Showing papers on "Cataract surgery published in 2008"
TL;DR: Investigation of intraocular concentrations and pharmacokinetics of bevacizumab after a single intravitreal injection in humans found that in human nonvitrectomized eyes, the aqueous half-life of 1.5 mgintravitreally injected bevacsimab is 9.82 days.
344 citations
TL;DR: Findings challenge the National Council on Radiation Protection and International Commission on Radiological Protection assumptions that the lowest cumulative ionizing radiation dose to the lens of the eye that can produce a progressive cataract is approximately 2 Gy and support the hypothesis that the highest cataracts produced in humans is substantially less than previously thought.
Abstract: The study aim was to determine the risk of cataract among radiologic technologists with respect to occupational and nonoccupational exposures to ionizing radiation and to personal characteristics. A prospective cohort of 35,705 cataract-free US radiologic technologists aged 24-44 years was followed for nearly 20 years (1983-2004) by using two follow-up questionnaires. During the study period, 2,382 cataracts and 647 cataract extractions were reported. Cigarette smoking for >or=5 pack-years; body mass index of >or=25 kg/m(2); and history of diabetes, hypertension, hypercholesterolemia, or arthritis at baseline were significantly (p or=3 x-rays to the face/neck was associated with a hazard ratio of cataract of 1.25 (95% confidence interval: 1.06, 1.47). For workers in the highest category (mean, 60 mGy) versus lowest category (mean, 5 mGy) of occupational dose to the lens of the eye, the adjusted hazard ratio of cataract was 1.18 (95% confidence interval: 0.99, 1.40). Findings challenge the National Council on Radiation Protection and International Commission on Radiological Protection assumptions that the lowest cumulative ionizing radiation dose to the lens of the eye that can produce a progressive cataract is approximately 2 Gy, and they support the hypothesis that the lowest cataractogenic dose in humans is substantially less than previously thought.
343 citations
TL;DR: Glaucoma progression rates calculated using the GPI seem to be considerably less affected byCataract and cataract surgery than rates based on the traditional MDI.
333 citations
TL;DR: The results indicate that phacoemulsification and posterior chamber AcrySof toric IOL implantation is an effective option to correct preexisting astigmatism in cataract surgery.
Abstract: PURPOSE: To evaluate the results of AcrySof toric intraocular lens (IOL) (Alcon) implantation to correct preexisting astigmatism in patients having cataract surgery. SETTING: Ophthalmology Service, Donostia Hospital, San Sebastian, Spain. METHODS: This prospective observational study included 30 eyes of 15 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having cataract surgery. Bilateral implantation of the AcrySof toric IOL was performed after phacoemulsification. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere, residual keratometric and refractive cylinders, and toric IOL axis were measured. RESULTS: The UCVA was 20/40 or better in 93.3% of eyes and 20/25 or better in 66.6%. All eyes achieved 20/25 or better BCVA. The mean refractive cylinder decreased significantly after surgery from 2.34 D G 1.28 (SD) to 0.72 G 0.43 D (P<.01). Vector analysis of attempted versus achieved correction showed that 100% of eyes were within G1.00 D and 80% and 93.9% were within G0.50 D for J0 and J45, respectively. The mean toric IOL axis rotation was 3.63 G 3.11 degrees, with rotation less than 10 degrees in 96.7% of eyes. CONCLUSIONS: The results indicate that phacoemulsification and posterior chamber AcrySof toric IOL implantation is an effective option to correct preexisting astigmatism in cataract surgery. The AcrySof toric IOL showed good rotational stability.
246 citations
TL;DR: Manual small incision extracapsular cataract surgery is significantly faster, less expensive and requires less technology than phacoemulsification, and may be the preferred technique for cataracts surgery in the developing world.
