Healthcare disparities contribute to missed follow-up visits after cataract surgery in the USA: results from the perioperative care for intraocular lens study

ObjectiveTo identify factors that contribute to missed cataract surgery follow-up visits, with an emphasis on socioeconomic and demographic factors.MethodsIn this retrospective cohort study, patients who underwent cataract extraction by phacoemulsification at Massachusetts Eye and Ear between 1 January and 31 December 2014 were reviewed. Second eye cases, remote and international patients, patients with foreign insurance and combined cataract cases were excluded.ResultsA total of 1931 cases were reviewed and 1089 cases, corresponding to 3267 scheduled postoperative visits, were included. Of these visits, 157 (4.8%) were missed. Three (0.3%) postoperative day 1, 40 (3.7%) postoperative week 1 and 114 (10.5%) postoperative month 1 visits were missed. Age<30 years (adjusted OR (aOR)=8.2, 95% CI 1.9 to 35.2) and ≥90 years (aOR=5.7, 95% CI 2.0 to 15.6) compared with patients aged 70–79 years, estimated travel time of >2 hours (aOR=3.2, 95% CI 1.4 to 7.4), smokers (aOR=2.7, 95% CI 1.6 to 4.8) and complications identified up to the postoperative visit (aOR=1.4, 95% CI 1.0 to 2.1) predicted a higher rate of missed visits. Ocular comorbidities (aOR=0.7, 95% CI 0.5 to 1.0) and previous visit best-corrected visual acuity (BCVA) of 20/50–20/80 (aOR=0.4, 95% CI 0.3 to 0.7) and 20/90–20/200 (aOR=0.4, 95% CI 0.2 to 0.9), compared with BCVA at the previous visit of 20/40 or better, predicted a lower rate of missed visits. Gender, race/ethnicity, language, education, income, insurance, alcohol use and season of the year were not associated with missed visits.ConclusionsMedical factors and demographic characteristics, including patient age and distance from the hospital, are associated with missed follow-up visits in cataract surgery. Additional studies are needed to identify disparities in cataract postoperative care that are population-specific. This information can contribute to the implementation of policies and interventions for addressing them.

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Cataract Surgery and Uveitis

Annals of King Edward Medical University ◽

10.21649/akemu.v9i3.1332 ◽

2016 ◽

Vol 9 (3) ◽

Author(s):

Mumtaz Hussain ◽

Muhammad Moin ◽

Nazir Ahmad Aasi ◽

Muhammad Waqas ◽

Jawaid Mughal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

General Hospital ◽

Cataract Extraction ◽

Extracapsular Cataract Extraction ◽

Iol Implantation ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

The study of 30 patients was performed at Lahore General Hospital, and Institute Of Ophthalmology Mayo Hospital, Lahore from June 1989 to June 2003 for 14 years. Total number of eyes were 34 where 2 patients had both eyes. Age ranged from 12-65 years. Males were 11 and females were 19. all the patients had planned extracapsular cataract extraction with IOL implantation. Total follow up period ranged from 1-5 years and best corrected visual acuity in these patients after surgery was 6/12 to 6/6. Post operatively, eyes had vitreous membranes and glaucomatous reaction.

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Evolution of cataract surgery: Smaller incision - less complications

Vojnosanitetski pregled ◽

10.2298/vsp1205385d ◽

2012 ◽

Vol 69 (5) ◽

pp. 385-388 ◽

Cited By ~ 3

Author(s):

Vladimir Draganic ◽

Miroslav Vukosavljevic ◽

Milorad Milivojevic ◽

Mirko Resan ◽

Nenad Petrovic

Keyword(s):

Cataract Surgery ◽

Surgical Techniques ◽

Visual Outcome ◽

Cataract Extraction ◽

Extracapsular Cataract Extraction ◽

Corneal Incision ◽

Visual Rehabilitation ◽

Operative Trauma ◽

Iol Implantation

Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ? 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

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Acute Transient Macular Edema after Uneventful Cataract Surgery

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-3-442-450 ◽

2021 ◽

Vol 18 (3) ◽

pp. 442-450

Author(s):

