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Meher T, Muhammad T, Ahmed W. Association Between Multimorbidity and Presence of Diagnosed Vision Problems Among the Middle-Aged and Older Population in India. Ophthalmic Epidemiol 2024:1-9. [PMID: 39116402 DOI: 10.1080/09286586.2024.2384061] [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: 11/21/2022] [Revised: 11/28/2023] [Accepted: 07/16/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE The aim of the study was to estimate the prevalence of diagnosed vision problems and to examine the association of single and multiple chronic conditions with vision problems among middle-aged and older adults in India. METHODS The study utilized data from the Longitudinal Ageing Study in India (LASI) Wave 1, (2017-18). Descriptive statistics along with bivariate and multivariable analyses were conducted to achieve the study objectives. RESULTS The prevalence of diagnosed vision problems in the sampled population was 48.2%. The older adults (60+ years) (55.3%) had shown a greater prevalence of vision problems than the middle-aged individuals (41%). Among chronic conditions, hypertension, diabetes, chronic lung diseases, chronic heart diseases, bone related diseases, psychiatric disorders, and high cholesterol were significantly associated with vision problems in the case of both middle-aged and older adults. Furthermore, odds of experiencing vision problems according to the presence of multimorbidity were higher in the middle-aged population [adjusted odds ratio (AOR) = 1.986; confidence interval (CI):1.855-2.126] than in the older population [AOR = 1.746; CI:1.644-1.854]. CONCLUSIONS Middle-aged and older adults with chronic illnesses and multimorbidity were at greater risk of vision problems. Due to the high prevalence of vision problem, interventions aimed at prevention or early detection are warranted.
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Affiliation(s)
- Trupti Meher
- Population Studies, International Institute for Population Sciences, Mumbai, India
| | - T Muhammad
- Population Studies, International Institute for Population Sciences, Mumbai, India
- Center for Healthy Aging, Pennsylvania State University, University Park, USA
| | - Waquar Ahmed
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
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2
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Halkiadakis I, Ntravalias T, Kollia E, Chatzistefanou K, Kandarakis SA, Patsea E. Screening for multifocal intraocular lens implantation in cataract patients in a public hospital. Int Ophthalmol 2024; 44:151. [PMID: 38507136 DOI: 10.1007/s10792-024-03088-8] [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: 09/30/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To identify the rate and characteristics of cataract surgery candidates suitable for multifocal intraocular lens implantation among patients undergoing preoperative evaluation in a public hospital. MATERIALS AND METHODS Screening was performed based on the patient's medical records, comprehensive ophthalmic examination, optical biometry (Zeiss, IOL Master 700) and optical coherence tomography (OCT) (Heidelberg, OCT Spectralis) in accordance with the relevant indications and contraindications mentioned in the pertinent literature. Patients were included in the present study if they were eligible for bilateral cataract surgery. The exclusion criteria were the presence of central nervous system or motility issues, prior refractive surgery, the presence of astigmatism greater than 1 dioptre and/or the presence of important ocular comorbidities in either eye. RESULTS The study evaluated 1200 consecutive patients. Four hundred thirty-two patients (36%) were not eligible for bilateral surgery and were excluded from the study. Of the 768 patients included in the present study, 346 (45.1%) were considered suitable candidates. Four hundred twenty-two patients (54.9%) were excluded for one or both eyes. Among them, 121 (28.7%) were excluded because of retinal disease, 120 (28.4%) because of regular astigmatism (> 1.0 D of corneal astigmatism), 32 (7.5%) because of pseudoexfoliation or zonular instability, and 30 (7.1%) because of glaucoma or ocular hypertension; in addition, 90 (21.3%) patients were excluded for multiple reasons. Suitable candidates were significantly younger (70 and 75 years, respectively) (p < 0.001). After being informed about the potential risks and benefits of MOIL implantation, 212 of 346 (83.8%) eligible patients provided consent. CONCLUSION Close to half of cataract patients in a public hospital were eligible for MOIL implantation, and the majority of patients would proceed to surgery. The most prevalent contraindication was macular disease.
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Affiliation(s)
- Ioannis Halkiadakis
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece.
| | - Thomas Ntravalias
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece
| | - Elpida Kollia
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece
| | - Klio Chatzistefanou
- First Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital "G. Gennimatas", Athens, Greece
| | - Stylianos A Kandarakis
- First Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital "G. Gennimatas", Athens, Greece
| | - Eleni Patsea
- Ophthalmiatrion Athinon, Athens Eye Hospital, Sarantaporou 7 Agios Stephanos, 145 65, Athens, Greece
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3
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Mukhija R, Nanavaty MA. How old is too old for routine cataract surgery? Eye (Lond) 2023; 37:3304-3305. [PMID: 37041347 PMCID: PMC10630324 DOI: 10.1038/s41433-023-02521-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 03/23/2023] [Accepted: 03/31/2023] [Indexed: 04/13/2023] Open
Affiliation(s)
- Ritika Mukhija
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton, BN2 5BF, UK
| | - Mayank A Nanavaty
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton, BN2 5BF, UK.
- Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, BN1 9PX, UK.
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4
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Savran O, Suppli Ulrik C. Inhaled Corticosteroid Exposure and Risk of Cataract in Patients with Asthma and COPD: A Systematic Review and Meta-Analysis. J Ophthalmol 2023; 2023:8209978. [PMID: 37899845 PMCID: PMC10602708 DOI: 10.1155/2023/8209978] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 08/28/2023] [Accepted: 10/14/2023] [Indexed: 10/31/2023] Open
Abstract
Purpose Both systemic and inhaled corticosteroids may increase the risk of cataract in patients with both chronic obstructive pulmonary disease (COPD) and asthma. Our aim was to assess the degree of association between cataract and corticosteroid exposure in patients with asthma and COPD. Methods A systematic literature review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The odds ratio estimates were extracted from each article. A random effects model was applied for estimate pooling in separate meta-analyses according to study design. Meta-regression was performed to assess the dose-response relationship between corticosteroid exposure and the risk of cataract development. Results A total of 19 studies met the criteria for inclusion in this review, of which 12 studies provided effect estimates for pooled analyses. All but one of the included observational studies reported a significant association between use of corticosteroids and cataract development in cohorts of asthma and/or COPD patients. Pooled analyses revealed on average a doubled risk of cataract in corticosteroid-exposed asthma and COPD patients. Studies have shown that daily high-dose inhaled corticosteroid (ICS) ≥ 1000 μg is associated with a significant risk of developing cataract and by that predispose to subsequent cataract surgery, although one study showed that systemic corticosteroids increase cataract risk more than ICS. Conclusion ICS treatment in asthma and COPD patients is a risk factor for cataract development. Our results emphasize a previously underestimated potential long-term risk of treatment with ICS and underline the importance of targeting ICS treatment, and not least dosing, to improve the risk-benefit ratio of maintenance treatment in both asthma and COPD.
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Affiliation(s)
- Osman Savran
- Department of Respiratory Medicine, Copenhagen University Hospital, Hvidovre, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital, Hvidovre, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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5
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Wu AM, Pitts KM, Pineda R, Chen SH, Wang M, Johnson G, Shen LQ, Margeta MA. Steroid Response Following Dropless Cataract Surgery Using Subconjunctival Triamcinolone. Clin Ophthalmol 2023; 17:2803-2814. [PMID: 37771393 PMCID: PMC10522460 DOI: 10.2147/opth.s426200] [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: 07/11/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
Purpose To assess the rates of postoperative steroid response following dropless cataract surgery using a subconjunctival depot of triamcinolone versus conventional cataract surgery using topical prednisolone. Patients and Methods We reviewed consecutive cataract surgery cases performed by a single surgeon to determine the likelihood of steroid response, defined as intraocular pressure (IOP) 50% above baseline or IOP > 24 mmHg postoperatively, excluding the first 72 hours. Logistic regression models were performed including baseline characteristics as exposures in the model and steroid response as the outcome. Main outcome measures were the proportion of eyes developing steroid response, risk factors for developing steroid response, and duration of steroid response. Results Of the 150 dropless and 218 conventional cases, 26 eyes developed steroid response (15 dropless and 11 conventional cases [10% vs 5%, P=0.096]). Risk factors for steroid response included dropless surgery (OR=2.43, 95% CI=1.03-6.02], P=0.046) and prior diagnosis of glaucoma (OR=7.18, 95% CI=2.66-19.22], P<0.001). Baseline IOP, age, sex, race, and axial length did not increase risk for steroid response. Of the eyes with steroid response, more dropless cases had an IOP elevation ≥30 days (9/15 eyes vs 1/11 eyes; P=0.008), including one patient with refractory IOP elevation in the dropless group who required urgent bilateral trabeculectomy for IOP control. Conclusion Dropless cataract surgery increases the risk of prolonged steroid response postoperatively. Patients with glaucoma have an increased risk of steroid response and may not be good candidates for dropless cataract surgery with subconjunctival triamcinolone.
