Showing papers on "Cataract surgery published in 2011"
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.
632 citations
TL;DR: Pressure reduction on fewer medications was clinically and statistically significantly better 1 year after stent plus cataract surgery versus cataracts surgery alone, with an overall safety profile similar to that of catarACT surgery alone.
437 citations
TL;DR: This review summarizes data collected by the Swedish National Cataract Register, which now contains data pertaining to more than a million cataract surgery procedures, representing 95.6% of the surgeries performed in Sweden during 1992-2009, and shows that preoperative visual acuity has risen steadily and endophthalmitis has decreased.
Abstract: This review summarizes data collected by the Swedish National Cataract Register, which now contains data pertaining to more than a million cataract surgery procedures, representing 95.6% of the sur ...
246 citations
TL;DR: The improvements in lens geometry and more accurate nomograms applied to the selection of the lens to be implanted, in addition to the surgeon's learning curve, might be factors in the decreased occurrence of postoperative complications reported currently.
Abstract: PURPOSE: To review the peer-reviewed literature reporting postoperative complications of the most recent models of Visian Implantable Collamer posterior chamber intraocular lenses (ICL, STAAR Surgical Co). METHODS: A literature search of the PubMed database was performed to identify all articles related to ICL complications. Articles were obtained and reviewed to identify those that reported complications using the latest ICL designs. RESULTS: Cataract was the major postoperative complication reported: 136 (5.2%) in 2592 eyes. Of those, 43.4% (n=59) were reported within 1 year, 15.4% (n=21) between 1 and 3 years, and 35.3% (n=48) >3 years after ICL implantation. Twenty-one (15.4%) cataracts were reported as surgically induced, 46 (33.8%) eyes had poor vault ( ,200 µm), and cataract surgery was carried out in 27.9% (n=38) of eyes. Early acute intraocular pressure increase was also reported to be relatively frequent, whereas acute pupillary block was less frequent and mostly resolved with additional iridotomies. A total of 42 ICLs were explanted due to cataract and IOP. Reported endothelial cell loss varied from 9.9% at 2 years to 3.7% 4 years postoperatively. This loss was reported to be more pronounced within the fi rst 1 to 2 years, with stability or lower progression after that time. CONCLUSIONS: The majority of reported complications after ICL implantation are cataract formation. The improvements in lens geometry and more accurate nomograms applied to the selection of the lens to be implanted, in addition to the surgeon’s learning curve, might be factors in the decreased occurrence of postoperative complications reported currently. [ J Refract Surg . 2011;xx(x):xxx-xxx.] doi:10.3928/1081597X-20110617-01 C urrently, phakic intraocular lenses (PIOLs) are generally accepted as an alternative treatment for ametropia correction among various refractive ranges, and their implantation is an emerging technique within the fi eld of refractive surgery. Faster visual recovery, high effi cacy and stability of visual quality, preservation of accommodation, and reversibility are several advantages that have been attributed to PIOL implantation. 1,2
204 citations
TL;DR: The findings largely are consistent with the results of previous studies, providing further evidence for possible modifiable risk factors for age-related cataract.
149 citations
TL;DR: Capsulotomy performed with an intraocular FS laser induced significantly less internal aberrations measured by the NIDEK OPD-Scan aberrometer compared to eyes that underwent CCC, which may result in better optical quality after the procedure.