Abstract: Purpose of review To review surveys published within the last year concerning the prevalence of cataract blindness, rates of cataract surgical coverage and visual outcomes of cataract surgery in various developing countries, and to review recent studies that compare the different cataract surgical techniques used in developing countries. Recent findings Up to 75% of blindness (visual acuity below 20/400) is due to cataract. Cataract remains the most common treatable cause of blindness. Reported cataract surgical coverage is low, and visual outcomes are poor and necessitate improvement. Phacoemulsification is the preferred technique for cataract surgery in developed countries, but large-scale implementation in developing countries may prove to be a challenge. An alternative surgical technique, manual sutureless small incision extracapsular cataract surgery, has been increasing in popularity, as the technique has been shown to yield similar surgical outcomes as phacoemulsification. Summary Treating cataract blindness worldwide continues to be a formidable challenge. Significant barriers include cost, lack of population awareness, shortage of trained personnel and poor surgical outcomes. Both phacoemulsification and manual small incision extracapsular cataract surgery achieve excellent visual outcomes with low complication rates, but manual small incision extracapsular cataract surgery is significantly faster, less expensive and requires less technology. Therefore, manual small incision extracapsular cataract surgery may be the preferred technique for cataract surgery in the developing world.
224 citations
TL;DR: Implantation of the AcrySof toric IOL proved to be an effective, safe, and predictable method of managing corneal astigmatism in cataract patients.
Abstract: Purpose To present clinical data from a single-center prospective clinical trial of the AcrySof toric intraocular lens (IOL). Setting Academic Hospital Maastricht, Maastricht, The Netherlands. Methods Fifty-three eyes (43 patients) had implantation of an AcrySof toric IOL. Three toric models were evaluated in cylinder powers of 1.50 diopters (D) (SN60T3; T3 group, n = 16), 2.25 D (SN60T4; T4 group, n = 14), and 3.00 D (SN60T5; T5 group, n = 23) at the IOL plane. The T5 group was subdivided into eyes that could be fully corrected (T5a, n = 13) and eyes that could be partially corrected (T5b, n = 10). Results Four months postoperatively, the mean uncorrected visual acuity (UCVA) was 0.77 ± 0.23 in the T3 group, 0.93 ± 0.23 in the T4 group, 0.82 ± 0.15 in the T5a group, and 0.47 ± 0.13 in the T5b group. More than 90% of the combined eyes in the T3, T4, and T5a groups achieved a UCVA of 20/40 or better, and almost 80% achieved a UCVA of 20/25 or better. Residual refractive astigmatism of less than 0.75 D was achieved in 74% of eyes and of less than 1.00 D in 91%. The mean IOL misalignment was 2.5 ± 2.1 degrees in the T3 group, 3.5 ± 2.3 degrees in the T4 group, and 4.1 ± 3.5 degrees in the T5 group. Conclusion Implantation of the AcrySof toric IOL proved to be an effective, safe, and predictable method of managing corneal astigmatism in cataract patients.
206 citations
TL;DR: The features and outcomes of endophthalmitis associated with clear corneal cataract surgery are similar to those reported in the EVS, which is associated with scleral incisions, but time to diagnosis was later with clearCorneal incisions.
182 citations
TL;DR: Considering existing prevalence and projected incidence ofCataract blindness over the period 2001-2020, visual outcomes after cataract surgery and sight restoration rate, elimination of cataracts blindness may not be achieved by 2020 in India.
Abstract: Background: India is a signatory to the World Health Organization resolution on Vision 2020: The right to sight. Efforts of all stakeholders have resulted in increased number of cataract surgeries performed in India, but the impact of these efforts on the elimination of avoidable blindness is unknown. Aims: Projection of performance of cataract surgery over the next 15 years to determine whether India is likely to eliminate cataract blindness by 2020. Materials and Methods: Data from three national level blindness surveys in India over three decades, and projected age-specific population till 2020 from US Census Bureau were used to develop a model to predict the magnitude of cataract blindness and impact of Vision 2020: the right to sight initiatives. Results: Using age-specific data for those aged 50+ years it was observed that prevalence of blindness at different age cohorts (above 50 years) reduced over three decades with a peak in 1989. Projections show that among those aged 50+ years, the quantum of cataract surgery would double (3.38 million in 2001 to 7.63 million in 2020) and cataract surgical rate would increase from 24025/million 50+ in 2001 to 27817/million 50+ in 2020. Though the prevalence of cataract blindness would decrease, the absolute number of cataract blind would increase from 7.75 million in 2001 to 8.25 million in 2020 due to a substantial increase in the population above 50 years in India over this period. Conclusions: Considering existing prevalence and projected incidence of cataract blindness over the period 2001-2020, visual outcomes after cataract surgery and sight restoration rate, elimination of cataract blindness may not be achieved by 2020 in India.
