR at the time of surgery. Tricuspid annuloplasty shows better long-term results after surgery than replacement and additional procedure may be required to prevent recurrence of TR after TAP. In this review, indication, the therapeutic procedures and prognosis depend on surgical procedure with or without ring or additional procedures are reviewed.

  16. 老年白内障超声乳化人工晶体手术护理的临床分析%Care clinical analysis of senile cataract phacoemulsification and intraocular lens surgery

    Institute of Scientific and Technical Information of China (English)

    阚泽云

    2012-01-01

      目的:分析60例老年白内障超声乳化人工晶体手术护理配合方法,方法:分析我院2012年1月-2012年6月间60例老年白内障手术的手术配合经验。手术室与巡回护士积极沟通,完成手术。结论:通过积极和沟通和配合,全部老年白内障手术顺利进行,人员配合好,减少或避免了患者不良反应,提高效率,反应较好。%  Objective: To analyze 60 cases of senile cataract phacoemulsification and intraocular lens surgery care with the method, the method of surgery: analysis of 60 elderly patients in our hospital in January 2012 -2012 in June cataract surgery with the experience. Operating room and roving nurses actively communicate with the completion of the surgery. Conclusion: through active communication and coordination, all of senile cataract surgery carried out smoothly, with the good, and to reduce or avoid adverse reactions in patients, improve efficiency, better reaction.

  17. Congenital cataract

    Science.gov (United States)

    ... EA, eds. Duane's Ophthalmology . 16th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:chap 74. Junk AK, Morris ... EA, eds. Duane's Ophthalmology . 16th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:chap 41. Read More Cataract - ...

  18. Cataracts and macular degeneration.

    Science.gov (United States)

    Shoch, D

    1979-09-01

    The intraocular lens restores general vision and some degree of independence and mobility to patients with dense cataracts and macular degeneration. The patient, however, must be repeatedly warned that fine central vision, particularly reading, will not be possible after the surgery. An aphakic spectacle leaves such patients a narrow band of vision when superimposed over the macular lesion, and contact lenses are too small for the patient to manage insertion without help.

  19. Long-term outcome after bilateral cataract surgery in infants with congenital cataract%婴儿期双眼先天性白内障术后远期疗效观察

    Institute of Scientific and Technical Information of China (English)

    鲍永珍; 陈宜; 吴夕; 苗恒

    2013-01-01

    Objective To evaluate the long-term visual outcome and complications after bilateral congenital cataract surgery performed prior to 12 months of age.Methods A prospective case study.31 cases (62 eyes) of bilateral congenital cataract were included.All patients received bilateral cataract extraction combined with primary capsulotomy and anterior vitrectomy simultaneously.After the operation,all patients wore aphakic glasses during the follow-up period.The unilateral and bilateral visual acuities (VA) at the last visit were determined and post-operative complications were evaluated,and the relationship between bilateral VA and the length of the follow-up period was also analyzed.Results The median age at surgery was 3.0M (0.5to11M),the median follow-up period was 4.0years (3.0 to 8.5 years).37 out of 62 eyes (59.68%) achieved unilateral best corrected visual acuity equal or better than 0.3.27 among 31 cases (87.1%) achieved binocular best corrected visual acuity equal or better than 0.3.Binocular best corrected visual acuity improved with the increase in the follow-up period and the patients' age (R2 =0.135,P =0.0024).Post-operative complications included strabismus (7 cases,22.58%),nystagmus (13 cases,41.94%),optical opacity (3 cases,9.68%),ocular hypertension (1 cases,3.23%).Conclusions Surgery for congenital cataracts performed prior to 12 months of age is safe,and most of the subjects can achieve functional vision acuity.As these children age,the bilateral best corrected visual acuity can still keep improving.(Chin J Ophthalmol,2013,49:395-398)%目的 探讨婴儿期双眼先天性白内障手术治疗的安全性和远期术后效果.方法 回顾性系列病例研究.2003年3月至2009年3月北京大学人民医院眼科收治的婴儿期双眼先天性白内障患儿31例(62只眼),所有患儿均接受了同期双眼白内障吸除、后囊膜切除及前段玻璃体切除手术,术后进行密切随访,对末次检查时的单眼视力、双眼

  20. 黑龙江省明水县农村人口白内障及其手术的调查分析%The investigation of cataract surgery of rural population in the Ming Shui county of Heilongjiang Province

    Institute of Scientific and Technical Information of China (English)