Abstract: PURPOSE: To compare ocular and internal aberrations after femtosecond laser anterior capsulotomy and con- tinuous curvilinear capsulorrhexis in cataract surgery. METHODS: In this prospective study, anterior capsu- lotomy was performed during cataract surgery with an intraocular femtosecond (FS) laser (Alcon LenSx Inc) in 48 eyes. As a control group, continuous curvilinear cap- sulorrhexis (CCC) was performed in 51 eyes. Wavefront aberrometry, corneal topography, and objective visual quality were measured using the OPD-Scan (NIDEK Co Ltd). Vertical and horizontal tilt, coma, and visual quality metrics were evaluated separately to determine whether the source of aberrations was ocular or internal. Main outcome measures included postoperative residual re- fraction, uncorrected and corrected visual acuities, ocu- lar and internal aberrations, Strehl ratio, and modula- tion transfer function (MTF). RESULTS: No statistically signifi cant differences were noted between the FS and CCC groups, respectively, in postoperative sphere (!0.60"1.50 vs !0.50"1.40 diopters (D)), postoperative cylinder (1.30"1.01 vs 1.10"1.10 D), uncorrected distance visual acuity (0.86"0.15 vs 0.88"0.08), or corrected distance visual acuity (0.97"0.08 vs 0.97"0.06). The FS group had signifi cantly lower values of intraocular vertical tilt (!0.05"0.36 vs 0.27"0.57) and coma (!0.003"0.11 vs 0.1"0.15), and signifi cantly higher Strehl ratios (0.02"0.02 vs 0.01"0.01) and MTF values at all measured cycles per degree, compared to the CCC group. CONCLUSIONS: Capsulotomy performed with an in- traocular FS laser induced signifi cantly less internal aberrations measured by the NIDEK OPD-Scan aber- rometer compared to eyes that underwent CCC, which may result in better optical quality after the procedure. (J Refract Surg. 2011;27(10):711-716.) doi:10.3928/1081597X-20110913-01
141 citations
TL;DR: Cataract surgery-induced improvements in visual acuity are translated by considerable gains in real life activities, emotional and social life components, and the best current strategy to optimize the impact of cataract surgery on health-related quality of life appears to be the best currently strategy.
Abstract: Purpose of reviewThis review summarizes the recent literature of the impact of cataract surgery from the patient's perspective, with a focus on second-generation patient reported outcome (PRO) measures that used Rasch analysis to explore their data.Recent findingsIrrespective of the instrument utili
138 citations
TL;DR: The results can help hospitals analyze the demand for and cost of using toric IOLs in patients with corneal astigmatism and to establish thedemand for toric intraocular lenses in a hospital unit.
Abstract: Purpose To analyze and quantify the pattern of corneal astigmatism in patients awaiting cataract surgery and to establish the demand for toric intraocular lenses (IOLs) in a hospital unit. Setting Singleton Hospital Abertawe Bro Morgannwg University NHS Trust, Swansea, United Kingdom. Design Cross-sectional study. Methods Keratometric measurements of all patients attending the preassessment clinic over a 4-month period were prospectively collected and analyzed. Results The study comprised 1230 eyes of 746 patients with a mean age of 75.54 years ± 0.71 (SD). The corneal astigmatism was 0.50 diopter (D) or less in 301 eyes (24.47%), 1.50 D or less in 978 eyes (79.50%), more than 2.50 D in 57 eyes (4.61%), and 3.00 D or more in 24 eyes (1.93%). Conclusions Of patients attending for routine cataract surgery at a single center, 497 (40.41%) had more than 1.00 D of astigmatism. The results can help hospitals analyze the demand for and cost of using toric IOLs in patients with corneal astigmatism. Financial Disclosure Neither author has a financial or proprietary interest in any material or method mentioned.
137 citations
TL;DR: In this paper, the prevalence and predictors of intraoperative and 90-day postoperative ocular complications associated with cataract surgery performed in the United States Veterans Health Administration (VHA) system were investigated.
130 citations
TL;DR: Changes in operative techniques have been accompanied by a significant decrease in complication rates over time, although the increase in IOL dislocations and complications after ECCE warrants further study.
129 citations
TL;DR: Intracameral injection of high doses of cefuroxime induced anterior and posterior inflammation and the final visual outcome was satisfactory in all cases, however, long‐term retinal function must be assessed through repeated ERG recordings.