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Affiliation(s)
- Annie M Wu
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Kristen M Pitts
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Harvard Ophthalmology AI Lab, Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Roberto Pineda
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Sherleen H Chen
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Mengyu Wang
- Harvard Ophthalmology AI Lab, Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Grace Johnson
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Lucy Q Shen
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Milica A Margeta
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Harvard Ophthalmology AI Lab, Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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6
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Sa’at N, Ghazali AK, Yaacob NM, Salowi MA. Factors Influencing Visual Improvement after Phacoemulsification Surgery among Malaysian Cataract Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11485. [PMID: 36141761 PMCID: PMC9517142 DOI: 10.3390/ijerph191811485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Blindness and visual impairment are part of the global burden of eye disease, with cataract being one of the leading causes of blindness. This study aimed to determine the factors affecting visual acuity (VA) improvement among cataract patients after phacoemulsification surgery in Malaysia. Cataract patients aged over 18 who underwent phacoemulsification surgery between January 2014 and December 2018 were included in this retrospective cohort study. Patients' sociodemographic, comorbidities, surgical, and related complication factors were extracted from the National Eye Database. The outcome was measured by the difference in visual acuity before and after the operation and was categorized as "improved", "no change", and "worse". A total of 180,776 patients were included in the final analysis. Multinomial logistic regression analysis showed "no changes in VA" was significantly higher in patients aged less than 40 years old (OR: 1.66; 95% CI: 1.22, 2.26), patients with ocular comorbidities (OR: 1.65; 95% CI: 1.53, 1.77), patients who had undergone surgery lasting more than 60 min (OR: 1.39; 95% CI: 1.14, 1.69), patients who had surgery without an intraocular lens (IOL) (OR: 1.64; 95% CI: 1.20, 2.26), and patients with postoperative complications (OR: 8.76; 95% CI: 8.13, 9.45). Worsening VA was significantly higher among male patients (OR: 1.11; 95% CI: 1.01, 1.22), patients who had ocular comorbidities (OR: 1.76; 95% CI: 1.59, 1.96), patients who had undergone surgery lasting more than 60 min (OR: 1.94; 95% CI: 1.57, 2.41), patients who had surgery without an IOL (OR: 2.03; 95% CI: 1.48, 2.80), and patients with postoperative complications (OR: 21.46; 95% CI: 19.35, 23.80). The factors impacting "no changes" in and "worsening" of VA after cataract surgery were the following: older age, male gender, ethnicity, ocular comorbidities, surgeon grade, absence of IOL, intraoperative complication, and postoperative problems.
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Affiliation(s)
- Nadiah Sa’at
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, USM, Kubang Kerian 16150, Malaysia
| | - Anis Kausar Ghazali
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, USM, Kubang Kerian 16150, Malaysia
| | - Najib Majdi Yaacob
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, USM, Kubang Kerian 16150, Malaysia
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Analysis of Korean Retinal Specialists' Opinions on Implanting Diffractive Multifocal Intraocular Lenses in Eyes with Underlying Retinal Diseases. J Clin Med 2022; 11:jcm11071836. [PMID: 35407444 PMCID: PMC8999910 DOI: 10.3390/jcm11071836] [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: 02/28/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 01/27/2023] Open
Abstract
Multifocal intraocular lenses (MF-IOLs) are increasingly implanted as the need for good near- and intermediate-distance vision increases. Although retinal disease is known to be a relative contraindication for MF-IOL implantation, there are no detailed guidelines for MF-IOL implantation with respect to the type and severity of retinal diseases/statuses. In this study, because retinal diseases can affect the performance of MF-IOLs, we analyzed the opinions of 111 retinal specialists, who were members of the Korean Retina Society, on the implantation of diffractive MF-IOLs in eyes with 15 retinal diseases/statuses using a web-based survey. For each underlying condition, retinal specialists were asked to rate their approval regarding implantation of MF-IOLs on a scale from 1 (completely disapprove) to 7 (completely approve), under the assumption that there were no known contraindications except for a given retinal disease/status. As a result, retinal specialists disapproved MF-IOL implantation (median value of Likert score < 4) in the eyes with wet age-related macular degeneration, dry age-related macular degeneration with geographic atrophy, proliferative diabetic retinopathy, nonproliferative diabetic retinopathy with macular edema, previous macula-off retinal detachment, previous retinal vein occlusion, and epiretinal membrane, but the scores varied by disease/status. The factors that affected the specialists’ opinions were the type of practice and the frequency of MF-IOL implantation (p = 0.013 and p = 0.021, respectively; one-way ANOVA).
