Developing a model for postoperative axial length in children undergoing bilateral cataract surgery to optimize visual outcomes

2017 ◽  
Vol 21 (4) ◽  
pp. e21-e22
Author(s):  
Eliza L. Barnwell ◽  
M. Edward Wilson ◽  
Rupal Trivedi
Keyword(s):  
Cataract Surgery ◽  
Axial Length ◽  
Bilateral Cataract ◽  
Visual Outcomes

scholarly journals Glaucoma following cataract surgery in the first 2 years of life: frequency, risk factors and outcomes from IoLunder2

2019 ◽  
Vol 104 (7) ◽  
pp. 967-973 ◽  
Author(s):  
Ameenat Lola Solebo ◽  
Jugnoo S Rahi
Keyword(s):  
Adverse Events ◽  
Cataract Surgery ◽  
Axial Length ◽  
Multivariable Analysis ◽  
Population Based ◽  
Secondary Glaucoma ◽  
Bilateral Cataract ◽  
Younger Age ◽  
Age At Surgery ◽  
Unilateral Disease

BackgroundWe investigated glaucoma related adverse events, predictors and impact at 5 years following surgery in the IoLunder2 cohortMethodsPopulation based observational cohort study of children undergoing cataract surgery aged 2 years or under between January 2009 and December 2010. Glaucoma was defined using internationally accepted taxonomies based on the consequences of elevated intraocular pressure (IOP). Glaucoma related adverse events were any involving elevated IOP. Multivariable analysis was undertaken to investigate potential predictors of secondary glaucoma with adjustment for within-child correlation in bilateral cataract. Unilateral and bilateral cataract were analysed separately.ResultsComplete follow-up data were available for 235 of 254, 93% of the inception cohort. By 5 years after primary cataract surgery, 20% of children with bilateral cataract and 12% with unilateral had developed secondary glaucoma. Glaucoma related complications had been diagnosed in 24% and 36% of children, respectively. Independent predictors of glaucoma were younger age at surgery (adjusted OR for reduction of week in age: 1.1, 95%C I 1.1 to 1.2, p<0.001); the presence of significant ocular comorbidity (adj OR 3.2, 95% CI 1.1 to 9.6, p=0.01); and shorter axial length (adj OR for each mm 1.7, 95% CI 10.0 to 1, p=0.05) for bilateral cataract. Shorter axial length was the single independent factor in unilateral disease (adj OR 9.6, 95% CI 1.7 to 52, p=0.009)ConclusionsBoth younger age at surgery (the strongest marker of ocular ‘immaturity’) and smaller ocular size (a marker of both immaturity and developmental vulnerability) can be used to identify those at greatest risk of glaucoma due to early life cataract surgery.

scholarly journals Simultaneous Bilateral Cataract Surgery in Outreach Surgical Camps

2017 ◽  
Vol 9 ◽  
pp. 117917211770173 ◽  
Author(s):  
Kagmeni Giles ◽  
Ebana Steve Robert ◽  
Ebana Mvogo Come ◽  
Peter Wiedemann
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Rural Areas ◽  
Small Incision Cataract Surgery ◽  
Intraoperative Complication ◽  
Bilateral Cataract ◽  
Visual Outcomes ◽  
Rural Cameroon ◽  
Posterior Capsule Rupture ◽  
Transient Elevation

Objectives: The aim of this study was to evaluate the safety and visual outcomes of simultaneous bilateral cataract surgery (SBCS) with intraocular lens implantation performed in outreach surgical eye camps. Methods: The medical records of 47 consecutive patients who underwent simultaneous bilateral small-incision cataract surgery between January 2010 and December 2015 in outreach surgical camps in rural Cameroon were reviewed. The measures included postoperative visual outcomes and intraoperative and postoperative complications. Results: Data from 94 eyes of 47 participants (30 men, 17 women; mean age: 60.93 ± 13.58 years, range: 45-80 years) were included in this study. The presented best visual acuity (VA) was less than 3/60 in 100% of the eyes. At the 4-week follow-up, 84.04% of the eyes showed increased VA of 1 line or more ( P = .001).Of these, 71 (75.53%) achieved good VA (greater than 6/18). Intraoperative or postoperative complications occurred in 19 (20.21%) eyes. The most serious intraoperative complication was a posterior capsule rupture and vitreous loss (2 patients, 2 eyes). The postoperative complications included a transient elevation in the intraocular pressure (6 eyes), chronic corneal oedema (5 eyes), iris capture (3 eyes), lens decentration (2 eyes), and hyphema (1 eye). No cases of postoperative endophthalmitis were recorded. Conclusions: Under the strict observation of endophthalmitis prophylaxis, SBCS is an option to reduce the cataract blindness backlog in rural areas of developing countries.

scholarly journals Bilateral paediatric cataract surgery - outcomes of 298 children from Kinshasa, the Democratic Republic of the Congo

2020 ◽  
Vol 20 (4) ◽  
pp. 1817-27
Author(s):  
Janvier Kilangalanga Ngoy ◽  
Thomas Stahnke ◽  
Serge Dinkulu ◽  
Emile Makwanga ◽  
Astrid Moanda ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Childhood Blindness ◽  
Bilateral Cataract ◽  
Visual Outcomes ◽  
Post Conflict ◽  
Long Term Follow Up ◽  
Republic Of The Congo ◽  
Paediatric Cataract

