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Cataract surgery

About: Cataract surgery is a(n) research topic. Over the lifetime, 15547 publication(s) have been published within this topic receiving 262950 citation(s). The topic is also known as: Cataract Extraction.


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Journal ArticleDOI
Abstract: Objective To evaluate the safety and efficacy of dexamethasone intravitreal implant (DEX implant; OZURDEX, Allergan, Inc., Irvine, CA) compared with sham in eyes with vision loss due to macular edema (ME) associated with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Design Two identical, multicenter, masked, randomized, 6-month, sham-controlled clinical trials (each of which included patients with BRVO and patients with CRVO). Participants A total of 1267 patients with vision loss due to ME associated with BRVO or CRVO. Intervention A single treatment with DEX implant 0.7 mg (n = 427), DEX implant 0.35 mg (n = 414), or sham (n = 426). Main Outcome Measures The primary outcome measure for the pooled data from the 2 studies was time to achieve a ≥15-letter improvement in best-corrected visual acuity (BCVA). Secondary end points included BCVA, central retinal thickness, and safety. Results After a single administration, the time to achieve a ≥15-letter improvement in BCVA was significantly less in both DEX implant groups compared with sham ( P P P ≤0.036). Improvement in mean BCVA was greater in both DEX implant groups compared with sham at all follow-up visits ( P ≤0.006). Improvements in BCVA with DEX implant were seen in patients with BRVO and patients with CRVO, although the patterns of response differed. The percentage of DEX implant-treated eyes with intraocular pressure (IOP) of ≥25 mmHg peaked at 16% at day 60 (both doses) and was not different from sham by day 180. There was no significant between-group difference in the occurrence of cataract or cataract surgery. Conclusions Dexamethasone intravitreal implant can both reduce the risk of vision loss and improve the speed and incidence of visual improvement in eyes with ME secondary to BRVO or CRVO and may be a useful therapeutic option for eyes with these conditions. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

873 citations

Journal ArticleDOI
TL;DR: The VF-14 is a reliable and valid measure of functional impairment caused by cataract and provides information not conveyed by visual acuity or a general measure of health status.
Abstract: Objective: To describe the development and the performance of a brief questionnaire designed to measure functional impairment caused by cataract (the VF-14). Design: Observational cross-sectional study. Patients were recruited between July 15 and December 15, 1991. Setting: Patients were recruited from the practices of 70 ophthalmologists, located in Columbus, Ohio (N=21), St Louis, Mo (N=26), and Houston, Tex (N=23). Patients: Seven hundred sixty-six patients undergoing cataract surgery for the first time. Main Outcome Measures: Preoperative best corrected visual acuity in each eye; scores on the VF-14, a new index of functional impairment in patients with cataract; patient reports of overall trouble and satisfaction with their vision; and scores on the Sickness Impact Profile, a measure of general health status. Results: The VF-14 has high internal consistency (Cronbach's α=.85) and correlates more strongly with the overall self-rating of the amount of trouble and satisfaction patients have with their vision than do several measures of visual acuity or the Sickness Impact Profile score. The VF-14 score is moderately correlated with visual acuity in the better eye. Conclusions: The VF-14 is a reliable and valid measure of functional impairment caused by cataract and provides information not conveyed by visual acuity or a general measure of health status.

855 citations

Journal ArticleDOI
TL;DR: Use of intracameral cefuroxime at the end of surgery reduced the occurrence of postoperative endophthalmitis, and there was evidence that men were more predisposed to infection.
Abstract: Aims to identify risk factors and describe the effects of antibiotic prophylaxis on the incidence of postoperative endophthalmitis after cataract surgery based on analysis of the findings of the European Society of Cataract and Refractive Surgeons (ESCRS) multicenter study. Setting: Twenty-four ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, and the United Kingdom. A prospective randomized partially masked multicenter cataract surgery study recruited 16 603 patients. The study was based on a 2 × 2 factorial design, with intracameral cefuroxime and topical perioperative levofloxacin factors resulting in 4 treatment groups. The comparison of case and non-case data was performed using multivariable logistic regression analyses. Odds ratios (ORs) associated with treatment effects and other risk factors were estimated. Twenty-nine patients presented with endophthalmitis, of whom 20 were classified as having proven infective endophthalmitis. The absence of an intracameral cefuroxime prophylactic regimen at 1 mg in 0.1 mL normal saline was associated with a 4.92-fold increase (95% confidence interval [CI], 1.87-12.9) in the risk for total postoperative endophthalmitis. In addition, the use of clear corneal incisions (CCIs) compared to scleral tunnels was associated with a 5.88-fold increase (95% CI, 1.34-25.9) in risk and the use of silicone intraocular lens (IOL) optic material compared to acrylic with a 3.13-fold increase (95% CI, 1.47-6.67). The presence of surgical complications increased the risk for total endophthalmitis 4.95-fold (95% CI, 1.68-14.6), and more experienced surgeons were more likely to be associated with endophthalmitis cases. When considering only proven infective endophthalmitis cases, the absence of cefuroxime and the use of silicone IOL optic material were significantly associated with an increased risk, and there was evidence that men were more predisposed to infection (OR, 2.70; 95% CI, 1.07-6.8). Use of intracameral cefuroxime at the end of surgery reduced the occurrence of postoperative endophthalmitis. Additional risk factors associated with endophthalmitis after cataract surgery included CCIs and the use of silicone IOLs.