Abstract: Purpose To report cases of intraocular inflammation after intracameral injection of a very high dose of cefuroxime at the end of uneventful cataract surgery. Setting Department of Ophthalmology, Bordeaux University Hospital, Bordeaux, France. Design Case series. Methods Patients were followed on an outpatient basis and were examined postoperatively at 1 and 5 days and 6 weeks. Central macular thickness, angiography, central corneal thickness (CCT), endothelial cell density (ECD), and electroretinography (ERG) were analyzed to evaluate ocular toxicity. Results One day postoperatively, the mean corrected distance visual acuity (CDVA) was 0.95 logMAR ± 0.40 (SD). All the cases had moderate anterior inflammation. Retinal optical coherence tomography scans systematically showed extensive macular edema (mean 843.2 ± 212.7 μm) associated with a large serous retinal detachment. Fluorescein angiograms showed diffuse leakage without abnormal retinal perfusion. At 5 days, the mean CDVA improved significantly to 0.52 ± 0.29 logMAR ( P P =.005). At 6 weeks, the mean CDVA reached 0.09 ± 0.06 logMAR. Modifications in CCT and ECD were similar to those observed after uneventful phacoemulsification. The macular thickness (mean 288.4 ± 22.6 μm) and profile returned to normal in all patients, although ERG recordings showed reduced rod photoreceptor cell function ( P Conclusions Intracameral injection of high doses of cefuroxime induced anterior and posterior inflammation. Without surgical intervention, the final visual outcome was satisfactory in all cases. Long-term retinal function, however, must be assessed through repeated ERG recordings. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.
TL;DR: The top 5 corneal power adjustment techniques and formula combinations in terms of mean prediction errors, standard deviations, and minimizing hyperopic "refractive surprises" were the Masket with the Hoffer Q formula, the Shammas, and the Haigis-L.
TL;DR: The risk for postoperative endophthalmitis in ISBCS appears to be at least as low as and possibly lower than published rates for unilateral surgery, particularly when recommended precautions are taken.
Abstract: Purpose To determine a best estimate of the incidence of endophthalmitis after immediately sequential bilateral cataract surgery (ISBCS) and assess the benefit of prophylactic intracameral antibiotics. Setting Eye Foundation of Canada, Toronto, Ontario, Canada. Design Cohort study. Methods A detailed literature search was performed to obtain recently reported frequencies of postoperative endophthalmitis with or without the use of prophylactic intracameral antibiotics. Members of the International Society of Bilateral Cataract Surgeons were surveyed. The data were collected to determine the results of unilateral and bilateral cataract surgeries performed by experienced bilateral cataract surgeons. The data were statistically analyzed. Results In recently published European prophylactic intracameral cephalosporin studies, the incidence of postoperative endophthalmitis after unilateral cataract surgery weight-averaged to 1 in 331 (0.3%) without prophylactic intracameral antibiotics and to 1 in 1977 (0.05%) with prophylactic intracameral antibiotics, whereas studies in the United States using only topical antibiotics reported infection rates as low as 0.028%. Four cases of bilateral simultaneous endophthalmitis after ISBCS have been reported in the past 60 years, all with breaches of aseptic protocol. No bilateral simultaneous endophthalmitis occurred in the 95 606 ISBCS cases collected. The overall rate of postoperative endophthalmitis after ISBCS was 1 in 5759. Infection rates were significantly reduced with intracameral antibiotics to 1 in 14 352 cases. Conclusions The risk for postoperative endophthalmitis in ISBCS appears to be at least as low as and possibly lower than published rates for unilateral surgery, particularly when recommended precautions are taken. Intracameral antibiotics significantly reduced the risk for postoperative endophthalmitis. Financial Disclosure Neither author has a financial or proprietary interest in any material or method mentioned.
TL;DR: Results of this study suggest that femtosecond laser-assisted cataract extraction does not differ in postoperative macular thickness as compared with standard ultrasound phacoemulsification.
