An evaluation of intracameral mydriasis for routine cataract surgery

2017 ◽  
Vol 102 (6) ◽  
pp. 784-789 ◽  
Author(s):  
Christopher B Schulz ◽  
Srini V Goverdhan ◽  
Roger C Humphry
Keyword(s):  
Cataract Surgery ◽  
Patient Experience ◽  
Pupil Size ◽  
Cost Effective ◽  
Turnaround Time ◽  
Real World Evidence ◽  
Intraoperative Floppy Iris Syndrome ◽  
Group 2 ◽  
Standard Regime ◽  
Group 1

BackgroundIntracameral Mydrane might facilitate a more streamlined cataract service and improve the patient experience. There is limited ‘real-world’ evidence of its use in a UK setting.MethodsAs part of a local evaluation of cataract surgery using intracameral Mydrane (group 2; n=60), data were collected on intraoperative pupil size and postoperative visual acuity (VA), as well as the rate of mechanical pupil dilation, intraoperative floppy iris syndrome (IFIS) and complications. Preoperative and theatre turnaround time was recorded and patients completed a validated measure of satisfaction postoperatively. Data were compared with a previous cohort subjected to the existing standard regime of preoperative topical mydriatics (group 1; n=60).ResultsPostoperative VA was comparable between groups (0.09±0.16 vs 0.08±0.15; p=0.59). Pupil size in group 2 was 7.0±1.0 mm prior to capsulorhexis and 6.5±0.29 mm after cortical aspiration, with a smaller pupil in patients on alpha-antagonists (4.7±1.1 mm; p=0.004) at this later time point. Comparing group 2 with group 1, preoperative waiting was less (87 vs 146 min; p<0.0001) and satisfaction was higher (76.0±11.2 vs 66.3±8.6; p<0.0001), although theatre turnaround time was longer (25 min vs 22 min).ConclusionIntracameral mydriasis was clinically effective in most patients undergoing cataract surgery and might be associated with an improved patient experience and a more streamlined preoperative flow. Mydrane represents a licensed alternative to the off-label use of other intracameral mydriatic agents, but was not judged to be a cost-effective intervention for routine use in this particular setting.

scholarly journals Use of a New Ocular Insert versus Conventional Mydriasis in Cataract Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
C. Torrón ◽  
P. Calvo ◽  
O. Ruiz-Moreno ◽  
J. Leciñena ◽  
A. Pérez-Iñigo
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cataract Surgery ◽  
Pupil Size ◽  
Pupil Diameter ◽  
Phenylephrine Hydrochloride ◽  
Before And After ◽  
Group 2 ◽  
Ocular Insert ◽  
Group 1

Background. To compare the efficacy and safety of a new ocular insert versus conventional mydriasis in cataract surgery.Methods. We selected 70 patients undergoing cataract surgery. Thirty five patients (Group 1) received instillation of mydriatic drops (tropicamide 1%, phenylephrine 10%, and cyclopentolate 1%) prior to surgery, and 35 patients (Group 2) had a Mydriasert insert (Théa Pharma) (0.28 mg of tropicamide and 5.4 mg of phenylephrine hydrochloride) placed in the inferior fornix. Pupil size before and after surgery, blood pressure, and heart rate were measured.Results. Before surgery, pupil diameter was  mm in Group 1 and in Group 2 (). Twenty four hours after surgery, pupil diameter was  mm in Group 1 and in Group 2 (). There were no statistically significant differences in blood pressure or heart rate between groups.Conclusions. The effect of the Mydriasert insert was similar to conventional mydriatic agents. Pupil size was restored to normal faster when using the Mydriasert insert compared with conventional mydriatic agents for pupil dilation.

scholarly journals Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

2019 ◽  
Vol 16 (3) ◽  
pp. 168-178
Author(s):  
Anu Malik ◽  
Smruti Ranjan Dethi ◽  
Yogesh Kumar Gupta ◽  
Alka Gupta
Keyword(s):  
Cataract Surgery ◽  
Randomized Study ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
The Mean ◽  
Group 2 ◽  
Surgically Induced ◽  
Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

scholarly journals A study to assess the macular thickness and visual outcome before and after cataract surgery

