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Govers BM, Keijser S, El Kandoussi M, van Overdam KA, Klevering BJ, Crama N. The effect of patient symptom awareness on the visual outcome in retinal detachment. Acta Ophthalmol 2024; 102:506-512. [PMID: 38009800 DOI: 10.1111/aos.15815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE To explore whether a patient's prior knowledge of the symptoms associated with rhegmatogenous retinal detachment (RRD) relates to the visual outcome after treatment. METHODS We performed a prospective survey study on 126 patients receiving treatment for primary RRD between March and July 2021. RESULTS Thirty-seven per cent (n = 47) of patients responded that they were aware of the RRD symptoms prior to the detachment. A history of RRD in the fellow eye or knowledge of family members treated for RRD was frequently reported as a reason for the patient's awareness of RRD symptoms. Patients aware of RRD symptoms presented significantly more often with an attached macula (χ2, p = 0.002) and a better visual outcome following surgery (Mann-Whitney U, p = 0.028) compared to patients who were not aware of RRD-related symptoms. Among 76 patients with a myopic refractive error, only 15% (n = 11) indicated that they had been warned about the increased RRD risk related to myopia, suggesting that three-quarters of patients were not actively informed by their eye care professionals. CONCLUSION RRD symptom awareness is significantly related to a higher rate of macula-on RRDs and better visual outcomes after treatment. There is limited awareness of increased RRD risk in myopic RRD patients. These findings suggest that counselling individuals at high risk of RRD about related symptoms is inadequate and better counselling may improve visual outcomes following RRD treatment.
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Affiliation(s)
- B M Govers
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - S Keijser
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - M El Kandoussi
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - K A van Overdam
- Department of Ophthalmology, Rotterdam Eye Hospital, Rotterdam, the Netherlands
| | - B J Klevering
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - N Crama
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, the Netherlands
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2
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Momenaei B, Zhou A, Kazan AS, Wakabayashi T, Obeid A, Morano M, Khan MA, Xu D, Kuriyan AE, Yonekawa Y, Hsu J, Ho AC. Retinal Tear and Retinal Detachment Following Cataract Surgery in Eyes with a Previous History of Treated Phakic Retinal Tears. Ophthalmology 2024:S0161-6420(24)00392-0. [PMID: 38960338 DOI: 10.1016/j.ophtha.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/18/2024] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE To investigate the incidence and outcomes of retinal tear (RT) and retinal detachment (RD) after cataract extraction in patients with a history of previous phakic RT. DESIGN Retrospective case series. SUBJECTS Phakic eyes with RT that were successfully treated with laser photocoagulation or cryotherapy and subsequently underwent cataract surgery. METHOD A retrospective review of phakic eyes treated for RTs between April 1, 2012 and May 31, 2023 was performed. Exclusions included prior vitreoretinal surgery before cataract removal and follow-up of less than 6 months post-cataract surgery. MAIN OUTCOME MEASURES The incidence of RTs and RDs after cataract surgery, along with visual and anatomic outcomes. RESULTS Of 12,109 phakic eyes treated for RTs, 1039 (8.6%) eyes underwent cataract surgery. After exclusions, 713 eyes of 660 patients were studied. The mean (standard deviation, SD) follow-up period post-cataract surgery was 34.8 (24.6) months with a median of 239 and 246 days to a new RT or RD development. The overall incidence for diagnosis of post-cataract surgery RT and RD was 7.3% (52/713) (2.9% and 4.3%, respectively), with a one-year incidence of 5.6% (2.2% and 3.4%, respectively). Multivariable regression analysis identified a higher risk of RT/RD among younger individuals (odds ratio [OR] 1.034; 95% confidence interval [CI] 1.004-1.065, P=0.028), males (OR 2.058; 95% CI 1.110-3.816, P=0.022), and those with shorter interval between laser treatment and cataract surgery (OR 1.001; 95% CI 1.001-1.001, P=0.011). Single surgery anatomic success for the RD repair was achieved in 25 eyes (80.6%) at 3 months, with a 100% final reattachment rate. The median final logMAR visual acuity was 0.10 (20/25) for RT, showing no significant change from post-cataract surgery, and 0.18 (20/30) for RD, a significant worsening from after cataract surgery. CONCLUSION One year post-cataract surgery, the rate of diagnosed RT and RD in patients with previously treated RTs was relatively high, occurring in nearly 1 in 18 eyes. Higher risk was noted among younger individuals, males, and patients with a shorter interval between initial treatment for RT and cataract surgery. RD repair achieved good anatomical results, but vision declined.
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Affiliation(s)
- Bita Momenaei
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Andrew Zhou
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adina S Kazan
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Taku Wakabayashi
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Anthony Obeid
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Michael Morano
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - M Ali Khan
- Permanente Medical Group, Granite Bay, CA
| | - David Xu
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Ajay E Kuriyan
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Yoshihiro Yonekawa
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Jason Hsu
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Allen C Ho
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA.
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Sabr M, Semidey VA, Rubio-Caso MJ, Aljuhani Jnr R, Sesma G. Incidence and Risk Factors for Retinal Detachment Following Pediatric Cataract Surgery. Clin Ophthalmol 2024; 18:1623-1636. [PMID: 38855013 PMCID: PMC11162630 DOI: 10.2147/opth.s464005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/21/2024] [Indexed: 06/11/2024] Open
Abstract
Background Retinal detachment is a major postsurgical threat in pediatric cataract surgery; however, the effect of axial length remains unclear. This study aimed to assess the relationship between axial length and detachment risk in vulnerable patients. Methods This retrospective cohort study analyzed 132 eyes of 84 pediatric cataract surgery patients aged <20 years old. Axial length was measured preoperatively, and the incidence of retinal detachment was recorded over a median follow-up of 4 years. Logistic regression analysis was used to examine the axial length-detachment relationship. Results Twenty eyes had postoperative retinal detachments. The median axial length was longer in the detachment group (23.6 mm) than in the non-detachment group (21.6 mm). Eyes with axial length ≤23.4 mm had 0.55-fold decreased odds of detachment compared to longer eyes. Preexisting myopia and glaucoma confer heightened risk. Approximately half of the patients retained some detachment risk eight years postoperatively. Conclusion Shorter eyes (axial length ≤23.4 mm) appear to be protected against pediatric retinal detachment after cataract surgery, whereas myopia, glaucoma, and axial elongation > 23.4 mm elevate the postoperative risk. Understanding these anatomical risk profiles requires surgical planning and follow-up care of children undergoing lensectomy.
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Affiliation(s)
- Mawaddah Sabr
- Pediatric Ophthalmology and Strabismus Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Valmore A Semidey
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Marcos J Rubio-Caso
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Gorka Sesma
- Pediatric Ophthalmology and Strabismus Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Alkharashi M, Abusayf MM, Otaif W, Alkharashi A. The Protective Effect of Rho-Associated Kinase Inhibitor Eye Drops (Ripasudil) on Corneal Endothelial Cells After Cataract Surgery: A Prospective Comparative Study. Ophthalmol Ther 2024; 13:1773-1781. [PMID: 38689101 PMCID: PMC11109060 DOI: 10.1007/s40123-024-00950-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Cataract surgery poses a risk to corneal endothelial cells. This study aimed to assess the protective effect of rho-associated kinase inhibitor eye drop (ripasudil) on corneal endothelial cells after cataract surgery over 12 months. METHODS We conducted a prospective, non-randomized, non-blinded comparative study including 43 patients divided into two groups: the ripasudil group (22 patients, 23 eyes) and the control group (21 patients, 21 eyes). All patients had grade 3 nuclear cataract and underwent uneventful phacoemulsification with intraocular lens implantation. In the ripasudil group, one drop of ripasudil hydrochloride hydrate (Glanatec® ophthalmic solution 0.4%) was administered three times a day for 5 days. Outcome measures included central corneal thickness (CCT) and endothelial cell density (ECD), which were evaluated preoperatively and 12 months postoperatively. RESULTS In the ripasudil group, the median ECD was 2398 (interquartile range [IQR] 410, 2201-2611) cells/mm2 at baseline and 2262 (IQR 298, 2195-2493) cells/mm2 at 12 months postoperatively. In the control group, the median ECD was 2503 (IQR 390, 2340-2730) cells/mm2 at baseline and 2170 (IQR 324, 2049-2373) cells/mm2 at 12 months postoperatively. Endothelial cell loss (ECL) was 12.8% in the control group, significantly reduced to 4.5% in the ripasudil group (p = 0.001*). CCT (p = 0.042), age (p = 0.383), sex (p = 0.944), and duration of surgery (p = 0.319) were not significant factors. No adverse effects were observed in either of the groups. CONCLUSIONS Incorporating ripasudil into postoperative management could help maintain corneal endothelial cell integrity and reduce cell loss after cataract surgery, potentially decreasing the need for endothelial transplantation in patients who have undergone intraocular surgeries.
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Affiliation(s)
- Majed Alkharashi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed M Abusayf
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Wael Otaif
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
- Department of Ophthalmology, King Khalid University Medical City, King Khalid University, Abha, Kingdom of Saudi Arabia.
| | - Abdullah Alkharashi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Liang X, Luo S, Deng K, Li L. Comparison of macular changes and visual outcomes between femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery for high myopic cataract patients. BMC Ophthalmol 2024; 24:212. [PMID: 38750496 PMCID: PMC11097499 DOI: 10.1186/s12886-024-03479-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND To evaluate differences in log MAR best-corrected visual acuity (BCVA) improvement and postoperative central foveal thickness (CFT) and choroidal thickness (CT) changes between conventional phacoemulsification surgery (CPS) and femtosecond laser-assisted cataract surgery (FLACS) for high-myopia cataracts. METHODS This was a retrospective and observational study. One hundred and two eyes of 102 patients with high-myopia cataracts were examined. CPS was performed in 54 eyes, and FLACS was performed in 48 eyes. All eyes underwent logMAR BCVA, CFT and CT of three different sectors preoperatively and one week and six months postoperatively. RESULTS The logMAR BCVA improved significantly after surgery in both groups (both P < 0.001), but no difference was observed in BCVA improvement between the groups (P = 0.554). Moreover, no significant differences were reflected in the changes in CFT, nasal 1 mm CT or temporal 1 mm CT between the two groups, and only subfoveal choroidal thickness (SFCT) in the CPS group decreased significantly compared with that in the FLACS group at any postoperative time (P = 0.003 and 0.026). AL, preoperative logMAR BCVA, and CT of the three regions exhibited a notable correlation with postoperative BCVA (all P < 0.05) according to univariate logistic regression analysis. However, only the AL, preoperative logMAR BCVA and SFCT remained significant in the multivariate model. Postoperative logMAR BCVA revealed a positive correlation with AL and preoperative logMAR BCVA but a negative correlation with SFCT. CONCLUSIONS FLACS was not superior to CPS in improving BCVA but had less impact on SFCT in the treatment of high-myopia cataracts. Eyes with a longer AL, worse preoperative logMAR BCVA and thinner SFCT had a high risk of worse postoperative BCVA.
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Affiliation(s)
- Xuemei Liang
- Department of Ophthalmology, Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, 510071, PR China
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China
| | - Shinan Luo
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China
| | - Kaiyu Deng
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China
| | - Li Li
- Department of Ophthalmology, Aier Eye Hospital, Jinan University, No. 191, Huanshi Middle Road, Yuexiu District, Guangzhou, Guangdong, 510071, PR China.
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China.
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Meng J, Cheng K, Huang Z, He W, Zhang K, Lu Y, Zhu X. COMBINED APPLICATION OF B-SCAN ULTRASONOGRAPHY AND EYE-STEERING ULTRAWIDE FIELD IMAGING TO IMPROVE THE DETECTION OF RETINAL TEARS BEFORE CATARACT SURGERY. Retina 2024; 44:810-819. [PMID: 38194664 DOI: 10.1097/iae.0000000000004040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
PURPOSE To investigate the efficacy of combined application of B-scan ultrasonography (US) and ultrawide field imaging (UWFI) in detecting retinal tears before cataract surgery. METHODS Of 1,277 cataract patients, 2,552 eyes were enrolled and received both B-scan US and UWFI examinations preoperatively. Three types of combination were applied: type 1 (union, B-scan US or centered UWFI), type 2 (intersection, B-scan US and centered UWFI), and type 3 (B-scan US and eye-steering UWFI). Sensitivity and specificity of detecting retinal tears by different methods were assessed. RESULTS Totally 4.55% (116/2,552) of eyes were presented with retinal tears. The sensitivity of B-scan US and UWFI was 87.93% and 84.48%, and specificity was 95.16% and 99.79%, respectively. By applying type 1 and type 2 combination, the sensitivity was 98.28% and 74.14%, and specificity was 95.03% and 99.92%, respectively. By type 3 combination, the sensitivity increased to 95.69% and specificity to 99.88%, both of which were comparable to indirect ophthalmoscopy regardless of the number, type, and location of tears ( P > 0.05). In eyes with any cataract type or axial length, type 3 combination also gained comparable performance to indirect ophthalmoscopy. CONCLUSION Combined application of B-scan US and eye-steering UWFI presented satisfactory performance in detecting retinal tears before cataract surgery.