Abstract: PURPOSE: To compare the effect of conventional and femtosecond laser-assisted (Alcon LenSx Inc) phacoemulsification on the macula using optical coherence tomography (OCT). METHODS: Twenty eyes of 20 patients underwent uneventful cataract surgery in both study groups: femtosecond laser-assisted (laser group) and conventional phacoemulsification (control group). Macular thickness and volume were evaluated by OCT preoperatively and 1 week and 1 month postoperatively. Primary outcomes were OCT retinal thickness in 3 macular areas and total macular volume at 1 week and 1 month postoperative. Secondary outcomes were changes in retinal thickness at 1 week and 1 month postoperatively, with respect to preoperative retinal thickness values and effective phacoemulsification time. RESULTS: Multivariable modeling of the effect of surgery on postoperative macular thickness showed significantly lower macular thickness in the inner retinal ring in the laser group after adjusting for age and preoperative thickness across the time course (P=.002). In the control group, the inner macular ring was significantly thicker at 1 week (mean: 21.68 μm; 95% confidence limit [CL]: 11.93-31.44 μm, P<.001). After 1 month, this difference decreased to a mean of 17.56 μm (95% CL: -3.21-38.32 μm, P=.09) and became marginally significant. CONCLUSIONS: Results of this study suggest that femtosecond laser-assisted cataract extraction does not differ in postoperative macular thickness as compared with standard ultrasound phacoemulsification.
TL;DR: The present systematic review evaluates the options available to prevent PCO or ensure a clear central visual axis after pediatric cataract surgery and new approaches to posterior capsule management such as pars plicata posterior capsulorhexis, sutureless vitrectomy, sealed‐capsule irrigation, and bag‐in‐the‐lens IOL are discussed.
Abstract: Management of the posterior capsule significantly affects the outcome of pediatric cataract surgery. Posterior capsule opacification (PCO) is rapid and virtually inevitable in very young children when adult-style cataract surgery is performed and the posterior capsule is left intact. In eyes with pediatric cataract, primary posterior capsulotomy and vitrectomy are considered routine surgical steps, especially in younger children. The site of intraocular lens (IOL) fixation and the surgical technique used also affect the prevalence of PCO. The present systematic review evaluates the options available to prevent PCO or ensure a clear central visual axis after pediatric cataract surgery. Newer approaches to posterior capsule management such as pars plicata posterior capsulorhexis, sutureless vitrectomy, sealed-capsule irrigation, and bag-in-the-lens IOL are discussed. Management of the posterior capsule in the presence of a preexisting posterior capsule defect and posterior capsule plaque and options to treat PCO are also reviewed. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.
TL;DR: Postoperative reduction in IOP was proportional to the increase in angle in both groups, but the IOP reduction per 0.1-mm increase in AOD500 in NA eyes was greater than that in OA eyes.
Abstract: Objective To determine the association of changes in anterior chamber angle and anterior chamber depth (ACD) with intraocular pressure (IOP) reduction after uncomplicated phacoemulsification. Methods In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or all quadrants was considered narrow angle (NA). Anterior segment optical coherence tomography and tonometry were performed preoperatively and 10 days and 1, 3, and 6 months after surgery. The ACD and angle opening distance at 500 μm anterior to the scleral spur (AOD500) were assessed from anterior segment optical coherence tomography. Results Data were collected from 63 eyes that underwent cataract surgery. Twenty-six eyes were classified as having NA. Before surgery, the mean (SD) AOD500 and ACD in the NA group were 0.179 (0.014) mm and 2.23 (0.07) mm, respectively. Six months after surgery, the mean (SD) AOD500 and ACD in the NA group were 0.389 (0.025) mm and 3.75 (0.05) mm, respectively. The postoperative IOP was reduced significantly in both groups. We found that each 0.1-mm increase in AOD500 corresponded to a mean (SD) 0.42 (0.18)–mm Hg decrease in IOP (P Conclusions Postoperative reduction in IOP was proportional to the increase in angle in both groups, but the IOP reduction per 0.1-mm increase in AOD500 in NA eyes was greater than that in OA eyes.