    张耀光; 宋甄; 冷飞; 曹书杰; 于楠楠; 王钧蔚; 刘平

    2012-01-01

    目的 明确明水县农村人口白内障的患病率以及治盲状况,白内障手术治疗的现状,并估计白内障手术覆盖率(CSC)、白内障手术负荷量,为制定今后的治盲策略提供可靠的数据支持.方法 以人群为基础,整群随机抽样.由两个调查组同时进行面谈,并进行眼科检查.统计白内障的患病率、双眼白内障盲的患病率,逻辑回归(Logistic回归)分析白内障和双眼白内障盲与年龄、性别的关系;并计算白内障手术覆盖率(CSC)、白内障手术负荷量.结果 白内障的患病率4.42% (95%CI:4.0%~4.8%),危险因素包括年龄(≥40岁)、女性.双眼白内障盲的患病率是0.35% (95%CI:0.24%~0.46%),性别并非其危险因素,年龄(≥50岁)是其危险因素.白内障手术覆盖率(CSC)为12.42%(95%CI:11.28%~13.56%),在50~59岁年龄中CSC最高.不同性别没有差别.白内障手术的负荷量是3.26%.结论 白内障是本地区≥50岁人群中致盲的首位原因,白内障手术覆盖率低,白内障盲人所造成的社会负担较重.提高白内障手术覆盖率是消灭白内障盲的根本手段.%Objective To determine the prevalence of cataract blindness and the treatment situation,the status of surgical treatment of cataract,the estimate of cataract surgical coverage (CSC),and the cataract surgery capacity of rural population in the county of Ming Shui,China,and to provide reliable data for the development strategy of the future blindness treatment. Methods Population-based,cluster random sampling method was employed.There were two investigation teams interviewed the volunteers; checked their visual acuity,intraocular pressure and other eye examinations at the same time.The prevalence of cataract and binocular cataract was statistical analyzed.Logistic regression was used to analyze the relationship between age,gender,education level and the blindness of cataract and binocular cataract; Logistic regression was

  1. Congenital cataract. Report 1. Modern concepts of etiology and principles of classification. A review of literature

    Directory of Open Access Journals (Sweden)

    N. Senchenko

    2013-01-01

    Full Text Available The analysis of literary sources, containing the results of research on the epidemiology and etiopathogenesis of congenital cataract, was made. The known classifications of this disease were also studied. The article describes the modern knowledge on the causal factors and pathogenic mechanisms, leading to irreversible pathological changes in the lens of the children. The evolution and effectiveness of clinical classifications was considered.

  2. 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

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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.

  5. Clinical research in pediatric cataract surgery%儿童白内障联合手术的临床研究

    Institute of Scientific and Technical Information of China (English)

    黄蔚如

    2012-01-01

    目的 探讨儿童先天性白内障手术方法及疗效.方法 采用超声乳化器的注吸系统吸出联合后囊连续环形撕囊(PCCC)+前部玻璃体切除术治疗儿童先天性白内障.结果 30例45眼术后1周矫正视力有不同程度地提高,5眼因年幼不会查视力,术后12个月随访40眼,最佳矫正视力(BCVA)≥0.5者30眼,占75.00%,BCVA<0.5者10眼,占25.00%.术后2例出现后囊浑浊.结论 采用白内障超声乳化吸除联合后囊连续环形撕囊及前部玻璃体切除术治疗儿童白内障疗效良好.%Objective To evaluate the therapeutic efficacy and surgical techniques of congenital pediatric cataract surgery.Methods Thirty children (45 eyes) with congenital cataract were treated by phacoemulsification I/A system combined with the posterior continuous curvilinear capsulorhexis (PCCC) and anterior vitrectomy.After operation,the vision and complication were observed.Results One week after the operation,the postoperative vision of 40 eyes were markedly improved,and 5 eyes were not been checked because of young.40 eyes were followed-up for 12 months,and 30 eyes (75%) obtained the best corrected visual acuity of 0.5 or above,and 10 eyes (25%) were lower than 0.5.Posterior capsular rupture occurred in 2 cases.Conclusion The phacoemulsification combined with PCCC and anterior vitrectomy is a effective and safe method for congenital pediatric cataract.

  6. 高度近视伴有硬核白内障给予小切口白内障囊外摘除术的临床研究%Clinical Research on High Myopia With Cataract Received Small Incision Extracapsular Cataract Surgery

    Institute of Scientific and Technical Information of China (English)

    顾志敏; 周利晓; 齐若

    2016-01-01

    Objective To study the high myopia with cataract received smal incision extracapsular cataract surgery of clinical curative effect.Methods The control group was treated with conventional cataract extraction. The study group was treated with smal incision cataract extraction. Compared two groups of curative effect and postoperative complications.ResultsThe total efficiency of 90.91% in the study group,significantly higher than the control group 75.00%(P<0.05). 11.36% the incidence of postoperative complications in the study group, significantly lower than the control group 29.54%(P<0.05).Conclusion High myopia accompanied with cataract given smal incision extracapsular cataract excision could significantly improve visual acuity,improve the curative effect and postoperative fewer complications.%目的:研究高度近视伴有硬核白内障给予小切口白内障囊外摘除术的临床疗效。方法对照组给予传统白内障囊外摘除术治疗,研究组给予白内障小切口囊外摘除术治疗。对比两组疗效及术后并发症。结果研究组总有效率90.91%,高于对照组的75.00%(P<0.05)。研究组术后并发症发生率11.36%,低于对照组29.54%(P<0.05)。结论高度近视伴有硬核白内障给予小切口白内障囊外摘除术可改善视力,提升疗效,术后并发症少。

  7. Quality of Life Outcomes of Bariatric Surgery: A Systematic Review.

    Science.gov (United States)

    Hachem, Aleeya; Brennan, Leah

    2016-02-01

    Bariatric surgery is often pursued to improve quality of life (QOL). This paper systematically reviews the literature examining QOL following bariatric surgery. Fifteen controlled trials examined changes in QOL in obese (BMI > 30) adults (18–65 years) following bariatric surgery; seven compared bariatric surgery to non-surgical interventions and six compared different types of bariatric surgery. Bariatric surgery resulted in greater improvements in QOL than other obesity treatments. Significant differences in QOL improvements were found between different types of bariatric surgery. QOL improvements were more likely to occur within the first 2 years following surgery, with greater improvements in physical QOL than mental QOL. Bariatric surgery improves QOL. Future research is needed to investigate changes in QOL in different domains in the short- and long-term following bariatric surgery.