157 citations
TL;DR: Vision-related QOL, cognitive impairment, and depressive mental status are all strongly related with each other, and cataract surgery significantly improved vision-relatedQOL in elderly patients, and cognitive impairment and depressive mentally status also improved in parallel with improvement in vision- related QOL.
154 citations
TL;DR: Routine eye screening for retinopathy of individuals with diabetes offers the opportunity to detect these other ocular diseases early, many of which are sight threatening, and physician education remains an important public health strategy in the prevention of vision loss in patients with diabetes.
Abstract: Diabetic retinopathy is the most well-known ocular complication of diabetes and the leading cause of blindness among people 20–64 years of age in the U.S. (1). Up to 4 million Americans with diabetes, 40 years of age and older, have retinopathy, and nearly 1 million have sight-threatening retinopathy (2). In major clinical trials, tight control of blood glucose and blood pressure has been demonstrated to reduce the risk of retinopathy and associated blindness (3).
A range of ocular diseases is also associated with diabetes, which may lead to vision loss. However, some of these ocular conditions may not be familiar to noneye clinicians (4–6). In this review, we aim to highlight the frequencies, clinical presentations, natural histories, and management of these ocular conditions. Physicians who manage patients with diabetes may benefit from knowledge of these associated conditions and are thus able to ensure adequate and timely referral and treatment. Routine eye screening for retinopathy of individuals with diabetes offers the opportunity to detect these other ocular diseases early, many of which are sight threatening. Physician education remains an important public health strategy in the prevention of vision loss in patients with diabetes.
### 1. Cataracts and cataract surgery
Cataract is a major cause of vision impairment in people with diabetes. Numerous studies have documented an association between diabetes and cataracts. This association is supported by an abundance of data from clinical epidemiological studies and basic science studies (7–22). Both cross-sectional and prospective data from three population-based studies, the Beaver Dam Eye Study, the Blue Mountains Eye Study, and the Visual Impairment Project, have documented associations between diabetes and both prevalent and incident posterior subcapsular cataract and, less consistently, with prevalent and incident cortical cataracts but not nuclear cataract (8–12,14–19,23,25). The Blue …
152 citations
TL;DR: Analytical results suggest that cataract formation is most likely to occur after PC pIOL implantation, and patients with preexisting progressive cataracts should be informed about the possibility ofCataract progression and possible need for Cataract surgery after pI OL implantation.
Abstract: We performed a systematic literature review to determine the incidence of and predisposing factors for cataract after phakic intraocular lens (pIOL) implantation. Of the 6338 eyes reported, 4.35% were noted to have new-onset or preexisting progressive cataract. The incidence of cataract formation was 1.29%, 1.11%, and 9.60% with anterior chamber, iris-fixated, and posterior chamber (PC) pIOLs, respectively. In the PC pIOL group, early cataract formation was related to surgical trauma and late-onset cataract was related to IOL–crystalline lens contact. Analysis of cataract progression in eyes with preexisting cataract showed a progression rate of 29.5% after pIOL surgery. These results suggest that cataract formation is most likely to occur after PC pIOL implantation. Patients with preexisting progressive cataract should be informed about the possibility of cataract progression and possible need for cataract surgery after pIOL implantation. Cataract surgical intervention resulted in restoration of visual acuity.
TL;DR: This study suggests that adding perioperative ketorolac to postoperative prednisolone significantly reduces the incidences of CME and macular thickening in cataract surgery patients already at low risk for this condition.
TL;DR: Circumferential viscodilation and tensioning of Schlemm canal combined with clear corneal phacoemulsification and posterior chamber intraocular lens (IOL) implantation was a safe and effective procedure to reduce intraocular pressure in adult patients with OAG.