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Cataract Surgery Is Not Associated with Decreased Risk of Retinal Vein Occlusion. OPHTHALMOLOGY SCIENCE 2021; 1:100041. [PMID: 36275940 PMCID: PMC9562376 DOI: 10.1016/j.xops.2021.100041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/25/2021] [Accepted: 07/07/2021] [Indexed: 11/21/2022]
Abstract
Purpose Design Participants Methods Main Outcome Measure Results Conclusions
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9
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Kanakamedala A, Go JA, Wendt S, Ugoh P, Khan M, Al-Mohtaseb Z. Systemic and Ocular Comorbidities of Black, Hispanic, and White Women with Cataracts. J Womens Health (Larchmt) 2021; 31:117-124. [PMID: 33826856 DOI: 10.1089/jwh.2020.8793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Cataracts are one of the leading causes of blindness in the world and disproportionately affect the elderly people and women. Sex- and race-related differences in cataract formation are not well understood. Furthermore, race and socioeconomic factors can play a role in developing systemic diseases. Earlier studies have supported a link between certain systemic diseases and cataract formation. Our study examined race-related differences in ocular and systemic comorbidities and analyzed differences among races and insurance types for cataract surgery visual outcomes among female patients with cataracts. Materials and Methods: Data were collected retrospectively and patients were grouped by race and insurance classifications. Female patients at a large tertiary center with an International Classification of Disease, 9th Edition (ICD-9) or ICD-10 cataract diagnosis or cataract extraction procedure code between January 2013 and June 2018 were included. A total of 909 female patients were included in the study. Frequency of systemic and ocular comorbidities was analyzed. Demographic factors were also compared among races. Finally, characteristics of cataract surgery patients, such as age at surgery, preoperative best-corrected visual acuity (BCVA), and visual outcomes among races and insurance types were analyzed. Results: There are differences among races for frequency of smoking, hemoglobin A1c, hypertension, and diabetes mellitus in female patients with cataracts and differences among races and insurance types for preoperative BCVA for patients who underwent cataract surgery (p < 0.001 for all). Conclusions: Female minority and non-minority patients with cataracts have a high frequency of systemic and ocular comorbidities at our county hospital. Patients with no insurance and white and Hispanic patients had worse preoperative BCVA.
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Affiliation(s)
| | - Jonathan A Go
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Sydney Wendt
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Peter Ugoh
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Mahmood Khan
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA
| | - Zaina Al-Mohtaseb
- Department of Ophthalmology, Baylor College of Medicine, Cullen Eye Institute, Houston, Texas, USA.,Department of Ophthalmology, Ben Taub General Hospital-Harris Health System, Houston, Texas, USA
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10
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Jacob L, López-Sánchez GF, Yang L, Haro JM, Shin JI, Veronese N, Soysal P, Gorely T, Koyanagi A, Smith L. Associations between cataract and multimorbidity: a cross-sectional study of 23,089 adults from Spain. Eye (Lond) 2020; 35:791-798. [PMID: 32405049 DOI: 10.1038/s41433-020-0962-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Little is known about the association between cataract and multimorbidity. Therefore, the aim of the present study was to examine the relationship between cataract and chronic conditions and multimorbidity in a large representative sample of Spanish adults. METHODS This study used data from the Spanish National Health Survey 2017, a cross-sectional sample of 23,089 adults aged ≥15 years from Spain [54.1% female; mean (standard deviation) age 53.4 (18.9) years]. Cataract and 30 other physical and mental chronic conditions were self-reported. Multimorbidity was defined as the presence of at least two physical and/or mental chronic conditions (excluding cataract). Control variables included sex, age, marital status, education, smoking, and alcohol consumption. Multivariable logistic and negative binomial regression analyzes were conducted to assess associations. RESULTS The prevalence of cataract and multimorbidity was 12.5% and 56.5%, respectively. All chronic conditions were significantly more frequent in individuals with than in those without cataract. Overall, there was a positive relationship between cataract and multimorbidity [odds ratio (OR) = 2.77; 95% confidence interval (CI): 2.39-3.21]. In addition, cataract was significantly associated with the number of chronic conditions in the whole population [incidence rate ratio (IRR) = 1.34; 95% CI: 1.29-1.38]. CONCLUSIONS Cataract is positively associated with chronic conditions and multimorbidity in adults. Interventions specifically designed for those with cataract to reduce or manage co-occurring chronic conditions and multimorbidity are urgently required.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, 78180, Versailles, France.,Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | | | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nicola Veronese
- National Research Council Neuroscience Institute, Padua, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Trish Gorely
- Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain.,ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, UK
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Guo M, Yu Y, Wen T, Zhang X, Liu B, Zhang J, Zhang R, Zhang Y, Zhou X. Analysis of disease comorbidity patterns in a large-scale China population. BMC Med Genomics 2019; 12:177. [PMID: 31829182 PMCID: PMC6907122 DOI: 10.1186/s12920-019-0629-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Disease comorbidity is popular and has significant indications for disease progress and management. We aim to detect the general disease comorbidity patterns in Chinese populations using a large-scale clinical data set. METHODS We extracted the diseases from a large-scale anonymized data set derived from 8,572,137 inpatients in 453 hospitals across China. We built a Disease Comorbidity Network (DCN) using correlation analysis and detected the topological patterns of disease comorbidity using both complex network and data mining methods. The comorbidity patterns were further validated by shared molecular mechanisms using disease-gene associations and pathways. To predict the disease occurrence during the whole disease progressions, we applied four machine learning methods to model the disease trajectories of patients. RESULTS We obtained the DCN with 5702 nodes and 258,535 edges, which shows a power law distribution of the degree and weight. It further indicated that there exists high heterogeneity of comorbidities for different diseases and we found that the DCN is a hierarchical modular network with community structures, which have both homogeneous and heterogeneous disease categories. Furthermore, adhering to the previous work from US and Europe populations, we found that the disease comorbidities have their shared underlying molecular mechanisms. Furthermore, take hypertension and psychiatric disease as instance, we used four classification methods to predicte the disease occurrence using the comorbid disease trajectories and obtained acceptable performance, in which in particular, random forest obtained an overall best performance (with F1-score 0.6689 for hypertension and 0.6802 for psychiatric disease). CONCLUSIONS Our study indicates that disease comorbidity is significant and valuable to understand the disease incidences and their interactions in real-world populations, which will provide important insights for detection of the patterns of disease classification, diagnosis and prognosis.