  8. Potentials and applications of robotic surgery in Oral and Maxillofacial Surgery. A literature review.

    Directory of Open Access Journals (Sweden)

    Dimitrios VOLAKOS

    2014-12-01

    Full Text Available SUMMARY: Robotic surgery can be described as the latest advance in minimally invasive surgery, following the laparoscopic surgical approach. Since its first clinical trial in 1985, many steps have been taken. Nowadays, it is used successfully in many surgical disciplines, such as Urology, Orthopedic Surgery, Cardiothoracic Surgery, Oral and Maxillofacial Surgery (OMFS. The aim of this literature review is to present generally in surgery and more precisely in OMFS the applications of robotics and also present its potential for future use in the field.

  9. Cataract blindness in the developing world: is there a solution?

    Science.gov (United States)

    Isaacs, Robert; Ram, Jagat; Apple, David

    2004-01-01

    Cataracts are the leading cause of blindness worldwide, accounting for half of the world's 40 million blind. The majority of the world's 20 million cataract blind live in the developing world. About 5 million new cases of cataract blindness occur each year. Only a small percentage of persons in the Third World who develop cataracts receive cataract surgery. Cataract blindness causes severe economic and social problems in these countries. Because of increased longevity and population growth in the Third World, the number of untreated cataract cases is escalating rapidly. Governmental, non-governmental and service club organizations have put extraordinary effort and resources into reversing the trend of increasing cataract blindness, but much work still needs to be done. Current surgical methods used in the Third World have not yet succeeded in reducing the backlog of cataracts, due in part to either their prohibitive cost or poor results. Extra capsular cataract extraction (ECCE) with placement of a posterior chamber intraocular lens (PC-IOL) is the hope for preferred method of treatment. This paper discusses a largely overlooked method of cataract surgery which may be an additional, cost-effective and efficacious means of providing good sight rehabilitation. Combining intracapsular cataract extraction, currently the most common method used in the rural developing world, with anterior chamber intraocular lens implantation (ICCE AC-IOL), may prove effective in reducing the cataract backlog in developing countries.

  10. 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.

  11. 先天性白内障人工晶状体植入术后近视漂移的分析%Myopic shift after congenital cataract surgery with intraocular lens implantation

    Institute of Scientific and Technical Information of China (English)

    顾铮; 宋旭东; 杨文利

    2008-01-01

    Objective To investigate the refractive changes after cataract extraction and implantation of a foldable intraocular lens (IOL) in children with congenital cataract. Methods 36 cases (62 eyes) of con- genital cataract were retrospectively reviewed. The follow-up period was 12~36 (24.52±7.54)months postop- eratively. These patients were divided into 3 groups according to their ages when they accepted operations, group A: 1.5 to 4 years old ; group B: 4.1 to 6 years old ; group C: 6.1 to 8 years old. Results The myopic shift ranged from -0.19~-3.25D. The mean shift power for these groups was -1.03D/y,-0.65D/y and -0.35D/y respectively. There was statistics significant difference in the change rate of power (D/y) in 3 groups (F =41.430, P=0.000) and between every 2 groups (P =0.000). Conclusions To adapt to the trend of myopia when growth,the target refractive status should be low or moderate hyperopia when implant lOis in children with congenital cataract. There should be a decrease in the power of hyperopia with the increase in the age at surgery.%目的 分析不同年龄的先天性白内障患者的人工晶状体度数数选择.方法 回顾性分析先天性白内障患儿36例(62只眼),植入折叠IOL,术后随访时间12~36(24.52±7.54)个月.分为三组:A组1.5~4岁,B组4.1~6岁,C组6.1~8岁.结果 近视移动范围为-0.19~-3.25D,A组平均漂移-1.03D/年,B组平均漂移-0.65D/年,C组平均漂移-0.35D/年.3组屈光度数变化率(D/年)比较,差异有统计学意义(F=41.430,P=0.000),三组之间两两比较,差异也具有统计学意义(P=0.000).结论 先天性白内障植入IOL后最好保留轻中度的远视,补偿发育带来的近视趋势,年龄越大,欠矫的度数应越少.

  12. Fibrin sealant in general surgery. Personal experience and literary review.

    Science.gov (United States)

    Gubitosi, Adelmo; Ruggiero, Roberto; Docimo, Giovanni; Esposito, Alessandro

    2014-01-01

    In consideration of the use of fibrin glue in a general surgery department, authors analyze their last two years series. Operations on liver and biliary ducts, bowel and proctologic surgery, thyroid and breast surgery, abdominal wall hernias, fistulas and difficult wounds are considered with a literary review on fibrin sealant.

  13. [Lactation after breast plastic surgery: literature review].

    Science.gov (United States)

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

    2015-02-01

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

  14. 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

  15. 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.

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

    Science.gov (United States)

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

    2012-04-01

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

  17. Cataract complications

    Directory of Open Access Journals (Sweden)

    David Yorston

    2008-03-01

    Full Text Available Any eye surgeon, no matter how experienced, will occasionally encounter a serious cataract complication. Although complications may be devastating for the patient and are always distressing for the surgeon, are they really a major issue for VISION 2020? The evidence says that they are.