Abstract: Purpose To evaluate the safety and efficacy of circumferential viscodilation and tensioning of the inner wall of Schlemm canal, a new nonpenetrating surgical procedure (canaloplasty) to treat open-angle glaucoma (OAG), combined with clear corneal phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Setting Multicenter surgical sites. Methods This international multicenter prospective study comprised adult patients with OAG having combined glaucoma and cataract surgery. Patients with qualifying treated preoperative intraocular pressure (IOP) of at least 21 mm Hg or higher and open angles were eligible. Evaluation was performed at baseline and 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Intraoperative and postoperative high-resolution ultrasound imaging was used to assess Schlemm canal and anterior segment angle morphology, including distension of the trabecular meshwork due to the tensioning suture. Results Data from 54 eyes that had combined glaucoma and cataract surgery performed by 11 surgeons at 9 study sites were analyzed for this interim analysis. The mean baseline IOP was 24.4 mm Hg ± 6.1 (SD) with a mean of 1.5 ± 1.0 medications per eye. In all eyes, the mean postoperative IOP was 13.6 ± 3.8 mm Hg at 1 month, 14.2 ± 3.6 mm Hg at 3 months, 13.0 ± 2.9 mm Hg at 6 months, and 13.7 ± 4.4 mm Hg at 12 months. Medication use dropped to a mean of 0.2 ± 0.4 per patient at 12 months. Surgical complications were reported in 5 eyes (9.3%) and included hyphema (n = 3, 5.6%), Descemet tear (n = 1, 1.9%), and iris prolapse (n = 1, 1.9%). Transient IOP elevation of more than 30 mm Hg was observed in 4 eyes (7.3%) 1 day postoperatively. Conclusion Circumferential viscodilation and tensioning of Schlemm canal combined with clear corneal phacoemulsification and posterior chamber IOL implantation was a safe and effective procedure to reduce IOP in adult patients with OAG.
TL;DR: There was no increased safety risk associated with a 250 μg/0.050 mL intracameral injection of moxifloxacin, which appears to be safe in the prophylaxis of endophthalmitis after cataract surgery.
Abstract: Purpose To evaluate posterior and anterior segment safety of an intracameral injection of moxifloxacin 0.5% ophthalmic solution as prophylaxis for endophthalmitis in patients having cataract surgery. Setting Three private practices, the University of Minnesota School of Medicine, Stillwater, Minnesota, and the University of Cincinnati, Cincinnati, Ohio, USA. Methods In this prospective randomized combined-center open-label trial, 57 eyes of 47 patients were treated with intracameral moxifloxacin (250 μg/0.050 mL) or an equal volume of balanced salt solution at the conclusion of cataract surgery with intraocular lens implantation. Safety parameters, including visual acuity, intraocular pressure, endothelial cell counts, corneal pachymetry, corneal clarity and edema, and anterior chamber cells and flare, were evaluated preoperatively and for 3 months postoperatively. Results Optical coherence tomography results showed no statistically significant differences between the 2 treatment groups preoperatively or at 3 months. There were also no statistically significant differences between the 2 treatment groups in all other parameters preoperatively or at 1 day, 2 to 4 weeks, or 3 months. No study-related adverse events occurred. Conclusion There was no increased safety risk associated with a 250 μg/0.050 mL intracameral injection of moxifloxacin, which appears to be safe in the prophylaxis of endophthalmitis after cataract surgery.
TL;DR: A ≥40% increase in baseline CPT, determined by OCT, offers a valid and objective method of reporting clinically relevant postcataract ME, which would allow objective assessment and comparison of treatment outcomes among clinical studies.
Abstract: Objective:To validate a method of reporting postcataract macular edema (ME) using optical coherence tomography (OCT).Methods:Data were analyzed for 130 eyes followed prospectively for ME after uncomplicated cataract surgery. Each eye underwent OCT within 4 weeks before surgery and at 1 month and 3 m
TL;DR: A cluster of metabolic abnormalities attributable to insulin resistance appears more likely to contribute to cataract formation than any individual cardiovascular risk factor alone.