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Affiliation(s)
- Mengfei Guo
- School of Computer and Information Technology and Beijing Key Lab of Traffic Data Analysis and Mining, Beijing Jiaotong University, Beijing, 100044, China
| | - Yanan Yu
- School of Computer and Information Technology and Beijing Key Lab of Traffic Data Analysis and Mining, Beijing Jiaotong University, Beijing, 100044, China
| | - Tiancai Wen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.,School of Computer Science, Northwestern Polytechnical University, Xi'an, 710129, Shanxi Province, China
| | - Xiaoping Zhang
- China Academy of Chinese Medicine Sciences, Beijing, 100070, China
| | - Baoyan Liu
- China Academy of Chinese Medicine Sciences, Beijing, 100070, China.
| | - Jin Zhang
- Data Center of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Runshun Zhang
- China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beijing, 100053, China
| | - Yanning Zhang
- School of Computer Science, Northwestern Polytechnical University, Xi'an, 710129, Shanxi Province, China.
| | - Xuezhong Zhou
- School of Computer and Information Technology and Beijing Key Lab of Traffic Data Analysis and Mining, Beijing Jiaotong University, Beijing, 100044, China.
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12
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Kossack N, Schindler C, Weinhold I, Hickstein L, Lehne M, Walker J, Neubauer AS, Häckl D. German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2017; 26:81-90. [PMID: 29416961 PMCID: PMC5794811 DOI: 10.1007/s10389-017-0851-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Aim Cataract extraction is one of the most frequent surgeries in Germany. In most cases, the clouded natural lens is replaced by a hydrophobic or hydrophilic acrylic intraocular lens (IOL) implant. The most common long-term complication after cataract surgery is the development of a posterior capsule opacification (PCO). Although no precise real world data are available, published evidence suggests a lower risk for PCO development for hydrophobic acrylic IOLs compared to hydrophilic acrylic IOLs. Therefore, in the present study we assessed real world data on the impact of different IOL material types on the incidence of post-operative PCO treatment. Subject and methods In this retrospective study, we included 3,025 patients who underwent cataract extraction and implantation of either an acrylic hydrophobic or hydrophilic IOL in 2010. We assessed clinical outcomes and direct costs in a 4-year follow-up period after cataract surgery from a statutory health insurance (SHI) perspective in Germany. Results PCO that required capsulotomies occurred significantly (p < 0.0001) less frequent in patients who had received a hydrophobic IOL (31.57% of 2,078 patients) compared to the group with hydrophilic IOL implants (56.6% of 947 patients) and costs per patient for postoperative treatment in a 4-year follow-up were 50.03 € vs. 87.81 € (i.e. 75% higher in the latter group, p < 0.0001). Conclusion Considering the high prevalence of cataract, the economic burden associated with adverse effects of cataract extraction is of great relevance for the German SHI. Hydrophobic lenses seem to be superior regarding both medical and economic results.
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Affiliation(s)
- Nils Kossack
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Christian Schindler
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | - Ines Weinhold
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
| | | | | | - Jochen Walker
- InGef Institut für angewandte Gesundheitsforschung, Berlin, Germany
| | | | - Dennis Häckl
- WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
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Teh BL, Megaw R, Borooah S, Dhillon B. Optimizing cataract surgery in patients with age-related macular degeneration. Surv Ophthalmol 2016; 62:346-356. [PMID: 28012877 DOI: 10.1016/j.survophthal.2016.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
Abstract
Age-related macular degeneration (AMD) is one of the leading causes of visual impairment. The development of cataract in AMD patients poses challenges in assessing timing of surgery, predicting potential benefit to the patient of surgery, and predicting short- and long-term effects of surgery on progression of their AMD. Although traditional cataract surgery remains the mainstay of treatment, recently several devices have been developed to address the specific needs of AMD patients with cataract. We look at the associations between cataract and AMD and outline the treatment approaches to cataract surgery in AMD, looking at the potential benefits and risks of both traditional approaches and newer devices. We provide clinicians treating patients with AMD and cataract with a framework for choosing the appropriate management.