  18. Improving cataract services in the Indian context

    Directory of Open Access Journals (Sweden)

    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.

  19. Working with patients to optimise cataract outcomes

    Directory of Open Access Journals (Sweden)

    Nick Astbury

    2016-10-01

    Full Text Available One of the delights of ophthalmology is to witness the joy on the face of a patient with cataract when the dressing is taken off and sight has been restored. Unfortunately, for some patients, the result does not live up to their expectations. Despite cataract surgery being one of the most successful surgical interventions available, there is evidence that the visual outcome of cataract surgery in sub-Saharan Africa is not always good (defined as a VA of 6/18 or better. The proportion of good outcomes range from only 23% up to 70%, failing to reach the WHO target of 85% or better.

  20. Robotic Colorectal Surgery: A Systematic Review

    OpenAIRE

    Sami AlAsari; Byung Soh Min

    2012-01-01

    Aim. Robotic colorectal surgery may be a way to overcome the limitations of laparoscopic surgery. It is an emerging field; so, we aim in this paper to provide a comprehensive and data analysis of the available literature on the use of robotic technology in colorectal surgery. Method. A comprehensive systematic search of electronic databases was completed for the period from 2000 to 2011. Studies reporting outcomes of robotic colorectal surgery were identified and analyzed. Results. 41 studies...

  1. A low cost DICOM review station for cardiac surgery

    NARCIS (Netherlands)

    Gerritsen, MG; Dijk, WA; Waterbolk, TW; Mook, PH; van der Velde, W; van der Putten, N; Dassen, WRM; Baljon, MH; Murray, A; Swiryn, S

    1998-01-01

    A low-cost PC based DICOM multi modality review station for cardiac surgery has been developed for use during Minimally Invasive Coronary Surgery. This system is a Windows 95 networked PC for review of DICOM coronary catheterization, ultrasound and MRI cine's stored at a departmental image server. F

  2. Editorial: Improving cataract outcomes through good postoperative care

    Directory of Open Access Journals (Sweden)

    Nick Astbury

    2016-10-01

    Full Text Available Cataract surgery is one of the most successful and frequently performed operations worldwide, and yet cataract remains the commonest cause of global blindness. This is in part due to the shortage and uneven distribution of trained personnel in some countries. More worryingly, a high rate of cataract blindness also reflects poor visual outcomes after surgery, as has been documented in many RAAB (rapid assessment of avoidable blindness studies.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 探讨拉坦前列素在小切口囊外摘除术治疗青光眼术后白内障的应用%To Explore the Effect on Latanoprost Treatment of Cataract After Glaucoma Surgery With Small Incision Extracapsular Surgery

    Institute of Scientific and Technical Information of China (English)

    闫莉萍

    2015-01-01

    目的:探讨拉坦前列素在小切口囊外摘除术治疗青光眼术后白内障中的应用。方法选取我院成人眼科病房收治的青光眼术后白内障患者60例,随机分为对照组和观察组,每组30例。对照组行小切口囊外摘除术治疗青光眼术后白内障,观察组则在对照组治疗的基础上结合拉坦前列素滴眼液进行治疗。结果观察组的各项数据优于对照组, P<0.05,差异具有统计学意义。结论小切口囊外摘除术结合拉坦前列素滴眼液治疗青光眼术后白内障的临床效果显著。%Objective To explore the effect on latanoprost in the application of small incision extracapsular cataract surgery in the treatment of cataract after glaucoma surgery. Methods Selected 60 cases with cataract in our hospital from adult department of ophthalmology ward after glaucoma surgery, were randomly divided into control group and observation group, each group has 30 cases. the control group underwent small incision extracapsular cataract surgery in the treatment of cataract after glaucoma surgery, the observation group in the control group on the basis of combining the latanoprost eye drops were treatment. Results The data of observation group was better than the control group, P<0.05 ,had difference statistically signiifcance. Conclusion The clinical effect on small incision extracapsular cataract extraction combined with latanoprost Eye Drops treatment of cataract after glaucoma surgery is signiifcant.

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

    Directory of Open Access Journals (Sweden)

    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

  6. 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.

  7. 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

  8. Aging and Health: Cataracts

    Science.gov (United States)

    ... Problems Glaucoma Macular Degeneration Join our e-newsletter! Aging & Health A to Z Cataracts Basic Facts & Information ... Are Cataracts? Cataracts are a common result of aging and occur frequently in older people. About one ...

  9. 重组人表皮生长因子眼液在白内障术后应用%Recombinant Human Epidermal Growth Factor Eye Drops in Cataract Surgery Applications

    Institute of Scientific and Technical Information of China (English)

    王春梅

    2013-01-01

    Objective To observe the Effects of recombinant human epidermallgrowth factor eye drops after cataract surgery incision healing Effect. Methods:40cases of cataract operation,were randomly divided into two groups,the controllgroup of locallroutine medication,the treatment group added epidermallgrowth factor eye drops with recombinant human,incision healing was observed after cataract surgery. Results:in treatment group,the average healing time was 1.5days shorter than the controllgroup in the 2.5day. Conclusion:the epidermallgrowth factor can accelerate the healing of incision,foreign body friction reduce postoperative scar resulting sense.%目的:观察重组人表皮生长因子眼液在白内障术后切口愈合的效果。方法选择白内障手术40例,随机分成两组,对照组局部常规用药,治疗组加用重组人表皮生长因子眼液,观察白内障术后切口愈合情况。结果治疗组愈合时间平均为1.5d短于对照组2.5d。结论表皮生长因子能加快切口愈合,减轻患者术后切口瘢痕导致的异物摩擦感。

  10. 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.