2021 ◽  
Author(s):  
Abhishek Salwan ◽  
Shakeen Singh
Keyword(s):  
Cataract Surgery ◽  
Sampling Technique ◽  
Visual Outcome ◽  
Mean Value ◽  
Mean Difference ◽  
Macular Thickness ◽  
P Value ◽  
Small Incision Cataract Surgery ◽  
Group 2 ◽  
Group 1

Background: Cystoid macular edema (CME) is the formation of fluid-filled cystoid spaces between the outer plexiform and inner nuclear layers of the retina. It may present as a complication of routine cataract surgery including phacoemulsification (PHACO) and small incision cataract surgery (SICS).Methods: An observational study of uncomplicated cataract surgery with assessment by ophthalmoscopy, slit Lamp, Snellen chart and OCT during pre- and post-operative period. 100 patients were selected by inclusion criteria and using convenient sampling technique and were divided into two groups of 50 each in PHACO and SICS groups.Results: During preoperative observation in SICS/group-1, mean value and SD of macular thickness was 223.38±12.61 and in PHACO/group-2 it was 224.14±12.69. Mean value, mean difference and p value of visual acuity in group 1 was 0.258, during 12 weeks 0.788 with mean difference -0.53 and p=0.000 and in group 2 it was 0.269, during 12 weeks 0.844 with mean difference -0.58 and p=0.000. Mean value, SD, mean difference and p value of macular thickness in SICS during 1 week was 238.28±12.29, during 12 weeks 227.04±12.58 with mean difference 11.24000 and p=0.000 and in PHACO mean value, SD, mean difference with p value during 1 week was 231.90±12.42, during 12 weeks was 225.02±11.74 with mean difference 6.88000 and p=0.000.Conclusions: A subclinical increase in post-operative macular thickness was recorded which returned nearly to baseline values during the 12 weeks follow up and did not affect visual outcome.

scholarly journals Topical anesthesia versus peribulbar anesthesia in phacoemulsification cataract surgery and intraocular lens implantation

2020 ◽  
Vol 5 (2) ◽  
pp. 100-103
Author(s):  
Incaf Elboukhani ◽  
◽  
Choaib Essadouni ◽  
Adil Mchachi ◽  
Leila Benhmidoune ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cataract Surgery ◽  
Topical Anesthesia ◽  
Advantages And Disadvantages ◽  
Anesthesia Group ◽  
Duration Of Surgery ◽  
Peribulbar Anesthesia ◽  
Group 2 ◽  
Phacoemulsification Cataract Surgery ◽  
Group 1

Topical anesthesia during phacoemulsification cataract surgery has become the best choice for ophthalmologists, which broadens the indications for surgery, and eliminates the risk of peribulbar injections. The aim of our study is to assess the advantages and disadvantages, the efficacy and the tolerance of this protocol. Prospective study extending from January 2018 to December 2019, including 116 patients operated for cataracts under topical anesthesia (group 1), and 179 patients under peribulbar anesthesia (group 2). All patients were operated by phacoemulsification. The patients evaluated their pain on a visual analog scale graduated from 1 to 10. The two groups were comparable in age, gender and history of high blood pressure. All patients received premedication before surgery (Atarax). It was the first eye operated for cataracts in 79 patients in group 1 and 75 patients in group 2. The two groups did not differ significantly in systolic blood pressure rate (p= 0,36), pain score (p=0.54), duration of surgery (p=0.52), anaesthesia-related intraoperative difficulties (p=0.17), or intraoperative surgical complication rate (p=0.49) or blood oxygen saturation (p=0.74). However, in the peribulbar groups, better patient and surgeon satisfaction scores were obtained (P < .005).

scholarly journals ‘Comparison of Safety and Performance of Two Ophthalmic Viscosurgical Devices in Cataract Surgery’

2021 ◽  
Author(s):  
öznur işcan ◽  
Banu Torun Acar ◽  
Burcu Nurozler Tarakcı
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Sodium Hyaluronate ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
And Performance ◽  
Group 1