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Affiliation(s)
| | - Roly Megaw
- Princess Alexandra Eye Pavilion, Edinburgh, UK
| | | | - Baljean Dhillon
- Princess Alexandra Eye Pavilion, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Rim TH, Kim DW, Kim SE, Kim SS. Factors Associated with Cataract in Korea: A Community Health Survey 2008-2012. Yonsei Med J 2015; 56:1663-70. [PMID: 26446652 PMCID: PMC4630058 DOI: 10.3349/ymj.2015.56.6.1663] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/19/2014] [Accepted: 02/03/2015] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To investigate sociodemographic factors, health behaviors, and comorbidities associated with cataracts in a large, nationally representative Korean sample. MATERIALS AND METHODS This cross-sectional study included 715554 adults aged 40 years or older who participated in the 2008-2012 Community Health Survey. Significant risk factors were identified using multivariate logistic regression analysis for self-reported cataract, and a nomogram for analysis of cataract risk was generated. RESULTS Roughly 11% of participants (n=88464) reported being diagnosed with cataracts by a doctor. Age was the most important independent risk factor [adjusted odds ratio (aOR)=1.11, 99% confidence interval (CI), 1.11-1.11 for each increasing year]. Significant comorbidities with descending order of effect size (aOR, 99% CI), included diabetes mellitus (1.78, 1.71-1.85), osteoporosis (1.62, 1.56-1.69), arthritis (1.54, 1.48-1.59), hepatitis B infection (1.46, 1.31-1.63), atopic dermatitis (1.50, 1.33-1.69), angina (1.46, 1.35-1.57), allergic rhinitis (1.45, 1.36-1.55), dyslipidemia (1.38, 1.31-1.45), asthma (1.35, 1.26-1.44), and hypertension (1.23, 1.19-1.28). Subjects who sleep less than 6 hours/day were more likely to have cataract than subjects who sleep more than 9 hours/day as a reference group (aOR=1.22, 99% CI, 1.11-1.34). CONCLUSION While the most important cataract risk factor was age, the ten comorbidities mentioned above were also significant risk factors. Interestingly, longer duration of sleep was associated with a protective effect against cataract development.
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Affiliation(s)
- Tyler Hyungtaek Rim
- Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Wook Kim
- Department of Policy Research Affairs, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Sung Eun Kim
- Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Kim
- Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Yonsei Healthcare Big Data Based Knowledge Integration System Research Center, Institute of Convergence Science, Yonsei University College of Medicine, Seoul, Korea.
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Kahawita SK, Goggin M. Cataract surgery audit at an Australian urban teaching hospital. Clin Exp Ophthalmol 2015; 43:514-22. [PMID: 25644026 DOI: 10.1111/ceo.12496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/04/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND To provide local data on visual acuity and surgical outcomes for cataract surgery performed in an Australian teaching hospital. DESIGN Continuous audit over 7 years in a public teaching hospital. PARTICIPANTS A total of 3740 eyes had cataract surgery performed at The Queen Elizabeth Hospital, South Australia, from May 2006 to September 2013. METHODS Visual acuity and complication rates were recorded for cataract surgery cases operated on between May 2006 and September 2013 on a digital database with data entry contemporaneous with final follow-up. MAIN OUTCOME MEASURES Visual acuity and surgical complications. RESULTS Of the patients, 91.4% achieved postoperative best-measured vision better than preoperative best-measured vision. The rate of posterior capsular tear was 2.59%, endophthalmitis was 0.11% and the overall complication rate was 11.7%. CONCLUSIONS This audit is the first to document modern cataract surgery, overwhelmingly dominated by phacoemulsification in an Australian population and can be used to benchmark cataract surgery outcome in an urban Australian population.
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Affiliation(s)
- Shyalle K Kahawita
- Department of Ophthalmology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.,South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Goggin
- Department of Ophthalmology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
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Wang JJ, Fong CSU, Rochtchina E, Cugati S, de Loryn T, Kaushik S, Tan JSL, Arnold J, Smith W, Mitchell P. Risk of age-related macular degeneration 3 years after cataract surgery: paired eye comparisons. Ophthalmology 2012; 119:2298-303. [PMID: 22959104 DOI: 10.1016/j.ophtha.2012.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 06/14/2012] [Accepted: 07/05/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To clarify possible associations between cataract surgery and progression of age-related macular degeneration (AMD). DESIGN Clinic-based cohort. PARTICIPANTS We followed cataract surgical patients aged 65+ years in the Australian Cataract Surgery and Age-related Macular Degeneration (CSAMD) study. Patients who remained unilaterally phakic for at least 24 months after recruitment were included. METHODS We performed annual examinations with retinal photography. We assessed AMD using side-by-side grading of images from all visits. Paired comparisons between operated and nonoperated fellow eyes (defined as nonoperated or operated <12 months previously) were made using generalized estimating equation models. MAIN OUTCOME MEASURES Incident early AMD was defined as the new appearance of soft indistinct/reticular drusen or coexisting retinal pigmentary abnormality and soft distinct drusen in eyes at risk of early AMD. Incident late AMD was defined as the new appearance of neovascular AMD or geographic atrophy (GA) in eyes at risk of late AMD. RESULTS Among 2029 recruited, eligible participants, 1851 had cataract surgery performed at Westmead Hospital, Sydney, and 1244 (70.7%) had 36-month postoperative visits. Of these participants, 1178 had gradable photographs at baseline and at least 1 follow-up visit. Of 308 unilaterally operated participants at risk of late AMD, this developed in 4 (1.3%) operated and 7 (2.3%) nonoperated fellow eyes (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.23-2.36) after adjusting for the presence of early AMD at baseline. Of 217 unilaterally operated participants at risk of early AMD, this developed in 23 (10.6%) operated and 21 (9.7%) nonoperated fellow eyes (OR, 1.07; 95% CI, 0.74-1.65). Incident retinal pigment abnormalities were more frequent in operated than nonoperated fellow eyes (15.3% vs. 9.9%; OR, 1.64; 95% CI, 1.07-2.52). There was no difference in the 3-year incidence of large soft indistinct or reticular drusen between the 2 eyes (8.8% vs. 7.9%; OR, 1.12; 95% CI, 0.79-1.60). CONCLUSIONS Prospective follow-up data and paired eye comparisons of this older surgical cohort showed no increased risk of developing late AMD, early AMD, or soft/reticular drusen over 3 years. There was a 60% increased detection of retinal pigmentary changes in surgical eyes.