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Affiliation(s)
- Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; and
| | - Kaiwen Cheng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; and
| | - Zhiqian Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; and
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; and
| | - Keke Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; and
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; and
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; and
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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Momenaei B, Wakabayashi T, Kazan AS, Oh GJ, Kozarsky S, Vander JF, Gupta OP, Yonekawa Y, Hsu J. Incidence and Outcomes of Recurrent Retinal Detachment after Cataract Surgery in Eyes with Prior Retinal Detachment Repair. Ophthalmol Retina 2024; 8:447-455. [PMID: 37989465 DOI: 10.1016/j.oret.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To investigate the incidence and outcomes of recurrent retinal detachment (RD) after cataract extraction (CE). DESIGN Retrospective case series. SUBJECTS Phakic eyes with RD that were successfully repaired with pneumatic retinopexy (PR), scleral buckle (SB), pars plana vitrectomy (PPV), or combined PPV/SB and subsequently underwent cataract surgery. METHODS A retrospective review of phakic eyes that underwent successful RD repair followed by subsequent cataract surgery between April 2012 and January 2023 was performed. Patients with multiple RD surgeries before CE and those with silicone oil tamponade before cataract surgery were excluded. Eyes that redetached were matched 1:2 with eyes that did not redetach after cataract surgery. MAIN OUTCOME MEASURES Incidence of redetachment after cataract surgery as well as visual and anatomic outcomes at 6 months after first redetachment and at the final visit. RESULTS Of 4833 phakic eyes at the time of initial RD, 1893 patients (39.2%) underwent cataract surgery. After applying exclusion criteria, 763 patients were included. The mean (standard deviation) duration of follow-up was 48.4 (29.1) months. The overall incidence of retinal redetachment after cataract surgery was 2.5% (19/763 eyes). The rate of redetachment based on the type of initial RD repair was 9.1% (1/11), 5.3% (2/38), 2.8% (9/317), and 1.8% (7/397) for PR, SB, PPV, and combined PPV/SB, respectively (P = 0.24). The median (interquartile range [IQR]; range) duration between the cataract surgery and first redetachment was 301 (104-1222; 8-2760) days. Single surgery anatomic success for the RD repair after cataract surgery was achieved in 17 eyes (89.5%) at 3 months and 14 eyes (73.7%) at 6 months and at the final visit. Final anatomic success rate for reattachment was 100% (19/19). The median (IQR) logarithm of the minimal angle of resolution visual acuity (VA) at the final visit was 1.00 (0.18-2.00, Snellen equivalent, 20/200) with significant worsening compared with vision after cataract surgery (0.18 [0.10-0.48], 20/30) (P = 0.001). CONCLUSION Recurrent RD was not uncommon in patients with a prior history of RD repair after CE. Reoperation resulted in relatively favorable anatomic success but there were declines in VA. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Bita Momenaei
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Taku Wakabayashi
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Adina S Kazan
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Glenn J Oh
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Scott Kozarsky
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - James F Vander
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Omesh P Gupta
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Yoshihiro Yonekawa
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason Hsu
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Schöneberger V, Tahmaz V, Menghesha L, Lüke JN, Cursiefen C, Schaub F, Bachmann BO. Retinal Detachment Rates After Uncomplicated DMEK Versus Cataract Surgery Combined (Triple-)DMEK. Cornea 2024:00003226-990000000-00541. [PMID: 38692685 DOI: 10.1097/ico.0000000000003554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/18/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE To evaluate the rate of and risk factors for rhegmatogenous retinal detachment (RRD) after Descemet membrane endothelial keratoplasty (DMEK) either alone or in combination with cataract surgery. DESIGN Retrospective analysis of prospective database. METHODS Consecutive eyes with Fuchs endothelial corneal dystrophy (FECD) that received DMEK surgery with a minimum follow-up of 1 year between July 2011 and January 2021 at the Department of Ophthalmology at the University of Cologne were analyzed. Exclusion criteria were complicated history including repeat DMEK within 1-year, previous retinal or glaucoma surgery, complicated phacoemulsification, congenital cataract, history of trauma. RESULTS From 3858 consecutive DMEKs, 1961 patients were identified suitable for analysis. 846 (43.1%) were pseudophakic DMEK, 91 (4.6%) phakic DMEK and 1,024 (52.2%) combined with cataract surgery. RRD occurred in 13 eyes (12 patients). Within two years after DMEK RRD occurred in 0.49% and 0.47% after DMEK and DMEK with cataract surgery, respectively. Mean age of 59.24 ± 8.42 years with subsequent RRD was significantly lower than overall 68.81 ± 9.89 years (t-test two-tailed; p < 0.001). The spherical equivalent was -4.69 ± 3.98 D (range -9.00 to 0.5) in RRD after pseudophakic DMEK compared to -2.79 ± 3.54 D (range -7.5 to 0.75) in combined procedures. Re-bubbling had no influence on RRD rate. CONCLUSIONS DMEK alone or in combination with cataract surgery showed similar postoperative RRD rates in the first two years, generally in the range of pseudophakic RRDs. Risk factors such as myopia and younger age could be identified. Re-bubbling has no influence on RRD rates.
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Affiliation(s)
- Verena Schöneberger
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Volkan Tahmaz
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Leonie Menghesha
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Jan Niklas Lüke
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Claus Cursiefen
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Friederike Schaub
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
- Department of Ophthalmology, University Medical Center Rostock, University of Rostock, Rostock, Germany
| | - Björn O Bachmann
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
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Scarfone HA, Rodriguez EC, Rufiner MG, Riera JJ, Fanego SE, Charles M, Albano R. Vitreous-lens interface changes after cataract surgery using active fluidics and active sentry with high and low infusion pressure settings. J Cataract Refract Surg 2024; 50:333-338. [PMID: 37938025 PMCID: PMC10959530 DOI: 10.1097/j.jcrs.0000000000001359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To determine whether the infusion pressure used during phacoemulsification may have a detrimental effect on the anterior hyaloid membrane barrier (AHMB) in a pressure fluctuation-free environment using diagnostic spectral-domain optical coherence tomography (SD-OCT) postoperatively. SETTING Tandil Eye Clinic, Tandil, Buenos Aires, Argentina, and Centro Oftalmológico Dr. Charles, CABA, Buenos Aires, Argentina. DESIGN Prospective, randomized, multicenter, experimental, and double-masked study. METHODS Phacoemulsification with intraocular lens implantation was performed in all patients with the Centurion Vision System equipment with active fluidics and active sentry. Patients were randomly assigned to configuration 1 or 2. Configuration 1 had intraocular pressure (IOP) 30 mm Hg and configuration 2 IOP 80 mm Hg. Inclusion criteria were axial length >22 mm and <25 mm, age older than 50 and younger than 70 years, and complete adhesion of AHMB. RESULTS 80 eyes of 80 patients were included. Berger space was identified in 17 cases (42.5%) of group 2 and 3 cases (7.5%) of group 1 postoperatively using SD-OCT. A statistically significant relationship was established using Fisher exact test ( P = .0003). Postoperatively, we observed posterior vitreous detachment changes in only 1 patient (1.25%) during the 3 months of follow-up ( P = .5). According to the Wong-Baker FACES Scale, the patient's subjective perception was better for the low infusion pressure group ( P = .0001, Fisher exact test). CONCLUSIONS Phacoemulsification with high infusion pressure can change the vitreous-lens interface. Positive Berger space after phacoemulsification is a biomarker of this change and can occur in eyes without risk factors. Incidence is directly related to the infusion pressure used.
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Affiliation(s)
- Hugo A. Scarfone
- From the Clinica de Ojos Tandil, Tandil, Buenos Aires, Argentina (Scarfone, Rodriguez, Rufiner, Riera, Fanego); Charles Centro Oftalmológico, Buenos Aires, Argentina (Charles, Albano)
| | - Emilia C. Rodriguez
- From the Clinica de Ojos Tandil, Tandil, Buenos Aires, Argentina (Scarfone, Rodriguez, Rufiner, Riera, Fanego); Charles Centro Oftalmológico, Buenos Aires, Argentina (Charles, Albano)
| | - Maira G. Rufiner
- From the Clinica de Ojos Tandil, Tandil, Buenos Aires, Argentina (Scarfone, Rodriguez, Rufiner, Riera, Fanego); Charles Centro Oftalmológico, Buenos Aires, Argentina (Charles, Albano)
| | - José J. Riera
- From the Clinica de Ojos Tandil, Tandil, Buenos Aires, Argentina (Scarfone, Rodriguez, Rufiner, Riera, Fanego); Charles Centro Oftalmológico, Buenos Aires, Argentina (Charles, Albano)
| | - Susel E. Fanego
- From the Clinica de Ojos Tandil, Tandil, Buenos Aires, Argentina (Scarfone, Rodriguez, Rufiner, Riera, Fanego); Charles Centro Oftalmológico, Buenos Aires, Argentina (Charles, Albano)
| | - Martín Charles
- From the Clinica de Ojos Tandil, Tandil, Buenos Aires, Argentina (Scarfone, Rodriguez, Rufiner, Riera, Fanego); Charles Centro Oftalmológico, Buenos Aires, Argentina (Charles, Albano)
| | - Rodrigo Albano
- From the Clinica de Ojos Tandil, Tandil, Buenos Aires, Argentina (Scarfone, Rodriguez, Rufiner, Riera, Fanego); Charles Centro Oftalmológico, Buenos Aires, Argentina (Charles, Albano)
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10
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Ruiss M, Pai V, Pilwachs C, Bayer N, Palkovits S, Findl O. Quality assurance via telephone interviews after cataract surgery: An explorative study. PLoS One 2024; 19:e0298149. [PMID: 38451971 PMCID: PMC10919583 DOI: 10.1371/journal.pone.0298149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/13/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Cataract surgery is a relatively safe procedure with satisfactory postoperative results in most patients. However, in rare cases severe complications can occur shortly after the intervention. Therefore, patients are advised to undergo an ophthalmological examination postoperatively, which should be performed as soon as possible in case of emergencies. However, exactly when these follow-up visits should take place is still discussed. A time- and cost-saving alternative to this could be short-term postoperative telemedical approaches. The aim of this study was to analyze patient complaints as well as satisfaction with and the best timepoint to perform telephone calls after cataract surgery. METHODS Patients scheduled for cataract surgery received a telephone call on the surgery day or the day after (study group) during which they were asked about complaints or additional examination visits. Patients without telephone calls served as control group. All patients had a follow-up visit one week after the intervention during which a questionnaire was filled out and the study group was asked about their satisfaction with the telephone calls. RESULTS 181 patients were recruited in this study. Ocular surface problems were the most common postoperative symptom. More than 80% of the patients were very satisfied with the telephone calls, with patients being contacted on the day of surgery being more calmed than those called on the next day. No difference in additional and planned follow-up visits was found between the study and the control group (P > .40). Postoperative patient complaints (Phi 0.372, P < .001) and additional prescribed therapy (Phi 0.480, P < .001) were moderately associated with additional visits. CONCLUSION Satisfaction with telephone reviews shortly after cataract surgery was very high and contacting patients on the evening of the day of the procedure could be a time- and cost-saving alternative to short-term in-house follow-up visits.
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Affiliation(s)
- Manuel Ruiss
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Viktoria Pai
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Caroline Pilwachs
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Natascha Bayer
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Stefan Palkovits
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
| | - Oliver Findl
- Vienna Institute for Research in Ocular Surgery (VIROS), a Karl Landsteiner Institute, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
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11
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Moussa G, Jalil A, Lippera M, Ivanova T, Cristescu I, Ally N, Jasani K, Patton N, Dhawahir-Scala F, Ferrara M. THE LONG-TERM RECOVERY OF VISION IN PSEUDOPHAKIC MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENTS. Retina 2024; 44:421-428. [PMID: 37973046 DOI: 10.1097/iae.0000000000003984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE To assess the long-term visual recovery in uncomplicated macula-off pseudophakic rhegmatogenous retinal detachment treated with pars plana vitrectomy and gas tamponade in the absence of other visual comorbidities. METHODS Single-center retrospective longitudinal study on eyes with macula-off pseudophakic rhegmatogenous retinal detachment successfully treated with pars plana vitrectomy between 2011 and 2020 and with at least 2 follow-ups (FU), first gas-free FU (first-FU) and a final-FU, were included. Patients with subsequent ocular surgery or comorbidities affecting best-corrected visual acuity were excluded. The duration between operation date and final-FU was calculated (total days FU) and split into total days quintiles-1: ≤57, 2: >57 and ≤77, 3: >77 and ≤152, 4: >152 and ≤508, and 5: >508 days. Multivariable regression was performed with logMAR gain between the first and the final-FU as the dependent variable. RESULTS In 209 eyes, the authors report association with increase of logMAR gain between the first and the final-FU, with reducing clock hours of pseudophakic rhegmatogenous retinal detachment ( P = 0.041) and relative to the total days Quintile 1. Mean (SD) logMAR gain between the first and the final-FU was 0.02 (0.07) in the first quintile, increasing to 0.14 (0.13) ( P < 0.001) by the fifth quintile on multivariable regression. For patients not achieving 0.30 logMAR at the first-FU, this was attained at the final-FU with a sensitivity of 51.9% and specificity of 95.5% at a cut off ≤0.58 logMAR at the first-FU (area under the curve 0.756 [95% confidence interval 0.664-0.848], P < 0.001). CONCLUSION The authors report a significant time-dependent visual improvement after uncomplicated pars plana vitrectomy with gas tamponade for macula-off pseudophakic rhegmatogenous retinal detachment without visual confounders and provide important quantitative data for counselling patients with macula-off repair.