Abstract Purpose: To compare the safety and performance of two ophthalmic viscosurgical devices (OVDs) Bio-Hyalur SV (Sodium Hyaluronate 3.0%) (Biotech Healthcare Group, Luzern, Switzerland) and Protectalon (sodium hyaluronate 2.0%) (VSY Biotechnology, Turkey) in cataract surgery. Methods: One hundred twenty eyes of one hundred twenty patients who underwent phacoemulsification surgery were included in the study. Postoperatively sixty eyes using Bio-Hyalur-SV were classified as Group 1, and sixty eyes using Protectalon as Group 2. Patients aged 45 and over, Grade I, II or III unilateral / double stained cataract, healthy eyes creating cataract inclueded in this study . Endothelial cell morphological parameters including endothelial cell density (ECD), cell number, cell area, coefficient of variation (CV) in cell size, cell hexagonality and central corneal thickness (CCT) were measured preoperatively and at postoperative first week, first and third month visits.Intraocular pressure (IOP) was measured with an applanation tonometer at every visit. Results: . There was a statistically significant decrease in the mean ECD all follow-up times when compared with the preoperative visit (p=0.000). In terms of mean ECD levels there was no significant difference between the two groups within three months postoperatively (p=0.616) In the first week after surgery, there was an significant increase in CCT in Group 1 and Group 2 respectively (p=0.000). The IOP was <23 mmHg in all of the patients on the first day after surgery. There was no significant difference in the incidence of IOP peaks between the two groups in every vizits. In both groups, a significant increase was observed in the mean IOP at first day, first week, and first month after surgery compared to preoperative values (p=0.000). But no significant difference in IOP increase in Group 1 (P=0.092), Group 2 (P=0.013) compared to preoperative values ​​at third month postoperatively (p <0.001 significant with Bonferrotti correction). Conclusion: The two OVD’s used in this study during cataract surgery were safe and effective. Both OVD’s resulted in similar rates of transient IOP increases and corneal endothelial damage also provided good anterior chamber depth and were fairly easy to remove.

scholarly journals Impact of Video Describing Cataract Surgical Simulator Training on Patients' Perceptions of Resident Involvement in Cataract Surgery

2021 ◽  
Vol 13 (02) ◽  
pp. e96-e101
Author(s):  
Zachary C. Landis ◽  
John B. Fileta ◽  
Allen R. Kunselman ◽  
Joseph Sassani ◽  
Ingrid U. Scott
Keyword(s):  
Cataract Surgery ◽  
Medical Training ◽  
Resident Training ◽  
Simulator Training ◽  
Surgical Simulator ◽  
Resident Involvement ◽  
Group 2 ◽  
The Impact ◽  
Group 1 ◽  
Patient Willingness

Abstract Purpose The aim of this article is to investigate the impact of a 1-minute video describing resident training with a cataract surgical simulator on patients' perceptions regarding resident involvement in cataract surgery and to identify factors associated with patient willingness to have cataract surgery performed by a resident. Design Cross-sectional survey. Methods An anonymous Likert-style survey was conducted among 430 consecutive adult patients who presented for eye examination at the Penn State Health Eye Center. The survey included questions regarding demographics, understanding of the medical training hierarchy, and patient willingness to have a resident perform their cataract surgery. There were six questions regarding patient willingness to have residents perform their cataract surgery and the second question in this set informs the patient that residents are supervised by an experienced cataract surgeon. Patients were randomly assigned to one of two groups: patients in Group 1 completed the survey only, while patients in Group 2 watched a 1-minute video describing resident training with a cataract surgical simulator prior to completing the survey. Results Four hundred fourteen of the 430 patients (96.3%) completed the survey. Overall, 24.7% (n = 102) of respondents expressed willingness to allow an ophthalmology resident to perform their cataract surgery, and that proportion increased to 54.0% (n = 223) if the patient was informed that the resident would be supervised by an experienced cataract surgeon. Patients in Group 2 were twice as likely compared with patients in Group 1 to express willingness to allow an ophthalmology resident to perform their cataract surgery (odds ratio 1.92 [1.18–3.11], p = 0.009). Conclusions A thorough informed consent process including information regarding attending supervision and a brief video detailing resident training with a cataract surgery simulator may increase patient willingness to allow resident participation in cataract surgery.