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Affiliation(s)
- Jie Jin Wang
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
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Gayton JL, Mackool RJ, Ernest PH, Seabolt RA, Dumont S. Implantation of multifocal intraocular lenses using a magnification strategy in cataractous eyes with age-related macular degeneration. J Cataract Refract Surg 2012; 38:415-8. [PMID: 22340604 DOI: 10.1016/j.jcrs.2011.12.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 08/18/2011] [Accepted: 09/09/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE To examine visual function after targeting -2.0 diopter (D) spherical equivalent (SE) when implanting a multifocal intraocular lens (IOL) in eyes with cataract and age-related macular degeneration (AMD). SETTING Three private practices. DESIGN Case series. METHODS Lenses of cataractous eyes with AMD were replaced with the Acrysof Restor SN60D3 multifocal IOL, targeting an SE of -2.0 D, which yielded +5.2 D near addition. Near and distance visual acuities were examined. Patients completed a visual function questionnaire preoperatively and 6 months postoperatively. RESULTS At 6 months, 13 patients with 20 eligible eyes were examined. The uncorrected near visual acuity improved in 18 eyes (90%) and was unchanged in 2 eyes. The corrected distance visual acuity improved in 14 eyes (70%), was unchanged in 4 eyes (20%), and decreased (≤ 3 lines) in 2 eyes (10%). All vision-related questionnaire items improved. CONCLUSION For cataractous eyes with AMD, replacing the crystalline lens with this myopia-targeted multifocal IOL improved or maintained near vision without severely compromising distance vision. FINANCIAL DISCLOSURE Drs. Mackool and Ernest are consultants to Alcon. Dr. Mackool is an inventor in the patent of the IOLs related to this strategy. No other author has a financial or proprietary interest in any material or method mentioned.
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Jan Teper S, Dobrowolski D, Wylegala E. Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers. Cent European J Urol 2011; 64:62-6. [PMID: 24578865 PMCID: PMC3921715 DOI: 10.5173/ceju.2011.02.art2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 01/24/2011] [Accepted: 02/03/2011] [Indexed: 11/22/2022] Open
Abstract
The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature published on this topic and provides recommendations on how to reduce incidence of iatrogenic IFIS or its severity and outcomes in patients with BPH.
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Affiliation(s)
- Slawomir Jan Teper
- Department of Ophthalmology, District Railway Hospital in Katowice, Poland
| | | | - Edward Wylegala
- Department of Ophthalmology, District Railway Hospital in Katowice, Poland
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Gayton JL, Seabolt RA. Clinical Outcomes of Complex and Uncomplicated Cataractous Eyes After Lens Replacement with the AcrySof Toric IOL. J Refract Surg 2011; 27:56-62. [DOI: 10.3928/1081597x-20100325-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 02/16/2010] [Indexed: 11/20/2022]
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Sharwood PL, Thomas D, Roberts TV. Adverse medical events associated with cataract surgery performed under topical anaesthesia. Clin Exp Ophthalmol 2009; 36:842-6. [PMID: 19278479 DOI: 10.1111/j.1442-9071.2009.01924.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cataract surgery in Australia is increasingly performed in an elderly population with multiple medical comorbidities. The purpose of this study was to investigate the frequency and type of adverse medical events associated with cataract surgery performed under topical anaesthesia with light sedation. METHODS Retrospective analysis was undertaken for 631 consecutive cases of clear corneal phaco-emulsification and implant surgery performed under assisted topical anaesthesia, by a single surgeon (TR) in a private ophthalmic day surgery unit. In the 238 patients who underwent bilateral surgery, data from the first procedure for each patient were analysed, unless the second procedure was associated with greater morbidity. RESULTS A total of 393 procedures were included in the study. The mean age was 73 +/- 11 years with 75% of patients having at least one significant medical comorbidity. The most common comorbidities were hypertension (51%), gastro-oesophageal reflux (19%), angina and myocardial infarction (14%), diabetes (13%) and asthma (9%). Significant intraoperative adverse medical events requiring intervention occurred in four cases (1%): bradycardia occurred in three cases and hypotension in one case. None of these adverse events resulted in death or hospitalization. There were no postoperative adverse events, hospitalizations or deaths within 7 days. Minor changes in heart rate, blood pressure and oximetry not requiring intervention were observed in 35 cases (9%). CONCLUSION This retrospective analysis shows that cataract surgery performed under assisted topical anaesthesia is safe with a low rate of systemic complications despite being performed in an elderly population.