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Affiliation(s)
- George Moussa
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | - Assad Jalil
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | - Myrta Lippera
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | - Tsveta Ivanova
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | - Irina Cristescu
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | - Naseer Ally
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | - Kirti Jasani
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | - Niall Patton
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
| | | | - Mariantonia Ferrara
- Manchester Royal Eye Hospital, Manchester, United Kingdom; and
- School of Medicine, University of Málaga, Málaga, Spain
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12
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Geiger MD, Lynch AM, Palestine AG, Grove NC, Christopher KL, Davidson RS, Taravella MJ, Mandava N, Patnaik JL. Are there sex-based disparities in cataract surgery? Int J Ophthalmol 2024; 17:137-143. [PMID: 38239954 PMCID: PMC10754674 DOI: 10.18240/ijo.2024.01.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/09/2023] [Indexed: 01/22/2024] Open
Abstract
AIM To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery. METHODS This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine. Data collected included the patient's health history, ocular comorbidities, operative and post-operative complications, and the post-operative best corrected visual acuity (BCVA). The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study. RESULTS A total of 11 977 eyes from 7253 patients were included in the study. Ocular comorbidities differed by sex, with males having significantly higher percentages of traumatic cataracts (males 0.7% vs females 0.1%), prior ocular surgery (6.7% vs 5.5%), and mature cataracts (2.8% vs 1.9%). Conversely, females had significantly higher rates of pseudoexfoliation (2.0% vs 3.2%). In unadjusted analysis, males had higher rates of posterior capsular rupture (0.8% vs 0.4%) and vitreous loss (1.0% vs 0.6%), but this difference was not significant after adjustment for confounders. Males had a significantly increased risk of post-operative retinal detachment, but in multivariable analysis this was no longer significant. Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for posterior capsule opacification (OR=0.8, 95%CI=0.7-0.9, P=0.0005). The BCVA was slightly worse for males pre-operatively; but post-operatively, both sexes exhibited similar visual acuity of Snellen equivalent 20/25. CONCLUSION The study finds that in a cohort of patients presenting for cataract surgery, sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males. However, observed surgical complication rates exhibit almost no difference by sex after adjusting for pre-operative differences and post-operative BCVA is similar between sexes.
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Affiliation(s)
- Matthew D Geiger
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Anne M Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Alan G Palestine
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Nathan C Grove
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Karen L Christopher
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Richard S Davidson
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Michael J Taravella
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Naresh Mandava
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA
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13
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Hjortdal J. Refractive and cataract surgery beyond VISION2020. Indian J Ophthalmol 2024; 72:3-5. [PMID: 38131561 PMCID: PMC10841810 DOI: 10.4103/ijo.ijo_2767_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark. E-mail:
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Morano MJ, Khan MA, Zhang Q, Halfpenny CP, Wisner DM, Sharpe J, Li A, Tomaiuolo M, Haller JA, Hyman L, Ho AC. Incidence and Risk Factors for Retinal Detachment and Retinal Tear after Cataract Surgery: IRIS® Registry (Intelligent Research in Sight) Analysis. OPHTHALMOLOGY SCIENCE 2023; 3:100314. [PMID: 37274012 PMCID: PMC10239011 DOI: 10.1016/j.xops.2023.100314] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 06/06/2023]
Abstract
Objective To report the incidence of and evaluate demographic, ocular comorbidities, and intraoperative factors for rhegmatogenous retinal detachment (RRD) and retinal tear (RT) after cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight). Design Retrospective cohort study. Participants Patients aged ≥ 40 years who underwent cataract surgery between 2014 and 2017. Methods Multivariable logistic regression was used to evaluate demographic, comorbidity, and intraoperative factors associated with RRD and RT after cataract surgery. Main Outcome Measures Incidence and risk factors for RRD or RT within 1 year of cataract surgery. Results Of the 3 177 195 eyes of 1 983 712 patients included, 6690 (0.21%) developed RRD and 5489 (0.17%) developed RT without RRD within 1 year after cataract surgery. Multivariable logistic regression odds ratios (ORs) showed increased risk of RRD and RT, respectively, among men (OR 3.15; 95% confidence interval [CI], 2.99-3.32; P < 0.001 and 1.79; 95% CI, 1.70-1.89; P < 0.001), and younger ages compared with patients aged > 70, peaking at age 40 to 50 for RRD (8.61; 95% CI, 7.74-9.58; P < 0.001) and age 50 to 60 for RT (2.74; 95% CI, 2.52-2.98; P < 0.001). Increased odds of RRD were observed for procedure eyes with lattice degeneration (LD) (10.53; 95% CI, 9.82-11.28; P < 0.001), hypermature cataract (1.61; 95% CI, 1.06-2.45; P = 0.03), complex cataract surgery (1.52; 95% CI, 1.4-1.66; P < 0.001), posterior vitreous detachment (PVD) (1.24; 95% CI, 1.15-1.34; P < 0.001), and high myopia (1.2; 95% CI, 1.14-1.27; P < 0.001). Lattice degeneration conferred the highest odds of RT (43.86; 95% CI, 41.39-46.49; P < 0.001). Conclusion In the IRIS Registry, RRD occurs in approximately 1 in 500 cataract surgeries in patients aged > 40 years within 1 year of surgery. The presence of LD conferred the highest odds for RRD and RT after surgery. Additional risk factors for RRD included male gender, younger age, hypermature cataract, PVD, and high myopia. These data may be useful during the informed consent process for cataract surgery and help identify patients at a higher risk of retinal complications. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
| | - M. Ali Khan
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Qiang Zhang
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
- Vickie and Jack Farber Vision Research Center at Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Colleen P. Halfpenny
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Douglas M. Wisner
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
| | - James Sharpe
- Wills Eye Hospital, Philadelphia, Pennsylvania
- Vickie and Jack Farber Vision Research Center at Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Alexander Li
- Wills Eye Hospital, Philadelphia, Pennsylvania
- Vickie and Jack Farber Vision Research Center at Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Maurizio Tomaiuolo
- Wills Eye Hospital, Philadelphia, Pennsylvania
- Vickie and Jack Farber Vision Research Center at Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Julia A. Haller
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Leslie Hyman
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
- Vickie and Jack Farber Vision Research Center at Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Allen C. Ho
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
| | - IRIS Registry Analytic Center Consortium
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania
- Wills Eye Hospital, Philadelphia, Pennsylvania
- Vickie and Jack Farber Vision Research Center at Wills Eye Hospital, Philadelphia, Pennsylvania
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15
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Lin C, Yang Y, Gao H, Zheng Y, Ma K, Guang C. Evaluation of continuous curvilinear capsulorhexis based on a neural-network. Int J Comput Assist Radiol Surg 2023; 18:2203-2212. [PMID: 37300662 DOI: 10.1007/s11548-023-02973-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Continuous curvilinear capsulorhexis (CCC), as a prerequisite for successful cataract surgery, is one of the most important and difficult steps in phacoemulsification. In clinical practice, the size and circularity of the capsular tear and eccentricity with the lens are often employed as indicators to evaluate the effect of CCC. METHODS We present a neural network-based model to improve the efficiency and accuracy of evaluation for capsulorhexis results. The capsulorhexis results evaluation model consists of the detection network based on U-Net and the nonlinear fitter built from fully connected layers. The detection network is responsible for detecting the positions of the round capsular tear and lens margin, and the nonlinear fitter is utilized to fit the outputs of the detection network and to compute the capsulorhexis results evaluation indicators. We evaluate the proposed model on an artificial eye phantom and compare its performance with the medical evaluation method. RESULTS The experimental results show that the average detection error of the proposed evaluation model is within 0.04 mm. Compared with the medical method (the average detection error is 0.28 mm), the detection accuracy of the proposed evaluation model is more accurate and stable. CONCLUSION We propose a neural network-based capsulorhexis results evaluation model to improve the accuracy of evaluation for capsulorhexis results. The results of the evaluation experiments show that the proposed results evaluation model evaluates of the effect of capsulorhexis better than the medical evaluation method.
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Affiliation(s)
- Chuang Lin
- School of Mechanical Engineering and Automation, Beihang University, Beijing, 100083, China
| | - Yang Yang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, 100083, China
| | - Handa Gao
- School of Mechanical Engineering and Automation, Beihang University, Beijing, 100083, China
| | - Yu Zheng
- College of Automation and College of Artificial Intelligence, Nanjing University of Posts and Telecommunications, Nanjing, 210023, China
| | - Ke Ma
- Eye Center of Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China
| | - Chenhan Guang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, 100083, China.
- College of Mechanical and Storage and Transportation Engineering, China University of Petroleum-Beijing, Beijing, China.
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16
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Fatahi B, Fatahi S, Nosrati S, Bagheri M. Effect of motion-graphic video-based training on the performance of operating room nurse students in cataract surgery in Iran: a randomized controlled study. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2023; 20:34. [PMID: 38013202 PMCID: PMC11009010 DOI: 10.3352/jeehp.2023.20.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE The present study was conducted to determine the effect of motion-graphic video-based training on the performance of operating room nurse students in cataract surgery using phacoemulsification at Kermanshah University of Medical Sciences in Iran. METHODS This was a randomized controlled study conducted among 36 students training to become operating room nurses. The control group only received routine training, and the intervention group received motion-graphic video-based training on the scrub nurse’s performance in cataract surgery in addition to the educator’s training. The performance of the students in both groups as scrub nurses was measured through a researcher-made checklist in a pre-test and a post-test. RESULTS The mean scores for performance in the pre-test and post-test were 17.83 and 26.44 in the control group and 18.33 and 50.94 in the intervention group, respectively, and a significant difference was identified between the mean scores of the pre- and post-test in both groups (P=0.001). The intervention also led to a significant increase in the mean performance score in the intervention group compared to the control group (P=0.001). CONCLUSION Considering the significant difference in the performance score of the intervention group compared to the control group, motion-graphic video-based training had a positive effect on the performance of operating room nurse students, and such training can be used to improve clinical training.
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Affiliation(s)
- Behnaz Fatahi
- Department of Operating Room, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samira Fatahi
- Department of Operating Room, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sohrab Nosrati
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masood Bagheri
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Govers BM, van Huet RAC, Roosing S, Keijser S, Los LI, den Hollander AI, Klevering BJ. The genetics and disease mechanisms of rhegmatogenous retinal detachment. Prog Retin Eye Res 2023; 97:101158. [PMID: 36621380 DOI: 10.1016/j.preteyeres.2022.101158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023]
Abstract
Rhegmatogenous retinal detachment (RRD) is a sight threatening condition that warrants immediate surgical intervention. To date, 29 genes have been associated with monogenic disorders involving RRD. In addition, RRD can occur as a multifactorial disease through a combined effect of multiple genetic variants and non-genetic risk factors. In this review, we provide a comprehensive overview of the spectrum of hereditary disorders involving RRD. We discuss genotype-phenotype correlations of these monogenic disorders, and describe genetic variants associated with RRD through multifactorial inheritance. Furthermore, we evaluate our current understanding of the molecular disease mechanisms of RRD-associated genetic variants on collagen proteins, proteoglycan versican, and the TGF-β pathway. Finally, we review the role of genetics in patient management and prevention of RRD. We provide recommendations for genetic testing and prophylaxis of at-risk patients, and hypothesize on novel therapeutic approaches beyond surgical intervention.
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Affiliation(s)
- Birgit M Govers
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ramon A C van Huet
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sander Keijser
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Leonoor I Los
- Department of Ophthalmology, University Medical Center Groningen, Groningen, the Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; AbbVie, Genomics Research Center, Cambridge, MA, USA
| | - B Jeroen Klevering
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
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Ferrara M, Song A, Al-Zubaidy M, Avery P, Laidlaw DA, Williamson TH, Yorston D, Steel DHW. The effect of sex and laterality on the phenotype of primary rhegmatogenous retinal detachment. Eye (Lond) 2023; 37:2926-2933. [PMID: 36849827 PMCID: PMC10517129 DOI: 10.1038/s41433-023-02443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 11/21/2022] [Accepted: 02/02/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND To assess the effect of sex and laterality on clinical features of primary rhegmatogenous retinal detachment (RRD). METHOD This study is a retrospective analysis of data prospectively collected. We extracted data from two online datasets over a 7-year period of patients older than 16 years who had undergone surgery for primary RRD. Data on baseline characteristics were analyzed to compare males versus females, and right versus left eyes. RESULTS Of 8133 eyes analyzed, 4342 (53.4%) were right. The overall male predominance (63.7%) was more marked in the age range 50-69 years. Men were more commonly pseudophakic and presented more frequently with baseline posterior vitreous detachment (PVD). Female sex was significantly associated with baseline myopia, retinal holes as causative retinal break, and isolated inferior RD. Men had more frequent foveal involvement, greater RRD extent, greater numbers and larger sized retinal tears including dialysis and giant retinal tears. Regarding laterality, foveal involvement, larger retinal breaks, isolated temporal RD and temporal retinal breaks were more common in right eyes, whereas left eyes were more myopic at baseline and presented more frequently with isolated nasal RD and nasal retinal breaks. CONCLUSIONS This study confirmed the predominance of male sex and right laterality in RRD. Sex and laterality were associated with multiple presenting features of RRD including extent, break distribution, number, size and type, as well as RD distribution.