TL;DR: The Catquest-9SF is short and highly responsive to cataract surgery, and so is ideal for measuring visual functioning outcomes, and other instruments may be preferred to measure different constructs.
TL;DR: A significantly greater loss of corneal endothelial cells in a diabetic group under good glycemic control, compared with nondiabetic group 3 months after phacoemulsification is revealed.
Abstract: Purpose To investigate the corneal endothelial cell density and morphology in patients with and without diabetes after phacoemulsification with intraocular lens implantation. Methods A clinical prospective study including 30 patients with type 2 diabetes and 30 control patients without diabetes scheduled to undergo cataract surgery. No difference in preoperative age was observed between the 2 groups (P = 0.90). Sample size was based on a power calculation (power 0.90; P = 0.05). The patients without diabetes had a casual blood glucose test performed to disclose undetected diabetes. The patients with diabetes had a serum glycosylated hemoglobin (HbA1c) test performed to reveal the glycemic control. The endothelial cell density, variation in endothelial cell size (CV), percentage of hexagonal cells, and central corneal thickness (CCT) were recorded at baseline and at 3 months postoperatively. Results The mean decrease in endothelial cell density at 3 months in the diabetic group was 154 cells per square millimeter (6.2%) and 42 cells per square millimeter (1.4%) in the control group. The difference in cell loss between the 2 groups was significant (P = 0.04). A significant decrease in the percentage of hexagonal cells was also seen in the diabetic group (P = 0.01). There was no statistically significant change in CV or CCT. Visual acuity increased significantly and equally in the 2 groups. Conclusions The present study reveals a significantly greater loss of corneal endothelial cells in a diabetic group under good glycemic control, compared with nondiabetic group 3 months after phacoemulsification. The morphological changes in the endothelial cells in patients with well-controlled diabetes were not reflected in impaired function as judged by CCT.
TL;DR: In this article, the long-term cumulative risk of late posterior chamber intraocular lens (IOL) dislocation after cataract extraction in a population-based cohort was estimated by using the Kaplan-Meier method.
TL;DR: The rates of ICs, AEs, and AISs 1 year after surgery were numerically higher in the IOL group, but their functional impact does not clearly favor either treatment group.
TL;DR: With awareness of the changed intraocular environment following laser lens fragmentation and capsulotomy and a modification of the surgical technique, no additional cases of intraoperative CBS have been seen in more than 600 laser-assisted cataract surgery procedures performed to date at the facility.
Abstract: We report intraoperative capsular block syndrome occuring during the first 50 femtosecond laser–assisted cataract surgeries performed in our facility. Two patients had uneventful combined laser fragmentation, capsulotomy, and corneal incision procedures. In both cases, following transfer to the operating room and manual removal of the laser-cut capsulotomy, posterior capsule rupture was noted during hydrodissection, resulting in posterior dislocation of the lens. Pars plana vitrectomy, removal of the crystalline lens, and sulcus implantation of an intraocular lens were performed in both patients with good visual outcomes. Femtosecond laser–assisted cataract surgery changes the intraoperative environment with the generation of intracapsular gas and laser-induced changes in the cortex. With awareness of the changed intraocular environment following laser lens fragmentation and capsulotomy and a modification of the surgical technique, no additional cases of intraoperative CBS have been seen in more than 600 laser-assisted cataract surgery procedures performed to date at our facility. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.
TL;DR: Toric IOL implantation in patients with cataract and corneal astigmatism provided good distance and near visual outcomes and acceptable intermediate visual outcomes, allowing patients with considerable amounts of cornealeastigmatism to achieve spectacle independence atdistance and near.