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Affiliation(s)
- Phillipa L Sharwood
- Northern Clinical School, University of Sydney, Royal North Shore Hospital, New South Wales, Australia
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Liu Y, Congdon NG, Fan H, Zhao X, Choi K, Lam DS. Ocular Comorbidities among Cataract-Operated Patients in Rural China. Ophthalmology 2007; 114:e47-52. [DOI: 10.1016/j.ophtha.2007.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2007] [Revised: 07/04/2007] [Accepted: 07/11/2007] [Indexed: 11/26/2022] Open
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Pham TQ, Cugati S, Rochtchina E, Mitchell P, Maloof A, Wang JJ. Early age-related maculopathy in eyes after cataract surgery. Eye (Lond) 2006; 21:512-7. [PMID: 16440007 DOI: 10.1038/sj.eye.6702254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To assess age-related maculopathy (ARM) in eyes of patients who had undergone cataract surgery for at least a year. METHODS Consecutive patients aged 60+ years who had undergone cataract surgery at Westmead Hospital, Sydney, Australia, during 2001-2003 were examined in 2004. Interview using standardized questionnaires and stereo retinal photography was performed. Retinal photographs were graded using the Wisconsin ARM grading system. The proportions with ARM were compared between surgical and nonsurgical eyes, and between this surgical cohort and the Blue Mountains Eye Study (BMES) population. RESULTS Of the 622 eligible patients, 454 (73%) were re-examined, with a mean follow-period of 2.8 years. Surgical eyes had a higher proportion of early ARM compared to nonsurgical eyes (15.2 vs10.3%, P=0.07) and to the early ARM prevalence found in BMES participants of similar age (14.5 vs6.9%, P<0.01), which persisted after age standardization to the BMES population (9.7 vs6.9%, P<0.05). CONCLUSIONS We found an increased prevalence of early ARM in surgical eyes of patients 1-3 years after cataract surgery. Whether this increased early ARM prevalence leads to an increased prevalence of late ARM in the long-term warrants further investigation.
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Affiliation(s)
- T Q Pham
- Department of Ophthalmology (Centre for Vision Research, Westmead Millennium Institute), Westmead Hospital, University of Sydney, Westmead, NSW, Australia
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Pham TQ, Cugati S, Rochtchina E, Mitchell P, Maloof A, Wang JJ. Age-related maculopathy and cataract surgery outcomes: visual acuity and health-related quality of life. Eye (Lond) 2005; 21:324-30. [PMID: 16284600 DOI: 10.1038/sj.eye.6702171] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To assess visual acuity (VA) and health-related quality of life (HRQoL) outcomes in patients with and without age-related maculopathy (ARM) after cataract surgery. METHODS Patients aged 60+ years who had undergone cataract surgery at the Westmead Hospital during 2001-2003 were re-examined 1-3 years after surgery. Tests included VA and assessment of visual- and HRQoL using standardised questionnaires (VF-14, SF-12). Preoperative comorbidity data were collected from medical records. Poor surgical outcomes (VA<6/12; no VA improvement; lowest quintile of VF-14, SF-12 scores) were compared in patients with and without ARM, adjusting for age, sex, preoperative systemic comorbidities, ocular comorbidities and surgical or postoperative complications. RESULTS Of 622 surviving patients, 454 (73%) were followed up for a mean period of 2.8 years. Similar proportions with VA>or=6/12 were observed in patients with (80.2%) and without (88.8%) pre-existing ARM. Preoperative early ARM was only associated with slightly lower mean VF-14 scores (87.64 with vs 92.58 without ARM, P=0.01). Increasing age and preoperative ocular comorbidities were associated with all poor outcomes measured. Low SF-12 scores were associated with preoperative systemic comorbidities. CONCLUSION Our study documents favourable cataract surgical outcomes 1-3 years after cataract surgery in patients with preoperative ARM.
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Affiliation(s)
- T Q Pham
- Department of Ophthalmology, Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
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