J. S. Beisekeeva ◽

A. V. Bezrukov ◽

S. A. Kochergin ◽

A. I. Samoylenko

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Clinical Case ◽

Systemic Disease ◽

Biomechanical Properties ◽

Depth Study ◽

The Right ◽

Previous Visit ◽

Posterior Keratoconus

Purpose: to provide a clinical case of recurrent keratoconus from our practice.Materials and method. A patient came to the clinic with a complaint of decreased visual acuity in the right eye. A series of standard instrumental examinations and Scheimpflug keratotopography were performed, and astigmatism of the right eye was diagnosed. Similar examinations were carried out during the patient’s attendance at follow-up examinations.Results. Based on the results of scanning Scheimpflug keratotopography, the diagnosis of keratoconus (forme fruste) was made. On examination after 1 year, there were no complaints of decreased visual acuity and data from the same instrumental examinations indicating keratoconus. After this examination, the patient came 3.5 years later with complaints of a new decreased visual acuity in the right eye. During instrumental examinations and keratopography, data were obtained indicating the presence of posterior keratoconus. After 1 year, a follow-up examination took place without complaints. The data of instrumental studies are identical to the previous visit; keratotopography revealed a decrease in posterior elevation.Discussions and conclusion. It was revealed that the patient was constantly taking the hydroxyurea drug against the background of systemic disease up to the 3rd visit, at the time of the 4th visit she had not taken it for 1 year. There are publications in the literature on the effect of this type of drugs on the collagen of the dermis of the skin, the type of which corresponds to the collagen of the cornea. We hypothesize that drugs may have an effect on the biomechanical properties of the cornea, which requires further in-depth study.

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Femto-assisted versus conventional phacoemulsification differently impact on choroid structure after surgery

European Journal of Ophthalmology ◽

10.1177/11206721211048360 ◽

2021 ◽

pp. 112067212110483

Author(s):

Romolo Appolloni ◽

Pasquale Viggiano ◽

Maria Luisa Carrella ◽

Federica Evangelista ◽

Alessandro Appolloni ◽

...

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Outcome Measures ◽

Choroidal Thickness ◽

Retinal Thickness ◽

Cataract Extraction ◽

Spectral Domain Oct ◽

Significant Difference ◽

Oct Imaging

Purpose: To report potential choroidal changes in eyes undergoing femtosecond laser cataract surgery (FLACS) and phacoemulsification surgery (PCS) by OCT. Methods: The patients were images by means Spectral Domain OCT imaging with EDI technology which may obtain OCT image. We exported a single EDI-OCT scan passing through the fovea and then it was imported into ImageJ program to perform a quantitative analysis. Main outcome measures: The main outcome measures were: (i) sub foveal choroidal thickness (SFCT); (ii) the choroidal vascularity index (CVI); and (iii) central retinal thickness (CRT). Results: At postoperative 1 week, FLACS group showed an increased CRT (241.2 ± 31.6–245.5 ± 36.4 µm; p = 0.016). Likewise, CVI and SFCT exhibited a slight increase but no statistically differences were highlighted ( p > 0.05). At the follow-up visit of 1 month, all OCT parameters did not display any significant difference ( p > 0.05). At post-operative 1 week, the PCS group displayed a significant increase in CRT, SFCT, and CVI. On the contrary, at the follow-up visit of 1-month, all choroidal parameters were characterized by a no statistically significant reduction ( p > 0.05). Conclusions: Our study exhibited a significant increase in CT and CVI in eyes that underwent conventional cataract surgery. Femtosecond laser-assisted cataract extraction did not result in macular change due to less postoperative inflammation.

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VISUAL OUTCOMES OF SAME DAY VERSUS DELAYED PARS PLANA VITRECTOMY FOR DROPPED NUCLEUS DURING CATARACT EXTRACTION

10.36106/ijsr/8014747 ◽

2021 ◽

pp. 9-11

Author(s):

Haniyaa Mufti ◽

Syed Tariq Qureshi ◽

Tufela Shaf

Keyword(s):

Cataract Surgery ◽

Pars Plana Vitrectomy ◽

Prospective Observational Study ◽

Visual Outcome ◽

Cataract Extraction ◽

Time Duration ◽

Ocular Coherence Tomography ◽

Iop Measurement ◽

Pars Plana

Purpose: To compare the visual outcome in patients of nucleus drop undergoing same day pars plana vitrectomy (PPV) versus delayed PPV. Methods: A prospective observational study was conducted on 50 eyes with posteriorly dislocated nucleus after cataract surgery who underwent PPV. Study variables included the time duration between nucleus drop and PPV, nal best-corrected visual acuity(BCVA), and complications after PPV. In 7(14%) eyes, PPV was performed on the same day of cataract surgery and in 43(86%) eyes, an elective PPV was performed after 1 week of cataract surgery. All our cases had intraocular lens(IOL) implanted at the end of PPV. Patients were followed up for 6 months with BCVA, intraocular pressure (IOP) measurement, indirect ophthalmoscopy and ocular coherence tomography(OCT).Results: Comparison was made between VA in patients who underwent PPV on same day (n=7) and those who underwent delayed PPV (n=43). In the same day group, 85.71% patients had BCVA ranged between 6/6 to 6/18, while only 14.29% had BCVA between 6/18 to 6/60 at the nal follow up. In the delayed PPV group , 60.47% had BCVA range between 6/6 to 6/18, 27.90% had BCVA ranged between 6/18 to 6/60 and only 11.63% patients had BCVA of <6/60- hand movements (HM) . Pvalue was 0.398 which was not statistically signicant.Conclusion: Majority of the patients obtain good VAafter PPVfor nucleus drop irrespective of the time. The visual outcome in both the groups was comparable, but slightly better results were obtained in the same day PPVgroup.