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Affiliation(s)
- Mariantonia Ferrara
- Newcastle Eye Centre, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4PL, UK
| | - Anna Song
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mohaimen Al-Zubaidy
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK
| | - Peter Avery
- School of Mathematics & Statistics, Newcastle University, Herschel Building, Newcastle Upon Tyne, NE1 7RU, UK
| | - D Alistair Laidlaw
- Guy's and St. Thomas' NHS Foundation Trust, New City Court 20 St. Thomas Street, London, SE1 9RT, UK
| | - Tom H Williamson
- Guy's and St. Thomas' NHS Foundation Trust, New City Court 20 St. Thomas Street, London, SE1 9RT, UK
| | - David Yorston
- Gartnavel Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - David H W Steel
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK.
- Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK.
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Cristescu IE, Ivanova T, Moussa G, Ziaei H, Ferrara M, Lippera M, El-Faouri M, Patton N, Jasani KM, Dhawahir-Scala F, Jalil A. The impact of 360-laser barricade on outcomes of vitrectomy for pseudophakic retinal detachment; The Manchester Pseudophakic Retinal Detachment Study. Eye (Lond) 2023; 37:3221-3227. [PMID: 36949246 PMCID: PMC10564870 DOI: 10.1038/s41433-023-02495-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/22/2023] [Accepted: 03/06/2023] [Indexed: 03/24/2023] Open
Abstract
PURPOSE To investigate the anatomical and functional outcomes and specifically, the effect of 360-degree barrier-laser, in pars plana vitrectomy (PPV) for primary pseudophakic rhegmatogenous retinal detachment (PRD). METHODS We conducted a single-centre retrospective, continuous and comparative study on eyes that had undergone PPV with focal-retinopexy (laser or cryotherapy) versus 360-laser for PRD repair between 2011-2020 at a single tertiary vitreoretinal centre in the UK. Primary outcomes were single surgery anatomical success (SSAS) rate and final postoperative visual acuity (VA). Multivariable regression covariates for primary re-detachment included age, gender, onset-of-detachment, pre-operative VA, ocular co-morbidities, macula-status, majority inferior (vs superior) PRD, number-of-tears and PRD extent (in clock-hours), 360-laser barricade, and perfluorocarbon liquid (PFCL) use. For VA gain, primary re-detachment was added as a covariate. RESULTS We included 467 eyes with a mean follow-up of 388 (161) days. The SSAS was 444/467 (95.1%) overall, and 351/370 (94.9%) and 93/97 (95.9%) in focal-retinopexy and 360-laser groups, respectively (p = 0.798). Compared to the focal-retinopexy group, the 360-laser group had significantly worse post-operative VA but similar logMAR gain (p = 0.812). A multivariable binary logistic regression found that only PFCL use was linked with increased primary re-detachment (OR:5.32 [p = 0.048]) and 360-laser did not contribute to increased SSAS. A multivariable linear regression analysis showed that poor logMAR gain was significantly associated with better pre-operative logMAR, ocular co-morbidities, greater PRD extent, use of 360-laser and primary re-detachment. However, when excluding macula-off RD (n = 211), 360-laser was no longer significant (p = 0.088). CONCLUSIONS Prophylactic 360-laser does not seem to impact on SSAS and functional outcomes following PPV for primary PRD.
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Affiliation(s)
| | - Tsveta Ivanova
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - George Moussa
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Hadi Ziaei
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
| | | | - Myrta Lippera
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Muhannd El-Faouri
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
- The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Niall Patton
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Kirti M Jasani
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK
| | | | - Assad Jalil
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK.
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Alfonso JF, Fernández-Vega-Cueto L, Lisa C, Alfonso-Bartolozzi B, Palacios A, Madrid-Costa D. Clinical and Aberrometric Outcomes of a New Implantable Collamer Lens for Myopia and Presbyopia Correction in Phakic Patients. J Refract Surg 2023; 39:589-596. [PMID: 37675906 DOI: 10.3928/1081597x-20230726-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To assess the clinical and aberrometric outcomes of a new Implantable Collamer Lens (EVO Viva ICL; STAAR Surgical) to correct moderate to high myopia and presbyopia. METHODS The study included 80 eyes of 40 patients who had bilateral EVO Viva ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, presbyopic add power, binocular through-focus visual acuity, total ocular spherical aberration (SA), coma aberration, and root mean square of ocular higher order aberrations (RMS HOAs) (i-Trace Aberrometer; Tracey Technologies) for a 4.5-mm pupil size were evaluated. RESULTS The mean binocular postoperative UDVA and CDVA were 0.09 ± 0.19 and 0.02 ± 0.03 logMAR, respectively. The postoperative spherical equivalent was -0.61 ± 0.54 diopters (D). The presbyopic add power reduced from +1.31 ± 0.74 D preoperatively to +0.44 ± 0.58 D after surgery (P < .0001). The mean visual acuity was 0.1 logMAR or better (20/25 or better) across the vergence range from +0.50 to -1.50 D, better than 0.2 logMAR (20/32 or better) up to the vergence of -2.00 D, and remained better than 0.3 logMAR (20/40 or better) up to the vergence of -2.50 D. The total ocular aberrations induced by EVO Viva ICL were -0.34 ± 0.09 µm of SA, 0.24 ± 0.18 µm of coma, and 0.26 ± 0.12 µm of RMS HOAs. CONCLUSIONS The outcomes support that the new ICL might be a good alternative for myopia and presbyopia correction in patients aged between 45 and 55 years. Further studies are needed to evaluate the threshold lens misalignment from which the patient´s visual quality would be affected. [J Refract Surg. 2023;39(9):589-596.].
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21
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Radeck VMM, Helbig H, Barth T, Gamulescu A, Maerker D, Wolf A. Are Retinal Detachments Becoming More Frequent? Data from 2 University Eye Clinics and Literature Review. Klin Monbl Augenheilkd 2023; 240:1046-1051. [PMID: 37353213 DOI: 10.1055/a-2116-9565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
There have been marked increases in the numbers of patients with retinal detachments at individual centres in recent years and this is supported by the subjective impression of many experts. We therefore surveyed the literature on changes in the incidence of retinal detachments worldwide. This revealed quite significant methodological differences between the studies, so that it was difficult to achieve a conclusive comparison of the development of the incidence of retinal detachment. Despite these limitations, all data from recent studies suggest an increase in the number of retinal detachments. The incidence of retinal detachment in the western world currently seems to be more than 20 cases per 100,000 person-years, which is significantly higher than described in earlier decades. It can be assumed that an increase in the number of individuals with myopia, a demographic increase in patients of the typical age group for retinal detachment and an increasing number of cataract surgeries, especially in younger patients, are responsible for the rising incidence of retinal detachment.
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Affiliation(s)
| | - Horst Helbig
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Deutschland
| | - Teresa Barth
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Deutschland
| | - Andreea Gamulescu
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Deutschland
| | - David Maerker
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Deutschland
| | - Armin Wolf
- Augenklinik, Universitätsklinikum Ulm, Deutschland
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22
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Dong P, Wang LF, Zhang LX, Li F, Yin HS, Dou ZX, Huang XJ, Xu R, Zhang WL. Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification. World J Clin Cases 2023; 11:5073-5082. [PMID: 37583853 PMCID: PMC10424011 DOI: 10.12998/wjcc.v11.i21.5073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND During anesthesia administration for cataract surgery, low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing, with the use of additional drops intraoperatively increasing the risk of complications. Accordingly, there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine. AIM To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy. METHODS A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study. Patients were divided into the proparacaine surface anesthesia (SA) group (65 cases) and the compound acupuncture-medicine anesthesia group (CAMA group, 65 cases). Patients in the CAMA group were provided acupuncture analgesia in addition to SA. Preoperative anxiety [Self-Rating Anxiety Scale (SAS) score and state anxiety inventory (SAI) score], intraoperative stress, vital signs, analgesia, and cooperation, as well as postoperative adverse events, were compared between groups. RESULTS More marked reductions in anxiety were observed among patients in the CAMA group, with corresponding reductions in SAS and SAI scores. During the operation, no change in the secretion of E, NE, or Cor group compared to the preoperative period was observed in the CAMA, which was markedly lower than that in the SA group. Heart rate, blood pressure, and respiratory rate were more stable intraoperatively in the CAMA group. In addition, the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group. Accordingly, patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery. Furthermore, marked reductions in intraoperative adverse effects were observed in the CAMA group, indicating greater overall safety. CONCLUSION Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.
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Affiliation(s)
- Ping Dong
- Department of Acupuncture and Rehabilitation, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Fang Wang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Li-Xiang Zhang
- Department of Pediatrics, Hebei General Hospital For Veterans, Xingtai 054000, Hebei Province, China
| | - Fang Li
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Hui-Su Yin
- Department of Science and Education, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Zhi-Xia Dou
- Department of Ocular Trauma, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Xiu-Ju Huang
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Rui Xu
- Department of Surgical Anesthesia, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
| | - Wu-Lin Zhang
- Department of Cataract, Hebei Eye Hospital, Xingtai 054001, Hebei Province, China
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Ludwig CA, Vail D, Al-Moujahed A, Callaway NF, Saroj N, Moshfeghi A, Moshfeghi DM. Epidemiology of rhegmatogenous retinal detachment in commercially insured myopes in the United States. Sci Rep 2023; 13:9430. [PMID: 37296124 PMCID: PMC10256775 DOI: 10.1038/s41598-023-35520-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Myopia is a known risk factor for rhegmatogenous retinal detachment (RRD). Given global trends of increasing myopia, we aimed to determine the absolute risk (incidence rate) of RRD in non-myopes, myopes and high myopes in the United States over ten years. We performed a retrospective cohort study of 85,476,781 commercially insured patients enrolled in the Merative™ Marketscan® Research Database. The incidence rate of RRD in phakic patients in the United States was 39-fold higher in high myopes than non-myopes (868.83 per 100,000 person-years versus 22.44 per 100,000 person-years) and three-fold higher in myopes than non-myopes (67.51 per 100,000 person-years versus 22.44 per 100,000 person-years). The incidence rate was significantly higher in males in each category (P < 0.01). Combined, the incidence rate of RRD in phakic patients in the United States from 2007 to 2016 was 25.27 RRDs per 100,000 person-years, a rate higher than those in prior published studies in North America, South America, Europe, Asia, and Australia. The absolute risk of myopia and high myopia increased from 2007 to 2016. The risk of RRD in phakic high myopes rose with increasing age. Notably, the magnitude of increased risk of RRD in myopes varied substantially according to the minimum follow-up period in our models and should be accounted for when interpreting data analyses.
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Affiliation(s)
- Cassie A Ludwig
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, 94304, USA
| | - Daniel Vail
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Ahmad Al-Moujahed
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, 94304, USA
- Retina Department, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Natalia F Callaway
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, 94304, USA
| | | | - Andrew Moshfeghi
- Department of Ophthalmology, USC Eye Institute, Keck School of Medicine of USC, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA
| | - Darius M Moshfeghi
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, 94304, USA.
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Ferrara M, Al-Zubaidy M, Song A, Avery P, Laidlaw DA, Williamson TH, Yorston D, Steel DHW. The effect of age on phenotype of primary rhegmatogenous retinal detachment. Eye (Lond) 2023; 37:1114-1122. [PMID: 35473967 PMCID: PMC10102138 DOI: 10.1038/s41433-022-02061-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To evaluate the influence of age on the clinical characteristics of primary rhegmatogenous retinal detachments (RRD). METHODS We conducted a retrospective review of a prospectively collected dataset. Data regarding adult patients (aged 16-100 years) who had undergone primary RRD repair, were extracted from two online databases. Baseline demographics, preoperative clinical characteristics and surgical management details were collected. Age-based groups (16-30, 30-39, 40-49, 50-59, 60-69, 70-79, ≥80) were compared using univariate analysis, with multivariate testing for interaction of age with sex, laterality and pseudophakia. RESULTS In total, 8,133 eyes were analysed, of which the majority (59%) were in the 50-69 age-range peaking at 60, with a male predominance (64%). Myopia was significantly more frequent in patients aged <50 years. The presence of posterior vitreous detachment increased up to 50 years, then remained >95%. Foveal involvement, grade C proliferative vitreoretinopathy, total RD and greater RD extent were more common and progressively increased after 60 years, with worsening visual acuity. Isolated superior RRDs became more prevalent with age reaching a plateau in the age-range 50-69, before reducing again; conversely, isolated inferior RRDs were commoner in those <30, with a minimum in the 70-79 age-range. The incidence of fellow-eye RRD decreased linearly with age. CONCLUSIONS Age appeared a key variable in RRD phenotype influencing a wide range of RRD characteristics. The higher incidence of myopia, PVD absent and bilateral RRD in patients <40 years and the significant phenotypical differences in the under 40 and over 50 age-groups highlight that there are several discrete forms of RRD.
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Affiliation(s)
- Mariantonia Ferrara
- Newcastle Eye Centre, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4PL, UK
| | - Mo Al-Zubaidy
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK
| | - Anna Song
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK
| | - Peter Avery
- School of Mathematics & Statistics, Newcastle University, Herschel Building, Newcastle Upon Tyne, NE1 7RU, UK
| | - D Alistair Laidlaw
- Guy's and St. Thomas' NHS Foundation Trust, New City Court 20 St. Thomas Street, London, SE1 9RT, UK
| | - Tom H Williamson
- Guy's and St. Thomas' NHS Foundation Trust, New City Court 20 St. Thomas Street, London, SE1 9RT, UK
| | - David Yorston
- Gartnavel Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - David H W Steel
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK.
- Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK.
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25
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Xu MN, Zhang JY, Yang H, Song BH, Wu RH, Jiang ZP, Feng KM, Ren MX, Lin K, Lin Z. Incidence of rhegmatogenous retinal detachments is increasing in Wenzhou, China. Int J Ophthalmol 2023; 16:260-266. [PMID: 36816225 PMCID: PMC9922621 DOI: 10.18240/ijo.2023.02.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 12/08/2022] [Indexed: 02/05/2023] Open
Abstract
AIM To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments (RRDs) in the Wenzhou area in 2015 to 2019. METHODS All newly developed RRD cases among residents of the Wenzhou area, from January 2015 to December 2019, were retrospectively retrieved from hospital records. Annual population data were extracted from the Wenzhou Statistical Yearbook. RESULTS There were 3629 eligible cases. The average incidence of RRD was 7.79 cases per 100 000 population (95% confidence interval, 7.24-8.34), and the incidences were 7.99 and 7.56 for males and females, respectively. The annual incidence increased gradually from 7.26 cases per 100 000 in 2015 to 10.00 cases per 100 000 in 2019, with an overall increase of 37.74%. The highest rate of increase occurred in the age group from 60 to 69 years. Of 2750 eyes with axial length (AL) data, 1675 (60.91%) had an AL greater than 24 mm. CONCLUSION A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.
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Affiliation(s)
- Ming-Na Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jia-Yu Zhang
- Department of Ophthalmology, the Third Affiliated Hospital of Wenzhou Medical University, Ruian 325200, Zhejiang Province, China
| | - Hui Yang
- Department of Ophthalmology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Ben-Hao Song
- Department of Ophthalmology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Rong-Han Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Zi-Pei Jiang
- Department of Ophthalmology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Ke-Mi Feng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Ming-Xue Ren
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Ke Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Zhong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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Wallsh JO, Langevin ST, Kumar A, Huz J, Falk NS, Bhatnagar P. Fellow-Eye Retinal Detachment Risk as Stratified by Hyaloid Status on OCT. Ophthalmology 2023; 130:624-630. [PMID: 36773761 DOI: 10.1016/j.ophtha.2023.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
PURPOSE To evaluate the risk of a rhegmatogenous retinal detachment (RRD) in the fellow eye using posterior hyaloid status as determined by OCT at the time of initial RRD. DESIGN Retrospective chart review. PARTICIPANTS Patients with a diagnosis of RRD. METHODS Posterior hyaloid status-presence or absence of a posterior vitreous detachment (PVD)-in both eyes at the time of initial RRD was determined by OCT imaging. Baseline characteristics, including lattice degeneration, refractive error, prior ocular laser procedures, lens status, and family history of RRD, were recorded. MAIN OUTCOME MEASURES The main outcome measures were the development of fellow-eye RRD and the time to fellow-eye RRD. In addition, OCT imaging was used in those fellow eyes with a visible posterior hyaloid to document whether a PVD developed during follow-up and time to such an event. RESULTS A total of 1049 patients with an RRD were followed up for an average of 5.7 ± 0.3 years. Overall, 153 patients (14.6%) received a diagnosis of bilateral sequential RRD during this follow-up period. OCT images were available for 582 fellow eyes; PVD was noted in 229 fellow eyes (39.3%), and an attached hyaloid was noted in 353 fellow eyes (60.7%). An RRD occurred in 7 fellow eyes (3.1%) with a PVD at presentation. Within the cohort of fellow eyes with an attached hyaloid, 28 eyes (7.9%) demonstrated an RRD during follow-up; however, when evaluating only those in which a PVD developed during follow-up, 23.7% of such eyes were found to have an RRD as well. At the time of PVD development in the fellow eye, an additional 21 eyes (17.8%) were noted to have a retinal tear that was treated without progression to RRD. CONCLUSIONS OCT imaging of the fellow eye at the time of presentation with an RRD offers a significant amount of information regarding risk stratification for RRD in this eye. Patients noted to have a completely detached posterior hyaloid are at a significantly lower risk of RRD than those with a visible posterior hyaloid, who need to be monitored closely at the time of PVD development. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Josh O Wallsh
- Retina Consultants PLLC, Slingerlands, New York; Albany Medical College, Department of Ophthalmology, Albany, New York
| | - Spencer T Langevin
- Retina Consultants PLLC, Slingerlands, New York; Albany Medical College, Department of Ophthalmology, Albany, New York
| | - Aman Kumar
- Albany Medical College, Department of Ophthalmology, Albany, New York
| | - Jonathan Huz
- Retina Consultants PLLC, Slingerlands, New York; Albany Medical College, Department of Ophthalmology, Albany, New York
| | - Naomi S Falk
- Retina Consultants PLLC, Slingerlands, New York; Albany Medical College, Department of Ophthalmology, Albany, New York
| | - Pawan Bhatnagar
- Retina Consultants PLLC, Slingerlands, New York; Albany Medical College, Department of Ophthalmology, Albany, New York.
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Crispin M, Gerhart J, Heffer A, Martin M, Abdalla F, Bravo-Nuevo A, Philp NJ, Kuriyan AE, George-Weinstein M. Myo/Nog Cells Give Rise to Myofibroblasts During Epiretinal Membrane Formation in a Mouse Model of Proliferative Vitreoretinopathy. Invest Ophthalmol Vis Sci 2023; 64:1. [PMID: 36723927 PMCID: PMC9904330 DOI: 10.1167/iovs.64.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Purpose Myo/Nog cells are the source of myofibroblasts in the lens and synthesize muscle proteins in human epiretinal membranes (ERMs). In the current study, we examined the response of Myo/Nog cells during ERM formation in a mouse model of proliferative vitreoretinopathy (PVR). Methods PVR was induced by intravitreal injections of gas and ARPE-19 cells. PVR grade was scored by fundus imaging, optical coherence tomography, and histology. Double label immunofluorescence localization was performed to quantify Myo/Nog cells, myofibroblasts, and leukocytes. Results Myo/Nog cells, identified by co-labeling with antibodies to brain-specific angiogenesis inhibitor 1 (BAI1) and Noggin, increased throughout the eye with induction of PVR and disease progression. They were present on the inner surface of the retina in grades 1/2 PVR and were the largest subpopulation of cells in grades 3 to 6 ERMs. All α-SMA-positive (+) cells and all but one striated myosin+ cell expressed BAI1 in grades 1 to 6 PVR. Folds and areas of retinal detachment were overlain by Myo/Nog cells containing muscle proteins. Low numbers of CD18, CD68, and CD45+ leukocytes were detected throughout the eye. Small subpopulations of BAI1+ cells expressed leukocyte markers. ARPE-19 cells were found in the vitreous but were rare in ERMs. Pigmented cells lacking Myo/Nog and muscle cell markers were present in ERMs and abundant within the retina by grade 5/6. Conclusions Myo/Nog cells differentiate into myofibroblasts that appear to contract and produce retinal folds and detachment. Targeting BAI1 for Myo/Nog cell depletion may be a pharmacological approach to preventing and treating PVR.
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Affiliation(s)
- Mara Crispin
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Jacquelyn Gerhart
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Alison Heffer
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York, United States
| | - Mark Martin
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Fathma Abdalla
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Arturo Bravo-Nuevo
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Nancy J. Philp
- Sydney Kimmel Medical School of Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Ajay E. Kuriyan
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York, United States,Current address: Retina Service/Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
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Muacevic A, Adler JR, Aljambi FA, Alotaibi MA, Alzahrani MA, Subyani AA, Alharbi MM, Aboalola AB, Alnajjar TA. Incidence and Risk Factors for Retinal Detachment Following Cataract Surgery at a Tertiary Center in Jeddah, Saudi Arabia. Cureus 2023; 15:e33968. [PMID: 36820125 PMCID: PMC9938717 DOI: 10.7759/cureus.33968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/20/2023] Open
Abstract
Introduction The incidence of retinal detachment in the general population is 0.08%, it has been reported to reach 0.7% or higher following cataract surgery. One of the most important risk factors for retinal detachment is posterior capsular rupture during cataract surgery. Additional risk factors include high myopia, history of ocular trauma, young age, male sex, and diabetes. In this study, we aimed to investigate the incidence and risk factors of retinal detachment following cataract surgery in patients treated at our hospital. Materials and methods This retrospective cohort study was conducted at King Abdulaziz University Hospital (KAUH), a tertiary center in Jeddah, Saudi Arabia. The medical records of 365 patients (365 eyes) who underwent cataract surgery from 2017 to 2021 were reviewed. Results The average age of the 365 patients was 63 years, and 47.7% (n=174) of patients were male. The incidence of retinal detachment was 3.3% (n=12). The risk of RD was 2.8 times higher for the right eye than for the left eye. The incidence of RD was significantly more in eyes with intraoperative posterior capsular rupture, zonular dehiscence, corneal trauma, and surgery combined with anterior vitrectomy than in other eyes. The most common complication of cataract surgery is corneal edema, which was observed in 22.7% of the eyes; our analysis revealed a significant relationship between corneal edema and the duration of surgery. Conclusion In our study, we highlighted the higher incidence of retinal detachment compared to those in other studies; most cases occurred one month postoperatively.
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Frederick GA, Bonilla-Escobar FJ, Acosta A, Candelo PC, Castro A. Associated factors with pseudophakic retinal detachment: Long-term follow-up in a Colombian population. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:663-669. [PMID: 36097149 DOI: 10.1016/j.oftale.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To identify associated factors with the appearance of pseudophakic retinal detachment in patients with history of cataract surgery. METHODS Retrospective case-control study of 802 eyes of 783 patients with history of cataract surgery. Cases were patients with pseudophakic retinal detachment (n = 258 eyes), while controls were patients with cataract surgery who did not developed retinal detachment during a 10-year follow-up period (n = 544 eyes). RESULTS Age at cataract surgery among cases was lower than in the control group (57 ± 13 vs. 67 ± 14 years old, respectively; p < 0.0001). Age at retinal detachment was 59 ± 13 years old (range 6-88) and the time between the cataract surgery and the retinal detachment had a median of 2 years (interquartile range 1-4) with a range of 1 month to 14 years. Associated factors for pseudophakic retinal detachment were younger age (<50 years: adjusted odds ratio [aOR] = 18.03, 95% confidence interval [95%CI] = 5.92-54.87; 50-59 years: aOR = 10.09, 95%CI = 3.37-30.23; and 60-69 years: aOR = 5.48, 95%CI = 1.88-15.93), male sex (aOR = 3.71, 95%CI = 2.54-5.44), anterior vitrectomy (aOR = 3.26, 95%CI = 1.16-9.16), history of retinal detachment in the fellow eye (aOR = 6.95, 95%CI = 3.15-15.31), and intraoperative complications during cataract extraction (aOR = 7.45, 95%CI = 3.54-15.69). CONCLUSIONS This is the first report of associated factors with pseudophakic retinal detachment in a Colombian population. Surgical complications, sex, and age were found to be associated with retinal detachment. Patients should be aware of these potential risks to make informed decisions about their eye health.
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Affiliation(s)
- G A Frederick
- Retina y Vítreo, Clínica de Oftalmología de Cali, Cali, Colombia.
| | - F J Bonilla-Escobar
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO, Servicio de Oftalmología, Universidad del Valleorg, Cali, Colombia; Grupo de investigación en Visión y Salud Ocular, VISOC, Servicio de Oftalmología, Universidad del Valle, Cali, Colombia; Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - A Acosta
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - P C Candelo
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - A Castro
- Retina y Vítreo, Clínica de Oftalmología de Cali, Cali, Colombia
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Nguyen JH, Yee KMP, Nguyen-Cuu J, Mamou J, Sebag J. Vitrectomy Improves Contrast Sensitivity in Multifocal Pseudophakia With Vision Degrading Myodesopsia. Am J Ophthalmol 2022; 244:196-204. [PMID: 35562070 DOI: 10.1016/j.ajo.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE Multifocal intraocular lenses (MFIOL) are associated with degradation in contrast sensitivity function (CSF); yet the contribution of vitreous is not known, nor is the benefit of vitrectomy. DESIGN Prospective, nonrandomized clinical study. METHODS A total of 180 eyes of 180 patients (55 MFIOL, 60 monofocal intraocular lenses [MIOL], 65 phakic) with symptomatic vitreous opacities were enrolled. Vitreous structure was assessed with quantitative ultrasonography (QUS). Vision was evaluated with visual acuity and CSF measurements. RESULTS Vitreous echodensity was the same in all lens cohorts, yet CSF was worse in MFIOL eyes (P < .001). In 86 patients who elected vitrectomy, there was 68% greater vitreous echodensity and 31% worse CSF than in observation controls (P < .0001 for each). Preoperatively, CSF was 25% worse in MFIOL than in MIOL (P = .014). Postoperatively, vitreous echodensity decreased by 55%, 51%, and 52%, whereas CSF improved by 37% 48% in and 43% in MFIOL, MIOL, and phakic eyes, respectively (P < .0001 for each). NEI Visual Function Questionnaire analyses showed improved visual well-being. CONCLUSIONS Patients with vision degrading myodesopsia who elected vitrectomy had greater vitreous echodensity and worse CSF than controls, but no other differences in age, sex, or myopia. MFIOL eyes had worse CSF than MIOL and phakic eyes, very possibly due to combined effects of the MFIOL and vitreous opacification. Limited vitrectomy reduced vitreous echodensity and improved CSF in all eyes. All patients with CSF-degrading vitreous opacities benefited from limited vitrectomy, including those with MFIOL. As MFIOL eyes had 37% improvement in CSF, patients with MFIOL and vision degrading myodesopsia merit consideration of vitrectomy.