Abstract: Purpose To evaluate visual outcomes and patient satisfaction after toric multifocal intraocular lens (IOL) implantation in patients with cataract and corneal astigmatism. Setting University Eye Clinic Maastricht, The Netherlands. Design Cohort study. Methods Patients with cataract, corneal astigmatism, and a motivation for spectacle independency had cataract surgery with implantation of a toric diffractive multifocal IOL (AT Lisa). Three months postoperatively, the uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities; corrected distance, intermediate, and near visual acuities; residual refractive astigmatism; defocus curve; contrast sensitivity; and patient satisfaction were evaluated. Results Forty-five eyes of 25 patients were enrolled. Postoperatively, the mean UDVA was 0.04 logMAR ± 0.15 (SD) and 98% of eyes achieved a UDVA of 20/40 or better. The mean UNVA was 0.20 ± 0.16 logMAR and the mean UIVA (at 60 cm), 0.40 ± 0.16 logMAR. Residual refractive astigmatism of −1.00 diopter or less was achieved in approximately 90% of eyes. Contrast sensitivity levels were high. Approximately 50% of patients reported moderate glare, halos, and starburst symptoms. Spectacle independency for distance and near vision was achieved by 95% of patients and 79% of patients, respectively. Conclusions Toric IOL implantation in patients with cataract and corneal astigmatism provided good distance and near visual outcomes and acceptable intermediate visual outcomes, allowing patients with considerable amounts of corneal astigmatism to achieve spectacle independence at distance and near. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
TL;DR: Compared with sequential bilateral cataract surgery, simultaneous bilateral catARact surgery provided comparable clinical outcomes with substantial savings in health‐care and non‐health‐care–related costs.
Abstract: Purpose To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Setting Helsinki University Eye Hospital, Helsinki, Finland. Design Economic analysis. Methods Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. Results The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Conclusion Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care–related costs. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.
TL;DR: Rates of sight-threatening adverse events after cataract surgery declined during 1994-2006, and future efforts should be directed to identifying ways to reduce severe adverse events in high-risk groups.
TL;DR: Patients with multifocal IOLs could perform several daily tasks at near and intermediate distances, with less night‐driving limitation with the full diffractive IOL than with apodized multifocal and monofocal Iols.
Abstract: Purpose To compare vision-related quality of life using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in patients with 1 of 3 types of intraocular lenses (IOLs) and to correlate it with postoperative visual outcomes. Setting Vissum Corporation–Instituto Oftalmologico de Alicante, Alicante, Spain. Design Comparative case series. Methods This study comprised eyes having cataract surgery with bilateral implantation of a monofocal IOL (Group A), apodized multifocal IOL (Group B), or full diffractive multifocal IOL (Group C). Distance and near visual acuities, contrast sensitivity, and quality of life were evaluated preoperatively and postoperatively. Results The study enrolled 106 eyes (53 patients; age range 49 to 80 years). All groups had significant improvement in uncorrected and corrected distance visual acuities postoperatively (P≤.05). Near vision outcomes were significantly better in Groups B and C (P≤.01). Groups B and C had significantly less difficulty in some near tasks, such as reading the newspaper (A–B, P=.02; A–C, P=.02) or reading bills (A–B, P=.04; A–C, P=.004). Group C also had significantly less difficulty driving at night than Group B (P Conclusions Patients with multifocal IOLs could perform several daily tasks at near and intermediate distances, with less night-driving limitation with the full diffractive IOL than with apodized multifocal and monofocal IOLs. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.
TL;DR: The incidence of capsule complications decreased over time, partly the result of fewer risk factors and of better surgical quality, and even after adjusting for this, there was an obvious decrease in capsule complications over time.
Abstract: Purpose: To define the incidence of capsule complication and its risk factors in Sweden over an 8-year period.
Setting: Fifty-two ophthalmic surgery units in Sweden.
Design: Database study.
Methods ...
TL;DR: Cataract prevalence increased with higher quartiles of blood glucose, systolic BP, and metabolic syndrome components, and high BP and diabetes were associated with age-related cataract.