662 citations

Journal ArticleDOI
TL;DR: Among patients with macular edema owing to BRVO or CRVO, single and repeated treatment with DEX implant had a favorable safety profile over 12 months.
Abstract: Objective To evaluate the safety and efficacy of 1 or 2 treatments with dexamethasone intravitreal implant (DEX implant) over 12 months in eyes with macular edema owing to branch or central retinal vein occlusion (BRVO or CRVO). Design Two identical, multicenter, prospective studies included a randomized, 6-month, double-masked, sham-controlled phase followed by a 6-month open-label extension. Participants We included 1256 patients with vision loss owing to macular edema associated with BRVO or CRVO. Methods At baseline, patients received DEX implant 0.7 mg (n = 421), DEX implant 0.35 mg (n = 412), or sham (n = 423) in the study eye. At day 180, patients could receive DEX implant 0.7 mg if best-corrected visual acuity (BCVA) was 250 μm. Main outcome measures The primary outcome for the open-label extension was safety; BCVA was also evaluated. Results At day 180, 997 patients received open-label DEX implant. Except for cataract, the incidence of ocular adverse events was similar in patients who received their first or second DEX implant. Over 12 months, cataract progression occurred in 90 of 302 phakic eyes (29.8%) that received 2 DEX implant 0.7 mg injections versus 5 of 88 sham-treated phakic eyes (5.7%); cataract surgery was performed in 4 of 302 (1.3%) and 1 of 88 (1.1%) eyes, respectively. In the group receiving two 0.7-mg DEX implants (n = 341), a ≥ 10-mmHg intraocular pressure (IOP) increase from baseline was observed in (12.6% after the first treatment, and 15.4% after the second). The IOP increases were usually transient and controlled with medication or observation; an additional 10.3% of patients initiated IOP-lowering medications after the second treatment. A ≥ 15-letter improvement in BCVA from baseline was achieved by 30% and 32% of patients 60 days after the first and second DEX implant, respectively. Conclusions Among patients with macular edema owing to BRVO or CRVO, single and repeated treatment with DEX implant had a favorable safety profile over 12 months. In patients who qualified for and received 2 DEX implant injections, the efficacy and safety of the 2 implants were similar with the exception of cataract progression. Financial disclosure(s) Proprietary or commercial disclosure may be found after the references.

560 citations

Journal ArticleDOI
TL;DR: The number of Americans affected by cataract and undergoingCataract surgery will dramatically increase over the next 20 years as the US population ages.
Abstract: Objectives: To determine the prevalence of cataract and pseudophakia/aphakia in the United States and to project the expected change in these prevalence figures by 2020Methods: Summary prevalence estimates of cataract and of pseudophakia/aphakia were prepared separately for black white and Hispanic persons (for whom only cataract surgery data were available) in 5-year age intervals starting at 40 years for women and men The estimates were based on a standardized definition of various types of cataract: cortical, greater than 25% of the lens involved, posterior subcapsular, present according to the grading system used in each study; and nuclear, greater than or equal to the penultimate grade in the system used Data were collected from major population-based studies in the United States, and, where appropriate, Australia, Barbados, and Western Europe The age-, gender-, and race/ethnicity-specific rates were applied to 2000 US Census data, and projected population figures for 2020, to obtain overall estimatesResults: An estimated 205 million (172%) Americans older than 40 years have cataract in either eye, and 61 million (51%) have pseudophakia/aphakia Women have a significantly (odds ratio=137; 95% confidence interval, 126-150) higher age-adjusted prevalence of cataract than men in the United States The total number of persons who have cataract is estimated to rise to 301 million by 2020; and for those who are expected to have pseudophakia/aphakia, to 95 millionConclusion: The number of Americans affected by cataract and undergoing cataract surgery will dramatically increase over the next 20 years as the US population ages

513 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20221
2021940
2020906
2019812
2018716
2017845