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Affiliation(s)
- Justin H Nguyen
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA
| | - Kenneth M P Yee
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA
| | - Jeannie Nguyen-Cuu
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA; DeBusk College of Osteopathic Medicine at LMU-Knoxville, Knoxville (J.N.-C.), Tennessee, USA
| | - Jonathan Mamou
- Department of Radiology (J.M.), Weill Cornell Medicine, New York, New York, USA
| | - J Sebag
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA; Doheny Eye Institute/UCLA (J.S.), Pasadena, California, USA; Department of Ophthalmology (J.S.), Stein Eye Institute, Geffen School of Medicine, UCLA, Los Angeles, California.
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Sun T, Liu Y, Zhao X, Gao Y, Yang T, Lan Q, Tang C, Qi H. Presbyopia-correcting performance and subjective outcomes of a trifocal intraocular lens in eyes with different axial lengths: A prospective cohort study. Front Med (Lausanne) 2022; 9:980110. [PMID: 36117984 PMCID: PMC9478862 DOI: 10.3389/fmed.2022.980110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo compare the presbyopia-correcting performance, visual quality, satisfaction and life quality after implantation of a diffractive trifocal intraocular lens (IOL) in eyes with different axial lengths (AL).MethodsThis prospective cohort study enrolled patients with implantation of a trifocal IOL. Manifest refraction, uncorrected and distance-corrected visual acuity at different distances, contrast sensitivity, aberrations and IOL decentration were measured 3 months after surgery. Spectacle independence, adverse photic phenomena, overall satisfaction and life quality were assessed with a questionnaire.ResultsThis study included 61 eyes of 61 patients: 16 eyes in the short AL group, 28 eyes in the control group and 17 eyes in the long AL group. Postoperatively, the prediction error (PE) of spherical equivalent showed a difference (P = 0.002). The uncorrected near visual acuity in the long AL group was higher (P = 0.047). Although a higher IOL decentration was obtained in the long AL group (P = 0.034), no significant difference was found in contrast sensitivity and aberrations (all P > 0.05). In the questionnaire, patients in the long AL group showed a relatively lower spectacle independence at near distance (P = 0.060) and had difficulties in near activities, mental health and role in daily life (P = 0.003, 0.021, and 0.033). However, no significant difference was observed in overall satisfaction (P = 0.124).ConclusionWith detailed preoperative evaluation, the trifocal IOL provided satisfactory visual outcomes for patients with different AL. AL had a certain influence on predictability and IOL decentration. And for patients with long AL, the inadaptability to the near focal point might become an important problem.
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Affiliation(s)
- Tong Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yiyun Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xiaorui Zhao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yufei Gao
- Department of Ophthalmology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Tingting Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Qianqian Lan
- Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Chuhao Tang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Hong Qi
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
- *Correspondence: Hong Qi,
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Irigoyen C, Goikoetxea-Zubeldia A, Sanchez-Molina J, Amenabar Alonso A, Ruiz-Miguel M, Iglesias-Gaspar MT. Incidence and Risk Factors Affecting the Recurrence of Primary Retinal Detachment in a Tertiary Hospital in Spain. J Clin Med 2022; 11:jcm11154551. [PMID: 35956167 PMCID: PMC9369824 DOI: 10.3390/jcm11154551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/13/2022] [Accepted: 08/02/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Objective: To determine the incidence, visual outcomes and risk factors associated with the recurrence of primary retinal detachment (RD) in a tertiary hospital. (2) Methods: A retrospective observational study was conducted, and data were collected on all eyes diagnosed with primary RD between January 2017 and December 2020. A detailed database was generated with data on anatomic and visual outcomes, and surgical technique information, for all the cases. (3) Results: 570 eyes with primary RD were included. Mean annual incidence of primary RD was 21.8 cases per 100,000 inhabitants. Mean follow-up time was 465 (±410.5) days. Mean time to redetachment was 114.4 (±215.8) days, with the median being 35 days. Statistically significant variables related to a higher risk of recurrence were: male sex (p = 0.04), type of tamponade (p = 0.01), surgeon (p = 0.035), inferonasal (p = 0.002) and inferotemporal (p = 0.032) involvement, complex RD (p < 0.001) and ocular comorbidity (p < 0.001). More satisfactory final visual acuity (VA) in patients not suffering redetachment was associated with shorter duration of central vision loss. (4) Conclusions: Sex, type of tamponade, inferior detachment, RD complexity, surgeon and ocular comorbidity were identified as prognostic factors for recurrence. Worse final postoperative VA was found in patients referring central vision loss for more than 4 days before surgery.
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Affiliation(s)
- Cristina Irigoyen
- Donostia University Hospital, 20014 San Sebastian, Spain
- Medicine Department, University of the Basque Country (EHU/UPV), 48940 San Sebastian, Spain
- Division of Neurosciences, Biodonostia Health Research Institute, 20014 San Sebastian, Spain
| | - Ainhoa Goikoetxea-Zubeldia
- Medicine Department, University of the Basque Country (EHU/UPV), 48940 San Sebastian, Spain
- Correspondence:
| | | | | | | | - Maria Teresa Iglesias-Gaspar
- Donostia University Hospital, 20014 San Sebastian, Spain
- Clinical Epidemiology, Biodonostia Health Research Institute, 20014 San Sebastian, Spain
- CIBERESP ISCIII, Carlos III Health Institute, 28029 Madrid, Spain
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Tost F, Rohrschneider K. Kommentar zum CME-Fortbildungsbeitrag „Die senile Katarakt“ von Neuhann I et al. Klin Monbl Augenheilkd 2022; 239: 615 – 633. Klin Monbl Augenheilkd 2022. [DOI: 10.1055/a-1863-8777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Frank Tost
- Augenklinik der Universitätsmedizin Greifswald, Ernst-Moritz-Arndt Universität
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Liu T, Zhao L, Yan D, Wang N. Circ_0060,144 inhibits the occurrence and development of age-related cataract via the miR-23b-3p/HIPK3 axis. Exp Eye Res 2022; 222:109179. [PMID: 35810770 DOI: 10.1016/j.exer.2022.109179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/01/2022] [Accepted: 07/02/2022] [Indexed: 11/18/2022]
Abstract
Age-related cataract (ARC) is a common eye disease that occurs mostly in the elderly. Emerging evidence suggests that circular RNA (circRNA) plays an important role in disease development. However, there are few reports about the role of circRNA in cataract. Here, we investigated the function of circ_0060,144 in ARC. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to measure the expression of circ_0060,144, miR-23b-3p, and homeodomain interacting protein kinase 3 (HIPK3) mRNA. CCK-8 and flow cytometry analysis of cell proliferation and apoptosis. Western blot was performed to measure protein-associated proliferation and apoptosis. ELISA was used to detect cellular MDA and GSH-Px levels. Dual-luciferase reporter, RNA immunoprecipitation (RIP), and RNA pull-down assays were used to investigate the association between miR-23b-3p and circ_0060,144 or HIPK3. Circ_0060,144 and HIPK3 mRNA expression were decreased in ARC tissues, and miR-23b-3p was increased. Circ_0060,144 overexpression promoted proliferation and inhibited apoptosis of SRA01/04 cells. And proliferation-related and apoptosis-related proteins also confirmed this conclusion. In addition, circ_0060,144 overexpression reduced MDA level and increased GSH-Px level. In terms of mechanism, circ_0060,144 inhibited HIPK3 expression via sponging miR-23b-3p. Circ_0060,144 promoted ARC development via regulation of miR-23b-3p/HIPK3 axis.
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Affiliation(s)
- Tao Liu
- Ophthalmology Department, Baoji Central Hospital, Baoji, Shaanxi, China
| | - Liping Zhao
- Ophthalmology Department, Baoji Central Hospital, Baoji, Shaanxi, China
| | - Dan Yan
- Ophthalmology Department, Baoji Central Hospital, Baoji, Shaanxi, China
| | - Na Wang
- Ophthalmology Department, Baoji Central Hospital, Baoji, Shaanxi, China.
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Morris RE. Vitreous Opacity Vitrectomy (VOV): Safest Possible Removal of “Floaters”. Clin Ophthalmol 2022; 16:1653-1663. [PMID: 35673347 PMCID: PMC9167598 DOI: 10.2147/opth.s361557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/11/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Primary opacities that develop in the aging vitreous, commonly termed “floaters,” were once considered merely a nuisance, not justifying any risk of surgical removal. However, vitreoretinal specialists are increasingly recognizing that extensive symptomatic vitreous opacities (SVO) that substantially interfere with activities that critically depend on vision (daily visual activities, DVA), constituting degenerative vitreous syndrome (DVS, see http://floaterstories.com), warrant removal albeit with minimal risk - but no description of how to reduce vitrectomy risks to least possible has been forthcoming. We here describe such a method. Patients and Methods The safest possible removal of extensive SVO as described herein was attained by an operation specifically designed for DVS treatment (vitreous opacity vitrectomy, VOV), rather than as only a means of achieving subsequent retinal surgery in the same procedure, as is usually the case. We retrospectively reviewed the outcomes of 100 consecutive VOV operations (in 81 patients, average age 66) performed with ultra-high speed, 27-gauge vitrectomy probes. Results All eyes rapidly achieved continuously clear vision, and no eye developed a clinically significant complication during a year of follow-up. Three small, existent retinal breaks were discovered prior to peripheral vitrectomy and one apparently iatrogenic retinal tear was found at VOV completion, when each was treated. In the eyes that were not pseudophakic, postoperative nuclear sclerosis progression was successfully managed by subsequent cataract extraction. Conclusion The goals of VOV for DVS are to safely restore continuously clear vision by performing tractionless vitreous removal with respect to the retina and to reduce the lifetime risk of retinal detachment, both by such vitreous removal and by microscopic examination of the peripheral retina under anesthesia (MEPRUA), guiding appropriate prophylactic retinopexy. The otherwise healthy DVS eyes so treated warrant this specific form of vitrectomy, continually focused on achieving least possible risk, to maintain an acceptable risk/benefit ratio. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/SiBjs81-Kzk
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Affiliation(s)
- Robert E Morris
- Helen Keller Foundation for Research and Education, Birmingham, Alabama, USA
- Retina Specialists of Alabama, LLC, Birmingham, Alabama, USA
- Correspondence: Robert E Morris, Helen Keller Foundation for Research and Education, 2208 University Boulevard, Suite 101, Birmingham, Alabama, 35233, USA, Tel +1 205 936-0704, Fax +1 205 558-2567, Email
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Iqbal SM, Iqbal K, Shahid A, Iqbal F, Rahman FU, Tahir MJ, Qazi ZA, Raheem U, Butt JB, Ahmed M. Incidence of Rhegmatogenous Retinal Detachment (RRD) in a Tertiary Care Center of Pakistan. Cureus 2022; 14:e25092. [PMID: 35719781 PMCID: PMC9204045 DOI: 10.7759/cureus.25092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background Regardless of the advancements in ophthalmology, rhegmatogenous retinal detachment (RRD) remains a substantial issue for physicians. The present study assessed the incidence of RRD among our population. Methodology A cross-sectional study was performed at the Layton Rehmatullah Benevolent Trust (LRBT) between June 2020 and May 2021. All the patients of RRD, irrespective of gender, within the age bracket of 20 years or more and diagnosed by a consultant ophthalmologist were included in the research study. Patients with serous retinal or tractional detachment and RRD with vitreous leakage were excluded from the study. A slit lamp and dilated fundus examination was performed preoperatively to assess the type of retinal detachment and associated factors as mentioned above. All data were collected on predesigned pro forma. Results About 25,000 individuals were presented to the outpatient department during the study period. Out of these, 100 patients were diagnosed with RRD. The incidence rate of the RRD in our center was 0.4%. There were a majority of the males. The mean age of patients did not vary significantly with respect to gender (p < 0.797). The most common type of RD was the total RD with a frequency of 53 cases followed by inferior RD with 19 cases. The majority of those with total RRD were males, i.e., 37%; however, the difference was statistically insignificant (p = 0.476). The study revealed that most of the RRD was diagnosed in patients < 45 years of age; however, the difference was not statistically significant (p < 0.227). Conclusion The present study highlighted the incidence of RRD and explored the sociodemographic and other clinical features in the Pakistani population. However, it is possible that the RRD condition is still under-diagnosed in our hospital settings. Further exploration is warranted to study comprehensively the risk factors associated with RRD.