  11. 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.

  12. The influence of the surgery selection of congenital cataract on the development of vision%先天性白内障手术选择对视觉发育的影响

    Institute of Scientific and Technical Information of China (English)

    郭智一; 许江涛; 袁援生

    2015-01-01

    目的:探讨先天性白内障术式对视觉发育的影响。方法对59例(109眼)先天性白内障行不同术式治疗,分为A组先天性白内障吸出联合后囊膜截囊术20例(36眼),B组先天性白内障吸出联合前段玻璃体切割术39例(73眼),进行回顾性分析,比较两种术式术后并发症并对其中部分病例长期观察随访评价疗效。结果经统计学处理表明两种先天性白内障摘除术后对视觉发育的影响,B组较A组更优越,(χ2=42.81,<0.01)。结论先天性白内障摘除联合前段玻璃体切割术并发症少、疗效稳定,是治疗先天性白内障、促进患儿早期视觉发育较理想的手术方式。%Objective To investigate the influence of the surgery selection of congenital cataract on the de-velopment of vision Methods 59 cases (109 eyes) were prepared to have the surgery of congenital cataract were divided into two groups. 20 cases (36 eyes) in group A had the congenital cataract extraction combined with pos-terior capsulotomy. 39 cases (73 eyes) in group B had the congenital cataract extraction combined with anterior vitrectomy. The postoperative complications of the two groups were compared and some cases have a long-term fol-low-up observations to evaluate the therapeutic effect. Results The visual acuity of group B was obviously better than group A (χ2 = 42.81, <0.01). Conclusion Congenital cataract extraction combined with anterior vitrectomy which have a stable therapeutic and is an ideal method to treat congenital cataract.

  13. A review of robotics in surgery.

    Science.gov (United States)

    Davies, B

    2000-01-01

    A brief introduction is given to the definitions and history of surgical robotics. The capabilities and merits of surgical robots are then contrasted with the related field of computer assisted surgery. A classification is then given of the various types of robot system currently being investigated internationally, together with a number of examples of different applications in both soft-tissue and orthopaedic surgery. The paper finishes with a discussion of the main difficulties facing robotic surgery and a prediction of future progress.

  14. The observation on lens capsular capture of intraocular lens in cataract surgery%晶状体囊夹持固定人工晶状体手术的效果观察

    Institute of Scientific and Technical Information of China (English)

    王峥; 庄鹏

    2013-01-01

    目的 评价白内障手术中应用晶状体囊孔夹持固定人工晶状体的安全性和有效性.方法 26例(27眼)白内障(包括老年性,先天性,外伤性,后发性和人工晶状体雨刷综合征)术中将人工晶状体光学部夹持固定在前囊或后囊孔,术后随访观察.结果 随访3个月至2年,所有病例视轴清澈,人工晶状体固定良好,20眼(74.1%)最佳矫正视力在0.6以上.结论 应用晶状体囊夹持固定人工晶状体,视力恢复好,人工晶状体稳定,并发症少.%Objective To evaluate the safety and efficacy of intraocular lens (IOL) optic capture in capsular opening during catract surgery.Methods The capture of IOL optic through an anterior or posterior opening was performed in 26 cases (27 eyes) with senile cataract or congenital cataract,traumatic cataract,after cataract and IOL windshield wiper syndrome.All patients were followed-up after surgery.Results The visual axis remained clear and the IOL remained stable in all eyes in 3 months to 2 years follow-up.The best corrected visual acuity was 0.6 or better in 20 eyes (74.1%).Conclusion Capsular capture fixation of IOL provided good visual acuity,stable IOL,and less complication.

  15. Using corneal topography design personalized cataract surgery programs%应用角膜地形图设计个性化白内障手术方案

    Institute of Scientific and Technical Information of China (English)

    黄金鸥; 陈金邦; 陈炜江; 裘义松; 魏肖红

    2014-01-01

    AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment. METHODS: Totally 202 cases ( 226 eyes ) cataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed. RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3. 0mm sclera tunnel incision group there were no statistically significance difference. After 55. 8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced. CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.%目的:探讨如何在角膜地形图的指导下,设计个性化

  16. Learning Curves in Robotic Rectal Cancer Surgery: A literature Review

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    Nasir

    2016-10-01

    Full Text Available Background Laparoscopic rectal cancer surgery offers several advantages over open surgery, including quicker recovery, shorter hospital stay and improved cosmesis. However, laparoscopic rectal surgery is technically difficult and is associated with a long learning curve. The last decade has seen the emergence of robotic rectal cancer surgery. In contrast to laparoscopy, robotic surgery offers stable 3D views with advanced dexterity and ergonomics in narrow spaces such as the pelvis. Whether this translates into a shorter learning curve is still debated. The aim of this literature search is to ascertain the learning curve of robotic rectal cancer surgery. Methods This review analyses the literature investigating the learning curve of robotic rectal cancer surgery. Using the Medline database a literature search of articles investigating the learning curve of robotic rectal surgery was performed. All relevant articles were included. Results Twelve original studies fulfilled the inclusion criteria. The current literature suggests that the learning curve of robotic rectal surgery varies between 15 and 44 cases and is probably shorter to that of laparoscopic rectal surgery. Conclusions There are only a few studies assessing the learning curve of robotic rectal surgery and they possess several differences in methodology and outcome reporting. Nevertheless, current evidence suggests that robotic rectal surgery might be easier to learn than laparoscopy. Further well designed studies applying CUSSUM analysis are required to validate this motion.