Abstract: Purpose: To assess associations between diabetes and selected cardiovascular risk factors and long-term incident cataract and cataract surgery. Methods: A cohort of initially 3654 elderly Australians were followed over a period of 10 years. Questionnaires ascertained relevant history and fasting blood samples were taken. Impaired fasting glucose (IFG) and metabolic syndrome were defined using World Health Organization criteria. Discrete logistic models were used to assess risk of incident cataract. Results: After controlling for age, sex, and other factors, baseline diabetes predicted nuclear cataract (relative risk, RR, 1.64; 95% confidence interval (CI), 1.02–2.64) and IFG predicted cortical cataract (RR, 2.01; CI, 1.20–3.36). Each standard deviation (SD) increase in glucose was positively associated with cortical cataract (RR, 1.13; CI, 1.01–1.27). Higher body mass index (BMI) was positively associated with posterior subcapsular cataract (RR per SD, 1.20; CI, 1.03–1.41). Persons using anti-hypertensive...
TL;DR: Cataract remains the most important cause of preventable blindness in this poor region of China, and affordable provision of surgery would help to address this problem.
TL;DR: At day 1 after clear corneal cataract surgery, CH is diminished, whereas CCT is increased significantly, and it is supposed that GAT and NCT measurements are significantly different because of postoperative changes in viscoelastic properties of the cornea.
TL;DR: Age- and gender-specific cataract incidences in this study were similar to those reported from the U.S. Beaver Dam Eye Study, and nuclear cataracts and PSC were significantly associated with visual impairment (visual acuity worse than 20/40).
TL;DR: Inverse associations were found between cataract and blood antioxidants in an antioxidant-depleted study sample of people aged >or=50 years.
Abstract: PURPOSE. To examine the association of blood antioxidants with cataract. METHODS. Cross-sectional study of people aged 50 years identified from a household enumeration of 11 randomly sampled villages in North India. Participants were interviewed for putative risk factors (tobacco, alcohol, biomass fuel use, sunlight exposure, and socioeconomic status) and underwent lens photography and blood sampling. Lens photographs (nuclear, cortical, and posterior subcapsular) were graded according to the Lens Opacities Classification System (LOCS II). Cataract was defined as LOCS II grade 2 for any opacity or ungradable, because of dense opacification or history of cataract surgery. People without cataract were defined as LOCS II 2o n all three types of opacity, with absence of previous surgery. RESULTS. Of 1443 people aged 50 years, 94% were interviewed, 87% attended an eye examination, and 78% gave a blood sample; 1112 (77%) were included in the analyses. Compared with levels in Western populations, antioxidants were low, especially vitamin C. Vitamin C was inversely associated with cataract. Odds ratios (OR) for the highest (15 mol/L) compared with the lowest (6.3 mol/L) tertile were 0.64, (95% confidence interval [CI] 0.48-0.85; P 0.01). Tertiles of zeaxanthin (P 0.03), -carotene (P 0.05), and retinol (P 0.02) were associated with decreased odds of cataract. In analysis of continuous data, significant inverse associations were found for vitamin C, zeaxanthin, lutein, lycopene, - and -carotene, and -cryptoxanthin, but not for -o r-tocopherol.
TL;DR: The results suggest that modern foldable IOLs have a low incidence of PCO after 3 years, and there is less PCO for sharp optic edge designs independent of IOL material.
TL;DR: The risk Profile for postoperative RD in this series cannot be distinguished from the risk profile for idiopathic RD in myopia of this extent and the true effect of prophylactic treatment of degenerative lesions remains to be elucidated.
Abstract: Purpose To determine the incidence of and risk factors for rhegmatogenous retinal detachment (RD) in highly myopic eyes after cataract surgery. Setting Two ophthalmology centers in Munich and Ahaus, Germany. Methods This retrospective medical chart review comprised 1519 consecutive patients (2356 eyes) with an axial length (AL) greater than 27.0 mm who had planned phacoemulsification and intraocular lens implantation in the capsular bag. In addition, all patients and/or the referring ophthalmologist were contacted regarding the occurrence of RD and laser capsulotomy and the date of occurrence. Results Follow-up was longer than 24 months in 84% of eyes. Because some cases of RD were questionably related to the preceding cataract surgery, the absolute incidence of postoperative RD was determined as highest (2.2%) and lowest (1.5%). Sex, history of laser capsulotomy, and increasing AL had no statistically significant effect on the rate of RD. The risk for postoperative RD was significantly higher in eyes of younger patients and eyes with preoperative prophylactic treatment for retinal degeneration. Conclusions The risk for postoperative RD in this study (1.5% to 2.2%) corresponds to the incidence of pseudophakic RD and idiopathic RD in myopia described in the literature. The risk profile for postoperative RD in this series cannot be distinguished from the risk profile for idiopathic RD in myopia of this extent. The true effect of prophylactic treatment of degenerative lesions remains to be elucidated.