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Gabriel M, Großpötzl M, Wallisch F, Djavid D, Pregartner G, Haas A, Wedrich A, Mayer‐Xanthaki C. In-depth analysis of risk factors for pseudophakic retinal detachments and retinal breaks. Acta Ophthalmol 2022; 100:e694-e700. [PMID: 34258879 PMCID: PMC9290023 DOI: 10.1111/aos.14974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Abstract
Purpose To provide a detailed analysis of risk factors for pseudophakic retinal detachments (PRD) and pseudophakic retinal breaks (PRB). Materials and methods We reviewed the medical records of cataract surgeries between 1996 and 2017 at a tertiary care hospital in Austria. A Cox proportional‐hazard regression model was used to analyse risk factors for PRD and PRB. Results Sixty‐five thousand six hundred and sixty‐two eyes (45 043 patients) underwent phacoemulsification, and 393 eyes (cumulative incidence 0.6%) were diagnosed with PRD (327 eyes) or PRB (66 eyes) during the follow‐up (median 7.1 years, range 0–21). Calculation of adjusted hazard ratios (HR) revealed a hierarchy of risk factors for either event including (from the highest to the lowest risk) posterior capsular rupture (PCR), patient age <65 years (compared with the age group >75 years), male gender and high myopia. Diabetes mellitus was associated with a lower risk. PCR was the strongest risk factor for PRD both in patients with and without perioperative vitrectomy (i.e. vitreous loss), but time to PRD was significantly reduced only following PCR with vitrectomy. Conclusions Posterior capsular rupture, young patient age, male gender and high myopia were risk factors for PRD, but diabetes mellitus was associated with a lower risk. PCR had the strongest association with PRD, regardless of the need for perioperative vitrectomy due to vitreous loss. Time to PRD was reduced in patients with PCR and vitrectomy compared with PCR without the need for vitrectomy or uneventful surgery.
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Affiliation(s)
| | - Manuel Großpötzl
- Department of Ophthalmology Medical University of Graz Graz Austria
| | - Fabian Wallisch
- Department of Ophthalmology Medical University of Graz Graz Austria
| | - Daniel Djavid
- Department of Ophthalmology Medical University of Graz Graz Austria
| | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics and Documentation Medical University of Graz Graz Austria
| | - Anton Haas
- Department of Ophthalmology Medical University of Graz Graz Austria
| | - Andreas Wedrich
- Department of Ophthalmology Medical University of Graz Graz Austria
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Vila J, Capsec J, Bigoteau M, Pommier K, Cook AR, Pisella PJ, Khanna RK. Impact of the first lockdown related to the COVID-19 pandemic on ophthalmic emergencies in a French University Hospital. J Fr Ophtalmol 2022; 45:587-596. [PMID: 35597678 PMCID: PMC9040442 DOI: 10.1016/j.jfo.2022.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
Introduction At the beginning of the COVID-19 pandemic, the French government implemented its first national lockdown between March and May 2020 in order to limit the dissemination of the virus. This historic measure affected patients’ daily lives and transportation, resulting in changes in the delivery of medical care, particularly emergency care. This study aimed to assess the impact of this restriction policy on the number and severity of ophthalmic emergencies seen in an ophthalmology emergency department. Methods This retrospective study conducted at the regional university Hospital of Tours included all patients presenting to the ophthalmology emergency department over four periods: lockdown (03/16/2020 to 05/10/2020), post-lockdown (05/11/2020 to 06/12/2020) and the two corresponding periods in 2019. The following data were recorded: sex, age, time of visit, reason for visit, diagnosis, severity of emergency graded on the BaSe SCOrE, time from first symptoms until visit, existence of a work-related injury, and referral source (ophthalmologist or other). Results A total of 1186 and 1905 patients were respectively included during the 2020 lockdown period and the corresponding period in 2019. The study populations for the 2019 and 2020 post-lockdown periods consisted of 1242 and 1086 patients respectively. During the lockdown, the number of consultations decreased significantly (−37.7%), affecting mild and severe emergencies similarly. During the post-lockdown period, the number of emergencies gradually increased but did not reach the level of the corresponding period in 2019 (−12.6%). Conclusion The first French lockdown resulted in a significant decrease in ophthalmic emergency visits, similar for all levels of severity. All age groups were impacted similarly, without the expected exaggerated decrease for patients over 50 years of age, who are considered to be at greater risk for developing a severe form of COVID-19. The post-lockdown period showed a gradual increase in ophthalmic emergency visits, although these remained fewer than the previous year.
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Affiliation(s)
- J Vila
- Department of Ophthalmology, University Hospital of Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - J Capsec
- Department of Medical Information, University Hospital of Tours, Tours, France
| | - M Bigoteau
- Department of Ophthalmology, University Hospital of Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - K Pommier
- Department of Ophthalmology, University Hospital of Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - A-R Cook
- Department of Ophthalmology, University Hospital of Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - P-J Pisella
- Department of Ophthalmology, University Hospital of Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - R K Khanna
- Department of Ophthalmology, University Hospital of Tours, 2, boulevard Tonnellé, 37000 Tours, France; Neurogénétique et Physiopathologie neuronale, iBrain, INSERM, U1253, University of Tours, Tours, France.
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Achour H, Thomseth VM, Kvaløy JT, Krohn J, Utheim TP, Forsaa VA. Substantial increase in the incidence of rhegmatogenous retinal detachment in Western Norway over 20 years. Acta Ophthalmol 2022; 100:763-768. [PMID: 35261167 DOI: 10.1111/aos.15119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/29/2022] [Accepted: 02/18/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Hamida Achour
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
| | - Vilde Marie Thomseth
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
- Department of Quality and Health Technology University of Stavanger Stavanger Norway
| | - Jan Terje Kvaløy
- Department of Mathematics and Physics University of Stavanger Stavanger Norway
- Department of Research Stavanger University Hospital Stavanger Norway
| | - Jørgen Krohn
- Department of Clinical Medicine, Section of Ophthalmology University of Bergen Bergen Norway
- Department of Ophthalmology Haukeland University Hospital Bergen Norway
| | - Tor P. Utheim
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
- Department of Quality and Health Technology University of Stavanger Stavanger Norway
- Department of Clinical Medicine, Faculty of Medicine University of Bergen Bergen Norway
| | - Vegard Asgeir Forsaa
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
- Department of Quality and Health Technology University of Stavanger Stavanger Norway
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Macular vascular density and visual function after phacoemulsification in cataract patients with non-pathological high myopia: a prospective observational cohort study. Graefes Arch Clin Exp Ophthalmol 2022; 260:2597-2604. [PMID: 35258718 DOI: 10.1007/s00417-022-05606-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 02/08/2023] Open
Abstract
PURPOSES This study aimed to evaluate changes in macular vascular density and macular function in patients with high myopia cataract (HMC) after phacoemulsification surgery, using optical coherence tomography angiography (OCTA) and multifocal electroretinography (mfERG). METHODS Patients with cataracts scheduled for phacoemulsification surgery were divided into a high myopia group (axial length > 26.5 mm) and a control group (22 mm < axial length ≤ 24.5 mm). OCTA examinations were performed before surgery and at 1 day, 1 week, 1 month, and 3-6 months post-surgery, while mfERG was conducted before surgery and at 3-6 months post-surgery. RESULTS A total of 38 patients were included, of whom 20 were HMC patients and 18 were control patients. The macular vascular density significantly increased after phacoemulsification surgery in both groups, while foveal avascular zone area decreased significantly (HMC group: all p < 0.01; control group: all p < 0.05). Mean changes in macular vascular density were significantly greater in HMC patients than in the control group at 1 day after surgery (all p < 0.05). The amplitude density and latency of P1 wave in all macular rings (Ring1-5) did not differ significantly before or after surgery in either group (all p > 0.1). CONCLUSION Phacoemulsification may not affect HMC patients' macular mfERG responses within 3-6 months post-surgery, but it may influence macular microcirculation. HMC patients should be closely monitored after surgery, as their retinal vascular density may fluctuate substantially in the early postoperative period.
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Posterior vitreous detachment after cataract surgery in eyes with high myopia: an optical coherence tomography study. Jpn J Ophthalmol 2022; 66:167-172. [PMID: 35122563 DOI: 10.1007/s10384-022-00903-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the progression of posterior vitreous detachment (PVD) after cataract surgery in eyes with high myopia with that in eyes without high myopia. STUDY DESIGN Prospective observational study. METHODS Eighty eyes of 80 patients with high myopia and 160 eyes of 160 patients without high myopia scheduled for phacoemulsification were recruited. PVD status was examined using swept-source optical coherence tomography at 2 days postoperatively (baseline) and at 3, 6, and 12 months postbaseline and classified into 5 stages: 0 (no PVD), 1 (paramacular PVD), 2 (perifoveal PVD), 3 (peripapillary PVD), and 4 (complete PVD). The PVD stage and incidence of progression to complete PVD of the 2 groups were compared. RESULTS The mean PVD stage did not differ significantly between the groups at baseline or at 3 months postbaseline but was significantly more progressed in the high myopia group than in the nonhigh myopia group at 6 months and 12 months postbaseline (P ≤ 0.0201). The Kaplan-Meier survival rate for complete PVD was significantly lower in the high myopia group (P = 0.0129). After adjusting for age, sex, and baseline PVD stage, the hazard ratio for complete PVD was 1.68-fold higher in the high myopia group than in the nonhigh myopia group (P = 0.0326, 95% CI 1.04-2.70). CONCLUSION After cataract surgery, PVD progressed significantly faster in eyes with high myopia than in eyes without high myopia, and the relative risk for complete PVD was 1.68-fold higher in eyes with high myopia, suggesting that highly myopic eyes are at considerably high risk for retinal disease postoperatively.
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Fonteh CN, Patnaik JL, Grove NC, Lynch AM, Christopher KL. Predictors of Pseudophakic Retinal Tears at a Tertiary Care Academic Medical Center. Ophthalmol Retina 2022; 6:450-456. [PMID: 35093584 DOI: 10.1016/j.oret.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the incidence and identify risk factors for retinal tears (RT) among patients who underwent cataract phacoemulsification surgery, as well as to describe the timing and features of the RTs. DESIGN Retrospective case-control study SUBJECTS: Patients who underwent cataract phacoemulsification surgery between January 2014 and December 2019 at an academic eye center in Colorado. METHODS Information was extracted from medical chart review into a cataract outcomes database. Measures of association and p-values were determined from logistic regression models with generalized estimating equations to account for some patients having two eyes included in the database. MAIN OUTCOME MEASURES RT diagnosis within one year following cataract surgery. Incidence of RTs were analyzed by demographics, comorbid medical history, ocular characteristics, surgical characteristics, and intra-operative complications. RESULTS In total 13,007 cataract surgeries were included in the analysis, and 79 (0.6%) of those eyes developed RTs within one year following cataract surgery. Males and patients <65 years old had higher incidences of RTs (0.8% vs 0.5% for females, p=0.0175 and 1.0% vs 0.2% for age, <65 years vs >75, p=0.0001). The mean preoperative best-corrected visual acuity was better for the RT group (logMAR 0.252 vs 0.366, p=0.0073) and axial myopia (>26mm) was more common (31.2% vs 10.9%, p<0.0001). Patients with intra-operative complications had a higher incidence of RTs (4.2%, p<0.0001). Mean time from cataract surgery to RT was 128 (SD=110) days. Most RTs were symptomatic (57.0%), located in the superior hemisphere (83.5%), and 40.5% were diagnosed concurrently with a retinal detachment. The multivariable model resulted in intra-operative complications, axial length, and preoperative visual acuity having the strongest association with RT. CONCLUSION Patients with better preoperative visual acuity, eyes with longer axial length, and those with intra-operative complications were at an increased risk for RT following cataract surgery. Careful counseling is important and post-operative follow-up is advised for patients identified pre-operatively as being at an elevated risk for RT given the large rate of asymptomatic RTs and high rate of progression to retinal detachment.
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Affiliation(s)
- Cheryl N Fonteh
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO.
| | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
| | - Nathan C Grove
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
| | - Anne M Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
| | - Karen L Christopher
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
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Lanza M, Koprowski R, Boccia R, Ruggiero A, De Rosa L, Tortori A, Wilczyński S, Melillo P, Sbordone S, Simonelli F. Classification Tree to Analyze Factors Connected with Post Operative Complications of Cataract Surgery in a Teaching Hospital. J Clin Med 2021; 10:jcm10225399. [PMID: 34830681 PMCID: PMC8625404 DOI: 10.3390/jcm10225399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Artificial intelligence (AI) is becoming ever more frequently applied in medicine and, consequently, also in ophthalmology to improve both the quality of work for physicians and the quality of care for patients. The aim of this study is to use AI, in particular classification tree, for the evaluation of both ocular and systemic features involved in the onset of complications due to cataract surgery in a teaching hospital. Methods: The charts of 1392 eyes of 1392 patients, with a mean age of 71.3 ± 8.2 years old, were reviewed to collect the ocular and systemic data before, during and after cataract surgery, including post-operative complications. All these data were processed by a classification tree algorithm, producing more than 260 million simulations, aiming to develop a predictive model. Results: Postoperative complications were observed in 168 patients. According to the AI analysis, the pre-operative characteristics involved in the insurgence of complications were: ocular comorbidities, lower visual acuity, higher astigmatism and intra-operative complications. Conclusions: Artificial intelligence application may be an interesting tool in the physician’s hands to develop customized algorithms that can, in advance, define the post-operative complication risk. This may help in improving both the quality and the outcomes of the surgery as well as in preventing patient dissatisfaction.