PSVII-21 Canadian Vytelle technology for determining residual feed intake epdsin raising Qazaq Aqbas bull calves

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 447-448
Author(s):  
Dauren Matakbayev ◽  
Assel Tilepova ◽  
Anuarbek T Bissembayev
Keyword(s):  
Feed Intake ◽  
Average Daily Gain ◽  
Residual Feed Intake ◽  
Cost Effective ◽  
Effective Work ◽  
Bull Calves ◽  
Selection For ◽  
Group 2 ◽  
Daily Gain ◽  
Group 1

Abstract The Abstract reviews the experience of implementing Vytelle technology in ZhanaBereke LLP, Akmola region in Kazakhstan. The trial objects are Qazaq Aqbas bull calves: group 1 aged 10–11 months (n = 22), group 2 aged 11–12 months (n = 24). Data analysis showed that more reliable Residual Feed Intake calculated for each individual animal on the basis of their phenotypes and information on pedigree, were found in group 1. The average RFI EPD for group 1 is -0.0607, for group 2 is -0.0297. The RFI% Rank in terms of RFI EPD for both trial groups varied within 4 ... 96%. However, the average RFI% Rank was lower in the first group (45%) compared to the second group (56%). From which it follows that the RFI EPD is higher in group 1. Average Daily Gain EPDs (ADG EPD) higher in group 1 -0.0018. A higher ADG EPDs indicate a more cost-effective metric. The ADG% Rank in terms of ADG EPD for group 1 varied within 1 ... 62%, for group 2: 1 ... 63%. The average ADG% Rank was slightly lower in the first group (30%) compared to the second group (33%). From the presented data, it follows that the breeding valueaccording to the ADG EPD is higher in group 1. The average Dry Matter Intake by animals per day during the trial (DMI EPD) is equal to -0,0600 in the first group, and -0,0292 in the second group. The DMI% RANK in terms of DMI EPD for group 1 varied within 31 ... 93%, for group 2: 38 ... 96%. The DMI% RANK was lower in the first group (60%) compared to the second group (67%). Summarizing the above, we can conclude that selection for this characteristic is less effective, work will continue to increase this indicator.

Femtosecond laser-assisted cataract surgery with RayOne trifocal lenses implantation

2021 ◽  
pp. 25-29
Author(s):  
M.M. Bikbov ◽  
◽  
O.I. Orenburkina ◽  
A.E. Babushkin ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Subjective Assessment ◽  
Lighting Conditions ◽  
Trifocal Iol ◽  
Group 2 ◽  
Bifocal Lenses ◽  
Group 1

Purpose. To study the results of femtosecond laser-assisted cataract surgery (FLACS) using RayOne diffractive trifocal IOLs in comparison with bifocal lenses. Material and methods. The patients were divided into 2 groups: the first group included 32 patients (46 eyes) who were implanted with a bifocal refractive IOL M-flex 630 F with +3 dptr addidation during FPCS. The second group consisted of 34 people (49 eyes) with implanted RayOne trifocal IOL. The surgical treatment was evaluated by determining uncorrected visual acuity (UCVA) in the distance, at close (30-45 cm) and medium distance (50-70 cm) at discharge, 1 month and six months after the operation in photopic and mesopic lighting conditions, with the study of postoperative refractometry data, the construction of a defocusing curve, and subjective assessment of patient satisfaction. Results. A month after tthe operation the postoperative spheroequivalent in the range of ±0.5 D was achieved in group 1 in 82.6% of cases and in group 2-in 91.8. Six months after surgery near visual acuity without correction in photopic and mesopic light conditions was on average 0.61±0.08, while in patients of group 2, the average values were recorded at 0.64±0.09 and 0.62±0.07, respectively. By this time, the patients of group 1 had significantly lower rates of UCVA at long and medium distances: 0.81±0.08 in photopic lighting conditions and 0.79±0.08 in mesopic conditions, and group 2 0.41±0.08 and 0.40±0.10, respectively. Conclusion. Patients who underwent FLACS with an implanted RayOne trifocal IOL, compared with patients with bifocal IOLs, had higher rates of subjective satisfaction with the results of surgical treatment and UCVA at various distances (including greater comfort with actions performed at close and medium distances) at different light levels. Key words: multifocal IOLs, femtosecond laser-assisted cataract surgery, RayOne Trifocal.