TL;DR: In this interim analysis of subjects with glaucoma and cataracts, this novel stent implantation in subjects undergoing cataract surgery represents a new surgical approach to provide clinically significant decreases in IOP and drug burden.
Abstract: Introduction
Reducing intraocular pressure (IOP) is the only proven treatment modality for reducing the risk of glaucomatous progression. In this study, we evaluated the safety and efficacy of a new tool in IOP reduction, implanted with cataract surgery: the Glaukos iStent trabecular micro-bypass stent.
TL;DR: Practical, short and medium term avenues must be explored to reduce delays of presentation in the care of children with congenital or developmental cataract in developing countries.
Abstract: Purpose: Worldwide, at least 190,000 children are blind due to cataract. Although, surgical intervention is the treatment of choice, in most developing countries the number of children with cataract being brought to hospital for surgery has been few in number, considerably less than the burden of disease in the community. Furthermore, long delay in presentation is a major deterrent to improved visual outcome and compromises the future quality of life of children and their families. The main objective of this qualitative study was to provide a better understanding of surgical delay in the care of children with congenital or developmental cataract. Methods: We conducted 117 semi-structured interviews with parents or guardians of children admitted for cataract surgery at a tertiary hospital in northern Tanzania. Results: We identified several factors influencing the treatment-seeking behaviors of parents and guardians, including gender relations within the household, local health beliefs about cataract and c...
TL;DR: To evaluate posterior capsule opacification (PCO) 2 years after cataract surgery following implantation of a hydrophilic or a Hydrophobic single‐piece acrylic intraocular lens (IOL) with a sharp edge.
Abstract: .
Purpose: To evaluate posterior capsule opacification (PCO) 2 years after cataract surgery following implantation of a hydrophilic or a hydrophobic single-piece acrylic intraocular lens (IOL) with a sharp edge.
Methods: Phacoemulsification cataract surgery was performed in one eye of 120 patients with senile cataract in this prospective study. They were randomized to implantation of either a hydrophilic acrylic IOL (BL27; Bausch & Lomb, Rochester, NY, USA) or a hydrophobic acrylic IOL (AcrySof® SA60AT; Alcon Laboratories, Fort Worth, TX, USA). Two years after surgery, retroillumination images were obtained and PCO area and severity were evaluated using pocoman software. Best corrected visual acuity (VA) (both high-contrast [100%] and low-contrast [2.5%]), glare, laser flare and intraocular pressure were measured. Capsulotomy rates were recorded.
Results: Patients implanted with the hydrophilic IOL had a greater percentage area and severity of PCO compared with patients with the hydrophobic IOL (p < 0.001). There was no difference in PCO between men and women in the hydrophilic group. However, in the hydrophobic group, women had significantly more PCO than men (p < 0.05). Patients with the hydrophobic acrylic IOL had better high- and low-contrast visual activity (VA) (p < 0.01) and less glare (p < 0.001) than those with a hydrophilic acrylic IOL. Of the patients with the hydrophilic IOL, 42% underwent capsulotomy, compared with 10% in the hydrophobic group (p < 0.001).
Conclusions: Two years after surgery, patients with the SA60AT hydrophobic acrylic IOL had less PCO and better high- and low-contrast VA than patients with the BL27 hydrophilic acrylic IOL.
TL;DR: Commonly reported complications of intraoperative floppy‐iris syndrome (IFIS) were significant iris trauma and posterior capsule rupture, with 52% and 23% of respondents, respectively, reporting these complications at a higher rate than in non‐IFIS eyes.