  17. Robotics in general surgery: an evidence-based review.

    Science.gov (United States)

    Baek, Se-Jin; Kim, Seon-Hahn

    2014-05-01

    Since its introduction, robotic surgery has been rapidly adopted to the extent that it has already assumed an important position in the field of general surgery. This rapid progress is quantitative as well as qualitative. In this review, we focus on the relatively common procedures to which robotic surgery has been applied in several fields of general surgery, including gastric, colorectal, hepato-biliary-pancreatic, and endocrine surgery, and we discuss the results to date and future possibilities. In addition, the advantages and limitations of the current robotic system are reviewed, and the advanced technologies and instruments to be applied in the near future are introduced. Such progress is expected to facilitate the widespread introduction of robotic surgery in additional fields and to solve existing problems.

  18. Pregnancy after Bariatric Surgery: A Review

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    N. L. Hezelgrave

    2011-01-01

    Full Text Available Maternal obesity is a major cause of obstetric morbidity and mortality. With surgical procedures to facilitate weight loss becoming more widely available and demanded and increasing number of women becoming pregnant after undergoing bariatric surgery, it is important and timely to consider the outcome of pregnancy following bariatric surgery. This paper aims to synthesize the current evidence regarding pregnancy outcomes after bariatric surgery. It concludes that bariatric surgery appears to have positive effects on fertility and reduces the risk of gestational diabetes and preeclampsia. Moreover, there appears to be a reduced incidence of fetal macrosomia post-bariatric procedure, although there remains uncertainty about the increased rates of small-for-gestational age and intrauterine growth restricted infants, as well as premature rupture of membranes in this group. A number of case reports highlight that pregnancy following bariatric surgery is not without complications and it must be managed as high risk by the multidisciplinary team.

  19. 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

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

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    Abrahão da Rocha Lucena

    2006-06-01

    Full Text Available INTRODUÇÃO: O descolamento da membrana de Descemet é complicação rara, mas devastadora após facectomia. Algumas alternativas têm sido usadas para reposição da Descemet: bolha de ar, sutura com transfixação da córnea, viscoelástico associado com bolha de ar e gás SF6 ou C3F8. O transplante de córnea é o último recurso utilizado. OBJETIVO: Avaliar os resultados anatômicos e funcionais, do descolamento iatrogênico da membrana de Descemet, com uso de C3F8 (16% na câmara anterior em seis olhos pós-facectomia. MÉTODOS: Após colocação de 0,5 ml do gás em câmara anterior avaliou-se localização justa-estromal da membrana de Descemet em lâmpada de fenda. Os olhos com deslocamento superior/central eram orientados a ficar em decúbito elevado por dois dias e no caso do deslocamento inferior solicitamos decúbito dorsal com leve supraversão. RESULTADOS: A média de idade foi de 71,3 ± 9,3 anos, sendo quatro do sexo feminino e dois do sexo masculino. Todos os olhos tiveram sucesso com a colocação do C3F8, havendo aumento da pressão intra-ocular em um caso. O edema corneano regrediu a partir do segundo dia com resolução completa até o quarto dia. A acuidade visual melhorou em todos os casos logo após regressão do edema, sendo reavaliada quarenta e cinco dias depois. CONCLUSÃO: A introdução unicamente do gás C3F8 não expansivo para colar a membrana de Descemet é citado pela primeira vez na literatura brasileira. O restabelecimento da acuidade visual é rápida, o método é seguro, efetivo e de fácil execução, sendo realizado sob anestesia tópica.INTRODUCTION: Descemet's membrane detachment is a rare but serious complication following cataract surgery. Extensive detachments that affect the visual axis may result in poor vision and require penetrating corneal grafts. Some alternatives have been used to reattach Descemet's membrane: air bubble, transcorneal sutures and intracameral viscoelastic gel plus SF6 or C3F

  1. 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.

  2. 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

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

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    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

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

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    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.

  5. Final visual outcome following re exploration of cataracts performed by trainee surgeons in India

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    Mehul A Shah

    2011-01-01

    Full Text Available Objective: To investigate the outcome of secondary intraocular lens implantation, compare final visual outcome between different categories of surgeon, and evaluate care provided by teaching hospitals to patients with capsular complications. Materials and Methods: Setting: Teaching hospital. Design: Retrospective study. Subjects were recruited by examination of electronic medical records. All patients operated for corrective surgery following capsular complications during cataract surgery were included. All patient medical records were reviewed, and data were collected for 359 eyes. Main outcome measures: Visual acuity and major complications. All collected data were entered into Microsoft Excel and analyzed by SPSS 17 software using cross tabulation and Chi-squared tests. Results: Surgical intervention made a significant difference to the final visual outcome (P < 0.001. The category of the trainee had a significant effect on the final visual outcome (P = 0.021. Conclusion: Capsular complications during cataract surgery should be surgically treated to improve outcome.