scholarly journals A Comparison of Endothelial Cell Loss in Combined Cataract and MIGS (Hydrus) Procedure to Phacoemulsification Alone: 6-Month Results

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Antonio M. Fea ◽  
Giulia Consolandi ◽  
Giulia Pignata ◽  
Paola Maria Loredana Cannizzo ◽  
Carlo Lavia ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Age Related ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Purpose. To compare the corneal endothelial cell loss after phacoemulsification, alone or combined with microinvasive glaucoma surgery (MIGS), in nonglaucomatous versus primary open angle glaucoma (POAG) eyes affected by age-related cataract.Methods. 62 eyes of 62 patients were divided into group 1 (n=25, affected by age-related cataract) and group 2 (n=37, affected by age-related cataract and POAG). All patients underwent cataract surgery. Group 2 was divided into subgroups A (n=19, cataract surgery alone) and B (n=18, cataract surgery and MIGS). Prior to and 6 months after surgery the patients’ endothelium was studied. Main outcomes were CD (cell density), SD (standard deviation), CV (coefficient of variation), and 6A (hexagonality coefficient) variations after surgeries.Results. There were no significant differences among the groups concerning preoperative endothelial parameters. The differences in CD before and after surgery were significant in all groups: 9.1% in group 1, 17.24% in group 2A, and 11.71% in group 2B. All endothelial parameters did not significantly change after surgery.Conclusions. Phacoemulsification determined a loss of endothelial cells in all groups. After surgery the change in endothelial parameters after MIGS was comparable to the ones of patients who underwent cataract surgery alone.

scholarly journals Cognitive training for robotic surgery: a chance to optimize surgical training? A pilot study

2020 ◽  
Author(s):  
Sandra Schönburg ◽  
Petra Anheuser ◽  
Jennifer Kranz ◽  
Paolo Fornara ◽  
Viktor Oubaid
Keyword(s):  
Pilot Study ◽  
Cognitive Training ◽  
Training Session ◽  
Cost Effective ◽  
Control Group ◽  
Training Simulator ◽  
Neo Personality Inventory ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

AbstractThe rapid rise of robotic-assisted surgery (RAS) has necessitated an efficient and standardized training curriculum. Cognitive training (CT) can significantly improve skills, such as attention, working memory and problem solving, and can enhance surgical capacity and support RAS training. This pilot study was carried out between 02/2019 and 04/2019. The participants included 33 student volunteers, randomized into 3 groups: group 1 received training using the da Vinci training simulator, group 2 received computer-based cognitive training, and group 3 was the control group without training. Before (T1) and after-training (T2), performance was measured. Additionally, expert ratings and self-evaluations were collected. Subjective evaluations of performance were supplemented by evaluations based on three scales from the revised NEO Personality Inventory (NEO PI-R). In total, 25 probands remained with complete data for further analyses: n = 8 (group 1), n = 7 (group 2) and n = 10 (group 3). There were no significant differences in T1 and T2 among all three groups. The average training gain of group 1 and 2 was 15.87% and 24.6%, respectively, (a restricting condition is the loss of the last training session in group 2). Analyses of semi-structured psychological interviews (SPIs) revealed no significant differences for T1, but in T2, significance occurred at ‘self-reflection’ for group 2 (F(2.22) = 8.56; p < .005). The efficacy of CT in training highly complex and difficult procedures, such as RAS, is a proven and accepted fact. Further investigation involving higher numbers of training trials (while also being cost effective) should be performed.

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