Abstract: PURPOSE. To examine the relationship between metabolic syndrome and its components, diabetes mellitus, high blood pressure (BP), obesity, and dyslipidemia, with age-related cataract. METHODS. A population-based sample of 2794 Malay adults aged 40 to 80 years in Singapore was used for this analysis. Cataract (n 1268) was defined as the presence of nuclear, cortical, or posterior subcapsular (PSC) cataract, from standardized grading of lens photographs or previous cataract surgery. Metabolic syndrome was defined as the presence of 3 of the following components: body mass index (BMI) 25 kg/m 2 , triglycerides 1.7 mM, high density‐lipoprotein (HDL) cholesterol 1.0 mM in men and 1.3 mM in women, BP 130/85 mm Hg, or use of BP medication and diabetes mellitus. RESULTS. Cataract prevalence increased with higher quartiles of blood glucose, systolic BP, and metabolic syndrome components (P trend 0.0001). The multivariable odds ratio (OR) (95% confidence interval [CI]) of cataract was 1.89 (1.42‐2.40) for diabetes, 1.92 (1.47‐2.52) for high BP, and 1.27 (1.04‐ 1.55) for metabolic syndrome. Of the individual metabolic syndrome components, high BP was associated with all three cataract types; diabetes was associated with cortical and PSC; low HDL, high BMI, and metabolic syndrome were associated with cortical cataract. The presence of both high BP and diabetes was associated with fourfold odds of having cataract (OR [95% CI] 4.73 [2.16‐10.34]). CONCLUSIONS. Metabolic syndrome and its two key components, high BP and diabetes were associated with age-related cataract. (Invest Ophthalmol Vis Sci. 2011;52:2397‐2404) DOI:
TL;DR: The objective was to investigate the impact on visual function from light scattering and glistenings in intraocular lenses in patients who had cataract surgery 10 years previously.
Abstract: Purpose: To investigate the impact on visual function from light scattering and glistenings in intraocular lenses (IOLs) in patients who had cataract surgery 10 years previously. Setting: Eye clini ...
TL;DR: The final visual outcome in eyes with mild to moderate retinopathy, without previous ME, is as good as in normal eyes, but an increased frequency of macular changes may protract recovery of full vision.
Abstract: Background
Cystoid macular edema (CME) is a well-known complication after cataract surgery, and diabetic retinopathy is reported to be an important risk factor for impaired visual recovery. In this prospective study, we compared visual outcome 6 months after surgery in eyes with moderate retinopathy and no previous ME with a control group, and observed the incidence of ME seen on fluorescein angiography (FA) and optical coherence tomography (OCT).
TL;DR: EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care, and whether this procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared withstandard care.
Abstract: Glaucoma is the leading cause of irreversible blindness. Although primary open-angle glaucoma is more common, primary angle-closure glaucoma (PACG) is more likely to result in irreversible blindness. By 2020, 5·3 million people worldwide will be blind because of PACG. The current standard care for PACG is a stepped approach of a combination of laser iridotomy surgery (to open the drainage angle) and medical treatment (to reduce intraocular pressure). If these treatments fail, glaucoma surgery (eg, trabeculectomy) is indicated. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to PACG, early clear lens extraction will improve glaucoma control by opening the drainage angle. This procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared with standard care. EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care. EAGLE is a multicentre pragmatic randomized trial. All people presenting to the recruitment centres in the UK and east Asia with newly diagnosed PACG and who are at least 50 years old are eligible. The primary outcomes are EQ-5D, intraocular pressure, and incremental cost per quality adjusted life year (QALY) gained. Other outcomes are: vision and glaucoma-specific patient-reported outcomes, visual acuity, visual field, angle closure, number of medications, additional surgery (e.g., trabeculectomy), costs to the health services and patients, and adverse events. A single main analysis will be done at the end of the trial, after three years of follow-up. The analysis will be based on all participants as randomized (intention to treat). 400 participants (200 in each group) will be recruited, to have 90% power at 5% significance level to detect a difference in EQ-5D score between the two groups of 0·05, and a mean difference in intraocular pressure of 1·75 mm Hg. The study will have 80% power to detect a difference of 15% in the glaucoma surgery rate. Trial Registration: ISRCTN44464607.