  6. Congenital and infantile cataract: aetiology and management.

    Science.gov (United States)

    Chan, Wai H; Biswas, Susmito; Ashworth, Jane L; Lloyd, I Christopher

    2012-04-01

    Congenital cataract is the commonest worldwide cause of lifelong visual loss in children. Although congenital cataracts have a diverse aetiology, in many children, a cause is not identified; however, autosomal dominant inheritance is commonly seen. Early diagnosis either on the post-natal ward or in the community is important because appropriate intervention can result in good levels of visual function. However, visual outcome is largely dependent on the timing of surgery when dense cataracts are present. Good outcomes have been reported in children undergoing surgery before 6 weeks of age in children with unilateral cataract and before 10 weeks of age in bilateral cases. Placement of an artificial intraocular lens implant after removal of the cataract has become established practice in children over 2 years of age. There remains debate over the safety and predictability of intraocular lens implantation in infants. Despite early surgery and aggressive optical rehabilitation, children may still develop deprivation amblyopia, nystagmus, strabismus, and glaucoma. The diagnosis and management of congenital cataracts has improved substantially over the past 30 years with a concurrent improvement in outcomes for affected children. Many aspects of the pre-, intra-, and postoperative management of these patients continue to be refined, highlighting the need for good quality data and prospective collaborative studies in this field.

  7. Developments in flexible endoscopic surgery: a review

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    Feussner H

    2014-12-01

    Full Text Available Hubertus Feussner,1 Valentin Becker,2 Margit Bauer,1 Michael Kranzfelder,1 Rebekka Schirren,1 Tim Lüth,3 Alexander Meining,2 Dirk Wilhelm1 1Department of Surgery, 22nd Medical Department, 3Institute of Microtechnology and Medical Device Technology, Klinikum rechts der Isar, Technische Universität München, Germany Abstract: Flexible endoscopy is increasingly developing into a therapeutic instead of a purely diagnostic discipline. Improved visualization makes early lesions easily detectable and allows us to decide ad hoc on the required treatment. Deep enteroscopy allows the exploration of even the small bowel – for long a "white spot" for gastrointestinal endoscopy – and to perform direct treatment. Endoscopic submucosal dissection is a considerable step forward in oncologically correct endoscopic treatment of (early malignant lesions. Though still technically challenging, it is increasingly facilitated by new manipulation techniques and tools that are being steadily optimized. Closure of wall defects and hemostasis could be improved significantly. Even the anatomy beyond the gastrointestinal wall is being explored by the therapeutic use of endoluminal ultrasound. Endosonographic-guided surgery is not only a suitable fallback solution if conventional endoscopic retrograde cholangiopancreatography fails, but even makes necrosectomy procedures, abscess drainage, and neurolysis feasible for the endoscopist. Newly developed endoscopic approaches aim at formerly distinctive surgical domains like gastroesophageal reflux disease, appendicitis, and cholecystitis. Combined endoscopic/laparoscopic interventional techniques could become the harbingers of natural orifice transluminal endoscopic surgery, whereas pure natural orifice transluminal endoscopic surgery is currently still in its beginnings. Keywords: flexible endoscopic surgery, endoscopic ultrasound, advanced techniques, natural orifice transluminal endoscopic surgery

  8. 婴幼儿先天性白内障术后继发性青光眼的临床分析%Clinical analysis of the occurrence of secondary glaucoma after pediatric congenital cataract surgery in the first 36 months of life

    Institute of Scientific and Technical Information of China (English)

    张辉; 谢立信

    2013-01-01

    目的 探讨婴幼儿先天性白内障手术及其二期人工晶状体(IOL)植入术后继发性青光眼的发生.方法 回顾性系列病例研究.1995年7月至2005年7月于山东省眼科研究所行先天性白内障手术的≤3周岁的儿童被纳入统计分析,排除术前与青光眼发生有关联的病例.详细记录手术年龄、白内障类型以及术后继发性青光眼的发生等相关信息.结果 115例患儿(204只眼)被纳入研究对象,平均手术年龄(12.5±9.2)个月,术后平均随访(83.7±43.8)个月.双眼先天性白内障术后的11例15只眼(7.4%)发生继发性青光眼,其中6例6只眼(6/15)术后早期继发,5例9只眼(9/15)平均于术后(54.9±34.3)个月发生晚期青光眼.发生青光眼者13只眼(13/15)手术年龄≤9个月,12只眼(12/15)为核性或全白内障,继发性青光眼发生眼均无同期IOL植入.此外,二期睫状沟植入IOL的86只眼中,13只眼(15.1%)发生继发性青光眼,其中6只眼(6/13)有二次手术病史.结论 婴幼儿双眼先天性白内障术后有一定的继发性青光眼发生率.晚期的继发性青光眼多在术后数年出现,且二期IOL植入术后亦有一定的继发性青光眼发生率,因此术后长期随访非常重要.%Objective To observe the rate of secondary glaucoma after pediatric congenital cataract surgery in the first 36 months of life.Methods Retrospective case series.The records of children who underwent surgery for congenital cataract within the first 36 months of life between July 1995 and July 2005 at Qingdao Eye Hospital were reviewed.Children with preoperative conditions associated with glaucoma were excluded.Age at surgery,unilateral or bilateral cataract,type of congenital cataract,primary intraocular lens (IOL) insertion,duration of follow-up,postoperative best corrected visual acuity,development of aphakic glaucoma,and development of glaucoma after secondary IOL implantation were evaluated.Results A total of 115 patients (204