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Affiliation(s)
- Michele Lanza
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
- Correspondence: ; Tel.: +39-08-1566-6778
| | - Robert Koprowski
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, Bedzińska 39, 41-200 Sosnowiec, Poland;
| | - Rosa Boccia
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
| | - Adriano Ruggiero
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
| | - Luigi De Rosa
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
| | - Antonia Tortori
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Będzińska Street 39, 41-200 Sosnowiec, Poland;
| | - Paolo Melillo
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
| | - Sandro Sbordone
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy; (R.B.); (A.R.); (L.D.R.); (A.T.); (P.M.); (S.S.); (F.S.)
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Lanza M, Koprowski R, Boccia R, Ruggiero A, De Rosa L, Tortori A, Wilczyński S, Melillo P, Sbordone S, Simonelli F. Classification Tree to Analyze Factors Connected with Post Operative Complications of Cataract Surgery in a Teaching Hospital. J Clin Med 2021; 10:jcm10225399. [PMID: 34830681 DOI: 10.3390/jcm10225399.pmid:34830681;pmcid:pmc8625404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI) is becoming ever more frequently applied in medicine and, consequently, also in ophthalmology to improve both the quality of work for physicians and the quality of care for patients. The aim of this study is to use AI, in particular classification tree, for the evaluation of both ocular and systemic features involved in the onset of complications due to cataract surgery in a teaching hospital. METHODS The charts of 1392 eyes of 1392 patients, with a mean age of 71.3 ± 8.2 years old, were reviewed to collect the ocular and systemic data before, during and after cataract surgery, including post-operative complications. All these data were processed by a classification tree algorithm, producing more than 260 million simulations, aiming to develop a predictive model. RESULTS Postoperative complications were observed in 168 patients. According to the AI analysis, the pre-operative characteristics involved in the insurgence of complications were: ocular comorbidities, lower visual acuity, higher astigmatism and intra-operative complications. CONCLUSIONS Artificial intelligence application may be an interesting tool in the physician's hands to develop customized algorithms that can, in advance, define the post-operative complication risk. This may help in improving both the quality and the outcomes of the surgery as well as in preventing patient dissatisfaction.
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Affiliation(s)
- Michele Lanza
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
| | - Robert Koprowski
- Institute of Biomedical Engineering, Faculty of Science and Technology, University of Silesia in Katowice, Bedzińska 39, 41-200 Sosnowiec, Poland
| | - Rosa Boccia
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
| | - Adriano Ruggiero
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
| | - Luigi De Rosa
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
| | - Antonia Tortori
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Będzińska Street 39, 41-200 Sosnowiec, Poland
| | - Paolo Melillo
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
| | - Sandro Sbordone
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 80100 Napoli, Italy
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Yao Y, Lu Q, Wei L, Cheng K, Lu Y, Zhu X. Efficacy and complications of cataract surgery in high myopia. J Cataract Refract Surg 2021; 47:1473-1480. [PMID: 33929806 DOI: 10.1097/j.jcrs.0000000000000664] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/20/2021] [Indexed: 11/26/2022]
Abstract
To evaluate the efficacy and complications of cataract surgery in high myopia, a comprehensive search query was conducted from January 2000 to August 2020. A total of 19 586 highly myopic eyes from 28 studies were included. Modern cataract surgery turns out efficacious in highly myopic eyes with significant improvement of visual acuity. However, phacoemulsification-related complications such as posterior capsular rupture (3.91%, 95% CI, 1.98%-6.37%), retinal detachment (1.74%, 95% CI, 1.36%-2.15%), progressed myopic traction maculopathy (5.07%, 95% CI, 1.80%-9.37%), capsular contraction syndrome (2.1%), intraocular lens dislocation (0.58%), and transient intraocular pressure elevation (28.15%, 95% CI, 20.29%-36.70%) occurred more frequently in the highly myopic population. Separate analyses were also conducted based on follow-up period. In conclusion, modern cataract surgery was effective for highly myopic cataract patients, whereas careful precautions and sufficient follow-ups were of great value because of higher incidences of intraoperative and postoperative complications.
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Affiliation(s)
- Yunqian Yao
- From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Elbaz U, Hakkala L, Hecht I, Achiron A, Gershoni A, Tuuminen R. Nd:YAG capsulotomy is not a risk factor for retinal detachment after phacoemulsification cataract surgery. Acta Ophthalmol 2021; 99:e1018-e1026. [PMID: 33423371 DOI: 10.1111/aos.14757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the cumulative incidence and risk factors of pseudophakic retinal detachment (PRD) following phacoemulsification cataract surgery. METHODS Cataract surgeries performed between the years 2007 and 2016 at the Ophthalmology Unit of Kymenlaakso Central Hospital, Kotka, Finland, were included. The cumulative incidence of PRD was estimated through Kaplan-Meier analysis. Patient mortality was incorporated as one of the censoring events. Cox regression analyses were used to evaluate potential risk factors, including age, gender, intraocular lens (IOL) power and previous neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomy. RESULTS A total of 17 688 eyes of 12 003 patients were included. The mean patient age at surgery was 75.2 ± 9.1 years with 63.5% females (n = 11 228). During the mean follow-up time of 4.3 ± 2.7 years, 83 laterality-matched PRDs were registered (incidence 0.11% per year). Univariate analyses showed that age (HR 0.93; 95% CI 0.92-0.95), male gender (HR 3.99; 95% CI 2.52-6.33) and IOL power (HR 0.86; 95% CI 0.83-0.90) were significantly associated with PRD (p < 0.001 for all) and remained significant in a multivariate analysis. Neither univariate (HR 1.45; 95% CI 0.82-2.54, p = 0.201) nor multivariate (HR 1.03; 95%CI 0.57-1.88, p = 0.919) analyses showed any association between Nd:YAG capsulotomy and PRD. CONCLUSIONS Male gender, low IOL power and younger age were confirmed as risk factors for PRD after phacoemulsification surgery. Real-world evidence suggests that Nd:YAG capsulotomy does not increase the risk for PRD.
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Affiliation(s)
- Uri Elbaz
- Department of Ophthalmology Rabin Medical Center Schneider Children's Medical Center of Israel Petah Tikva Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Laura Hakkala
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
| | - Idan Hecht
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
- Department of Ophthalmology Shamir Medical Center Tel Aviv Israel
| | - Asaf Achiron
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
- Cornea Unit Bristol Eye Hospital Bristol UK
| | - Assaf Gershoni
- Department of Ophthalmology Rabin Medical Center Schneider Children's Medical Center of Israel Petah Tikva Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Raimo Tuuminen
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
- Department of Ophthalmology Kymenlaakso Central Hospital Kotka Finland
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Increasing frequency of hospital admissions for retinal detachment and vitreo-retinal surgery in England 2000-2018. Eye (Lond) 2021; 36:1610-1614. [PMID: 34290443 PMCID: PMC8294214 DOI: 10.1038/s41433-021-01647-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/24/2021] [Accepted: 06/14/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives To analyse the changes in reported frequency of retinal detachment admissions and vitreo-retinal surgery procedures performed between 2000 and 2018 in England. To obtain information useful to contribute towards the planning of service delivery. Methods Analysis of England’s Hospital Episode Statistics from the Health and Social Care Information Centre and population data from the United Kingdom’s Office for National Statistics. Results Episodes of ‘retinal detachments with breaks’ increased year on year from 3447 (7.0/100 M) in 2000 to 10,971 (19.7/100 M) in 2018 (p < 0.001), whereas records of ‘tractional retinal detachment’ increased from 290 (0.6/100 M) to 910 (1.6/100 M) in the same period (p < 0.0001). The number of reported pars plana vitrectomies irrespective of indication increased over fourfold from 5761 to 26,900 (p < 0.0001), while the number of scleral buckling records decreased by two thirds from 2897 to 780 (p < 0.0001). During the same period, the population of England increased from 49.2 to 55.6 million, proportionally at a slower rate than that for recorded hospital episodes. Conclusions The frequency of admissions to hospital for surgically treated retinal detachment seems to have been increasing significantly since 2000. This effect is more marked in cases of rhegmatogenous retinal detachment. This may be explained by increased incidence of disease (due to increased rates of cataract surgery, increasing longevity and increasing rates of myopia) as well as repeat surgery in cases of recurrent retinal detachment. Other factors which may play a role include improvements in patient access, increased public awareness and improved local coding and reporting practice.
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Effect of Nd: YAG laser capsulotomy on the risk of retinal detachment after cataract surgery: A systematic review and meta-analysis. J Cataract Refract Surg 2021; 48:238-244. [PMID: 34538778 DOI: 10.1097/j.jcrs.0000000000000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/20/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT We aimed to evaluate the impact of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy on the incidence of pseudophakic retinal detachment (RD). The PubMed and Embase databases were searched for meta-analysis. Subgroup analyses were conducted according to study location, number of cases, mean follow-up time, and cataract procedure. The final analysis included 11 studies with 309 cases of RD in 65,117 eyes undergoing cataract surgery. Among them, 8,232 eyes underwent Nd:YAG capsulotomy. Our analysis demonstrated an increased risk of RD with Nd:YAG laser capsulotomy (RR=1.57; 95%CI, 1.17-2.12; P=0.003; HR=1.64; 95%CI, 1.03-2.62; P=0.04). Subgroup analysis suggested somewhat stronger associations in Asian (RR=4.54; 95%CI, 2.20-9.38; P<0.0001) than in non-Asian populations (America, P=0.12; Europe and others, P=0.21), and with extracapsular cataract extraction (RR=2.97; 95%CI, 1.83-4.83; P<0.0001) than with phacoemulsification (P=0.95). To conclude, Nd:YAG laser capsulotomy may be associated with an increased risk of pseudophakic RD.
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Caridi B, Doncheva D, Sivaprasad S, Turowski P. Galectins in the Pathogenesis of Common Retinal Disease. Front Pharmacol 2021; 12:687495. [PMID: 34079467 PMCID: PMC8165321 DOI: 10.3389/fphar.2021.687495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/29/2021] [Indexed: 12/15/2022] Open
Abstract
Diseases of the retina are major causes of visual impairment and blindness in developed countries and, due to an ageing population, their prevalence is continually rising. The lack of effective therapies and the limitations of those currently in use highlight the importance of continued research into the pathogenesis of these diseases. Vascular endothelial growth factor (VEGF) plays a major role in driving vascular dysfunction in retinal disease and has therefore become a key therapeutic target. Recent evidence also points to a potentially similarly important role of galectins, a family of β-galactoside-binding proteins. Indeed, they have been implicated in regulating fundamental processes, including vascular hyperpermeability, angiogenesis, neuroinflammation, and oxidative stress, all of which also play a prominent role in retinopathies. Here, we review direct evidence for pathological roles of galectins in retinal disease. In addition, we extrapolate potential roles of galectins in the retina from evidence in cancer, immune and neuro-biology. We conclude that there is value in increasing understanding of galectin function in retinal biology, in particular in the context of the retinal vasculature and microglia. With greater insight, recent clinical developments of galectin-targeting drugs could potentially also be of benefit to the clinical management of many blinding diseases.
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Affiliation(s)
- Bruna Caridi
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Dilyana Doncheva
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Sobha Sivaprasad
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Patric Turowski
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
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Wang T, Moinuddin O, Abuzaitoun R, Hwang M, Besirli C, Wubben TJ, Zacks DN. Retinal Detachment After Endophthalmitis: Risk Factors and Outcomes. Clin Ophthalmol 2021; 15:1529-1537. [PMID: 33880012 PMCID: PMC8053519 DOI: 10.2147/opth.s302757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/09/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze the risk factors, clinical course, and visual and anatomic outcomes of retinal detachment (RD) after endophthalmitis. Patients and Methods This retrospective study included 108 patients diagnosed with endophthalmitis between August 2014 and May 2019 at a single tertiary referral center. Sixteen patients developed RD after endophthalmitis. Retrospective analysis was performed to compare the cohort of endophthalmitis alone versus the cohort that developed RD after endophthalmitis, with analysis of potential risk factors for RD after endophthalmitis and treatment outcomes. Results The incidence of RD after endophthalmitis was 14.8% (N=16/108). The median time to develop RD after endophthalmitis was 27 days (range: 1-581 days, IQR: 25.3). Thirteen (81.3%) cases of RD occurred less than 2 months after the diagnosis of endophthalmitis. The incidence of aphakia (p=0.023) and posterior synechia (PS) (p=0.014) were significantly higher in the RD group. The mean initial and final visual acuity (VA) of the endophthalmitis alone group was 1.9±0.8 logMAR and 1.2±1.0 logMAR (p<0.0001), respectively, and 1.9±0.9 logMAR and 1.3±1.2 logMAR (p=0.07) in the RD group, respectively. Enucleation or evisceration occurred in 31.3% of cases with RD after endophthalmitis. The rate of final retinal re-apposition for the RD cohort was 56.3%. Conclusion The anatomic and functional outcomes for RD after endophthalmitis remain poor, with significant risk for permanent vision loss. Aphakia and posterior synechiae were seen more often in cases with RD after endophthalmitis.
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Affiliation(s)
- Tiantian Wang
- Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA.,Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Omar Moinuddin
- Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA
| | - Rebhi Abuzaitoun
- Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA
| | - Min Hwang
- Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA
| | - Cagri Besirli
- Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA
| | - Thomas J Wubben
- Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA
| | - David N Zacks
- Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA
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