Introduction: The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and to diminish the burden of childhood blindness. Objective: To report in a retrospective observational cohort study the long-term outcomes of 298 children who had bilat- eral cataract surgery with IOL implantation from 2001-2016 in Kinshasa. Methods: A standardized surgical treatment of paediatric cataract was practiced on 298 children. Patient’s follow-up, com- plications, and visual outcomes were recorded and analysed. Results: The mean age was 5.7 ± 4.3 years and males were predominant (64.9%). Most of children were living mainly in urban poorest areas (96.3%). Strabismus, nystagmus and microcornea were encountered in 20.1%, 25.1% and 8.7% of children, respectively. Using WHO criteria most of patients were classified as blind preoperatively and 81.9% of them had improved visual outcomes after surgery. Main reasons for reduced vision during follow-up were secondary cataract (5.7%), IOL decentration (1.2%), retinal detachment (1.2%), and secondary glaucoma (1.5%). Conclusion: In spite of the post conflict challenges, elimination of cataract blindness in children remains a priority. Children present at a late age for surgery and long term follow-up is poor. There is need for program strengthening in these areas. Keywords: Paediatric cataract surgery; bilateral cataract; outcomes.

Povidone-Iodine 3-Minute Exposure Time is Viable in Preparation for Cataract Surgery

2017 ◽  
Vol 27 (5) ◽  
pp. 573-576 ◽  
Author(s):  
Chu L. Nguyen ◽  
Lawrence J. Oh ◽  
Eugene Wong ◽  
Ian C. Francis
Keyword(s):  
Clinical Practice ◽  
Cataract Surgery ◽  
Exposure Time ◽  
Ocular Surface ◽  
Povidone Iodine ◽  
Bacterial Load ◽  
Minute Exposure ◽  
Visual Outcomes ◽  
Preoperative Prophylaxis ◽  
Operating Room Staff

Purpose Povidone-iodine (PI) is widely used to reduce the preoperative conjunctival bacterial load. This study aimed to evaluate the employment of PI 10% in an attempt to sterilize the ocular surface prior to cataract surgery, and to show that PI could be left in contact for 3 minutes. The viability of this exposure time in clinical practice, associated adverse events, and visual outcomes were documented. Methods In this prospective cohort study, phacoemulsification cataract surgery was performed in 604 patients by a single surgeon. Preoperative preparation was undertaken with PI 10%, applied to the cornea, conjunctival sac, eyelids, and periorbital skin with sterile cotton gauze. Povidone-iodine was then flushed onto the ocular surface. Operating room staff timed the precise duration of exposure. After the 3-minute preparation, the lids were thoroughly dried with fresh dry gauze. Results The median PI exposure time was 3.17 minutes, with an interquartile range of 0.25. All cases were followed up postoperatively at 1 day, 1 week, and 1 month. There were no complications attributable to PI. Visual outcomes were satisfactory. Conclusions Implementation of a preoperative prophylaxis protocol that used PI 10% with a 3-minute exposure time can be performed in clinical practice. The 3-minute exposure time had no adverse sequelae.

scholarly journals Dynamic monocyte chemoattractant protein-1 level as predictors of perceived pain during first and second phacoemulsification eye surgeries in patients with bilateral cataract

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feng Zhang ◽  
Jin-Hua Wang ◽  
Mei-Sheng Zhao
Keyword(s):  
Cataract Surgery ◽  
Pain Score ◽  
Aqueous Humor ◽  
Anxiety Score ◽  
Monocyte Chemoattractant Protein 1 ◽  
Bilateral Cataract ◽  
Monocyte Chemoattractant ◽  
Eye Surgery ◽  
Monocyte Chemoattractant Protein ◽  
Perceived Pain

Abstract Background The purpose of the study was to investigate whether dynamic monocyte chemoattractant protein-1 (MCP-1) level might be as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract. Methods Consecutive bilateral cataract patients undergoing bilateral sequential phacoemulsification were retrospectively enrolled. Patients’ preoperative anxiety score and intraoperative pain score were registered. Aqueous humor samples were obtained during surgery. MCP-1 level in the aqueous humor was measured by enzyme linked immunosorbent assay (Elisa). Patients were assigned to seven subgroups based on the interval between first-eye and second-eye cataract surgery. Comparisons were performed for a subjective sensation and MCP-1 levels among different subgroups. Results pain score during second-eye surgery was significantly higher than during first-eye surgery. Whereas there was no statistical difference in anxiety score between both surgeries. Result from subgroups comparison showed that the visual analog scale (VAS) pain score was statistically greater in 1-group and 6-group during the second eye surgery. Anxiety score did not statistically differ in subgroups. Additionally, the second-eye MCP-1 level was significantly higher at week 1and 6 intervals. Preoperative MCP-1 level was positively correlated with perceiving pain score during both surgeries. Conclusions MCP-1 level in aqueous humor significantly correlated with perceived pain during cataract surgery. Dynamic MCP-1 level could function as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract, which might support clinicians in treatment optimization and clinical decision-making.

Visual outcomes after toric intraocular lens implantation in pediatric eyes undergoing cataract surgery

2020 ◽  
Vol 46 (8) ◽  
pp. 1102-1107
Author(s):  
Vaishali Vasavada ◽  
Lajja Shastri ◽  
Abhay R. Vasavada ◽  
Priyanka Patel ◽  
Deepa Agarwal ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Toric Intraocular Lens ◽  
Visual Outcomes ◽  
Lens Implantation
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