  9. Molecular genetics of congenital nuclear cataract.

    Science.gov (United States)

    Deng, Hao; Yuan, Lamei

    2014-02-01

    A cataract is defined as opacification of the normally transparent crystalline lens. Congenital cataract (CC) is a type of cataract that presents at birth or during early childhood. CC is one of the most common causes of visual impairment or blindness in children worldwide. Approximately 50% of all CC cases may have a genetic cause which is quite heterogeneous. CC occurs in a variety of morphologic configurations, including polar/subcapsular, nuclear, lamellar, sutural, cortical, membranous/capsular and complete. Nuclear cataract refers to the opacification limited to the embryonic and/or fetal nuclei of the lens. Although congenital nuclear cataract can be caused by multiple factors, genetic mutation remains to be the most common cause. It can be inherited in one of the three patterns: autosomal dominant, autosomal recessive, or X-linked transmission. Autosomal dominant inheritance is the most frequent mode with high penetrance. There may be no obvious correlation between the genotype and phenotype of congenital nuclear cataract. Animal models have been established to study the pathogenesis of congenital nuclear cataract and to identify candidate genes. In this review, we highlight identified genetic mutations that account for congenital nuclear cataract. Our review may be helpful for genetic counseling and prenatal diagnosis.

  10. Systematic review of obesity surgery mortality risk score--preoperative risk stratification in bariatric surgery.

    Science.gov (United States)

    Thomas, Harun; Agrawal, Sanjay

    2012-07-01

    Bariatric surgery is the best long term treatment for morbid obesity. However, it carries risks of considerable morbidity and potential mortality. There is no published review on pre-operative identification of high-risk patients in bariatric surgery. This systematic review analyses obesity surgery mortality risk score (OS-MRS) as a tool for pre-operative prediction of mortality risk in bariatric surgery. Medline and Embase was systematically searched using the medical subjects headings (MeSH) terms 'bariatric surgery' and 'mortality' with further free text search and cross references. Studies that described OS-MRS to predict mortality risk after bariatric surgery were included in this review. Six studies evaluated 9,382 patients to assess the validity of OS-MRS to predict the mortality risk after bariatric surgery. Patient's age ranged from 19 to 67 years, and the body mass index ranged from 30 to 84. There were 83 deaths among the 9,382 patients (0.88 %) with individual studies reporting a mortality range from 0 % to 1.49 %. There were 13 deaths among 4,912 (0.26 %) class A patients, 55 deaths among 4,124 (1.33 %) class B patients and 15 deaths among 346 (4.34 %) class C patients. Mortality in classes A, B and C was significantly different from each of the other two classes (P < 0.05, χ(2)). This systematic review confirms that OS-MRS stratifies the mortality risk in the three-risk classification subgroups of patients. The OS-MRS can be used for pre-operative identification of high-risk patients undergoing primary Roux-en-Y gastric bypass surgery.

  11. [Therapeutic approach in patients with age-related macular degeneration and cataract].

    Science.gov (United States)

    Tomi, Anca; Moldoveanu, A; Marin, Irina

    2011-01-01

    Management of the patient with coexisting cataract and AMD presents unique challenges to the cataract surgeon, the retina specialist, and the patient. A common clinical scenario is the patient in whom both the cataract and macular pathology appear to be contributing to decreased visual acuity. As with any surgery, the expectations from cataract removal must be evaluated thoroughly and understood clearly by both the patient and the cataract surgeon. Most patients with AMD who undergo cataract surgery feel that the surgery is worthwhile, and they report improvement of visual function and quality of life. In patients with mild AMD, improvement in central visual acuity and attainment of driving vision are realistic and achievable goals. In an eye with central disciform scarring or geographic atrophy there may be potential for improvement in color discrimination, contrast, or clarity of peripheral vision. In cases of dense cataract obscuring macular detail, cataract removal may be necessary to allow for adequate biomicroscopy and angiography, especially in an eye that may be at high risk for the development of choroidal neovascularization. It is often challenging to estimate the relative impact on visual impairment made by the lens opacities and the macular changes and the benefits and risks of cataract surgery in eyes with AMD should be carefully evaluated. Is cataract surgery justified in these patients? Does cataract surgery aggravate AMD in some patients?

  12. Clinical observation of the treatment of cataract surgery after glaucoma filtering surgery%青光眼滤过术后白内障手术治疗的临床观察

    Institute of Scientific and Technical Information of China (English)

    郭晓娜; 张仲臣

    2013-01-01

    Objective To observe the clinical efficacy of cataract surgery after glaucoma filtration.Methods Phacoemulsification and intraocular lens implantation through clear corneal incision were performed on 43 eyes of 32 cases after glaucoma filtering surgery.Results The postoperative visual acuity was improved in all cases compared with preoperative varying degrees.The visual acuity of 0.3 ~ 0.5 was 10 eyes (23.26%),0.6 to 0.8 was 15 eyes (34.88%),≥ 1.0 was 8 eyes (18.60%).The postoperative complications were intraoperative posterior capsular rupture in 1 eye (2.32