Abstract: According to an online survey, most members of the American Society of Cataract and Refractive Surgery believe that tamsulosin makes cataract surgery more difficult (95%) and increases the risks of surgery (77%). Commonly reported complications of intraoperative floppy-iris syndrome (IFIS) were significant iris trauma and posterior capsule rupture, with 52% and 23% of respondents, respectively, reporting these complications at a higher rate than in non-IFIS eyes. There was no single preferred surgical method for managing IFIS; 33% of respondents routinely used multiple strategies. Of respondents with sufficient experience, 90% believe that IFIS is more likely with tamsulosin than with nonspecific α 1 -antagonists. Ninety-one percent believe that physicians prescribing α 1 -antagonists should become better educated about IFIS, and 59% would recommend a pretreatment ophthalmic evaluation for patients with cataracts or decreased vision. If they themselves had mildly symptomatic cataracts, 64% of respondents would avoid taking tamsulosin or would have their cataract removed first.
TL;DR: No untoward effects were observed after intracameral injection of moxifloxacin 0.1% solution in a 100 microg/0.1 mL dose at the conclusion of routine cataract surgery and the effect on macular thickness was assessed using optical coherence tomography (OCT).
Abstract: PURPOSE: To establish the safety of an intracameral injection of self-preserved moxifloxacin at the conclusion of routine cataract surgery for the prophylaxis of endophthalmitis and to assess the effect on macular thickness using optical coherence tomography (OCT). SETTING: Private practice, Bettendorf, Iowa, USA. METHODS: A retrospective review of the charts of consecutive cataract procedures was conducted to compare outcome measures in patients with or without intracameral injection of moxifloxacin that was diluted to a 0.1% solution in a 100 microg/0.1 mL dose at the conclusion of cataract surgery. In addition, in a prospective manner, macular thickness was measured by OCT in 31 eyes before and 6 weeks after cataract surgery in patients who received the intracameral injection. RESULTS: Aqueous cell counts 1 day postoperatively were significantly lower in the moxifloxacin-treated group (P=.0007). At 1 week, there was no difference between the 2 treatment groups in the number of patients who had no or trace cells. No stromal edema was observed in the moxifloxacin-treated group. Optical coherence tomography studies showed mean increases of less than 3% in macular thickness in all sectors and less than 4% in macular volume at all locations. No drug-related adverse effects were reported. CONCLUSION: No untoward effects were observed after intracameral injection of moxifloxacin 0.5% ophthalmic solution diluted to a 0.1% concentration at the conclusion of routine cataract surgery.
TL;DR: Used prophylactically after cataract surgery, ketorolac tromethamine 0.5% was efficacious in decreasing postoperative macular edema.
Abstract: Purpose To evaluate the efficacy of prophylactic administration of the topical nonsteroidal antiinflammatory drug (NSAID) ketorolac tromethamine 0.5% on acute (within 4 weeks of surgery) cystoid macular edema (CME) and total macular volume (TMV) in patients having phacoemulsification cataract surgery. Setting Department of Ophthalmology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario, Canada. Methods This open-label nonmasked randomized (random number assignment) study comprised 106 eyes of 98 patients. Exclusion criteria included hypersensitivity to the NSAID drug class, aspirin/NSAID-induced asthma, and pregnancy in the third trimester. Ketorolac tromethamine 0.5% was administered starting 2 days before surgery and for 29 days after surgery for a total of 31 days. The outcome measure was macular swelling, which was quantified by the optical coherence tomography. Results At 1 month, there was a statistically significant difference in TMV between the control group (0.4420 mm 3 ) and the ketorolac group (0.2392 mm 3 ), with the ketorolac group having 45.8% less macular swelling ( P = .009). Multiple linear regression with backward selection indicated a 44.3% ( P = .013) and 46.1% ( P = .030) reduction in macular swelling in the ketorolac group at 1 week and 1 month, respectively. Conclusion Used prophylactically after cataract surgery, ketorolac 0.5% was efficacious in decreasing postoperative macular edema.
TL;DR: Patients with preoperative predictors at presentation such as young age at the time of surgery, a family history of aphakic glaucoma, nuclear cataracts, or persistent fetal vasculature syndrome offer a clear target for extensive postoperative care after congenital cataract surgery.