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Mobile femtosecond laser platform for pediatric cataract surgery

European Journal of Ophthalmology ◽

10.5301/ejo.5001055 ◽

2017 ◽

Vol 28 (2) ◽

pp. 246-250 ◽

Cited By ~ 4

Author(s):

Simon S.M. Fung ◽

John Brookes ◽

Mark R. Wilkins ◽

Gillian G.W. Adams

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Intraoperative Complications ◽

Cataract Extraction ◽

Pediatric Cataract ◽

Corrected Visual Acuity ◽

Pediatric Cataract Surgery ◽

Anterior Capsulotomy ◽

Paediatric Cataract

Purpose: To describe the use of a mobile femtosecond laser platform in assisting paediatric cataract surgery. Methods: A mobile femtosecond laser was brought into the operating room and calibrated on the day of the surgery. After general anesthesia is induced, the femtosecond laser was docked onto the eyes with a liquid-filled interface, without any perioperative adaptations or additional surgical procedures. An anterior capsulotomy was created with the femtosecond laser, followed by conventional cataract extraction and intraocular lens implantation. Results: Five eyes of 3 children with congenital cataracts were treated with this technique. Docking and capsulorhexis were successful in all cases. No perioperative or intraoperative complications were noted in any of the cases. At median follow-up of 15 months (range 6-18 months), all patients had improved best-corrected visual acuity. Conclusions: Using the mobile femtosecond laser platform, a perfectly sized anterior capsulotomy could be created with high precision and accuracy in paediatric cataract cases, while ensuring that perioperative care for the children undergoing the procedure was not compromised.

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Effect of Timing of Initial Cataract Surgery, Compliance to Amblyopia Therapy on Outcomes of Secondary Intraocular Lens Implantation in Chinese Children: A Retrospective Case Series

Journal of Ophthalmology ◽

10.1155/2018/2909024 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Liuyang Li ◽

Yan Wang ◽

Caihong Xue

Keyword(s):

Cataract Surgery ◽

Congenital Cataract ◽

Visual Outcome ◽

Cataract Extraction ◽

Extraction Time ◽

Good Compliance ◽

Iol Implantation ◽

Secondary Iol Implantation ◽

Congenital Cataract Surgery

Purpose. As a secondary analysis, we reassess the association of initial congenital cataract surgery times, compliance to amblyopia therapy, and visual outcomes for a long-term follow-up in a secondary IOL implantation. Methods. Retrospective review of records of all infants with congenital cataracts who underwent secondary IOL implantation in the Eye and ENT Hospital of Fudan University from January 1, 2001, to December 31, 2007, and the minimum follow-up period was 5 years. Multiple regression analysis was used and the possible confounding factors were also analyzed to assess the effect on visual outcome. Results. A total of 110 patients (male: 59.1%) were included. The median (min–max) age at cataract extraction and IOL implantation was 7.5 (3.0–15.0) and 35.0 (22.0–184.0) months, respectively, and the average follow-up period was 99.3 ± 23.6 months. The median (min–max) BCVA at final follow-up was 0.20 (0.01–1.00). Compliance to amblyopia therapy was none, poor, and good in 21.8%, 24.5%, and 53.6%, respectively. Postoperative BCVA [logMAR, median (min–max) 0.70 (0.00–2.00)] linearly decreased with increasing cataract extraction time (per month) (β=0.04, 95% CI: 0.03–0.06, p<0.0001) in multivariable models with laterality and compliance to amblyopia therapy adjusted. Good compliance to amblyopia therapy was associated with better BCVA (logMAR) at last follow-up (β=−0.40, 95% CI = −0.53 to −0.27, p<0.0001) with laterality, opacity type, and extraction time adjusted. Conclusions. For Chinese infants with congenital cataract, an earlier primary congenital cataract surgery at an age of 3 to 15 months is associated with a better visual outcome. Good compliance to amblyopia therapy was also significant to visual outcome.

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Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case—control Study

Current Journal of Glaucoma Practice with DVD ◽

10.5005/jp-journals-10028-1234 ◽

2017 ◽

Vol 11 (3) ◽

pp. 107-112 ◽

Cited By ~ 1

Author(s):

Georgios Bontzos ◽

Michail Agiorgiotakis ◽

Efstathios T Detorakis

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Case Control Study ◽

Cataract Extraction ◽

Control Group ◽

Pressure Lowering ◽

Long Term Follow Up ◽

Control Study

ABSTRACT Aim In this study, we reviewed demographics and biometric characteristics among patients receiving chronic β-blockers and prostaglandins (PGs) for primary open-angle glaucoma. We compared the age at the time of cataract surgery in different patient groups and in a control group which was not under any medication. Materials and methods Retrospective chart review of glaucomatous patients who underwent cataract extraction at the Department of Ophthalmology of the University Hospital of Heraklion, Crete, Greece, between January 1998 and December 2016 was done. Age at cataract surgery, axial length (AL), and preoperative and postoperative best-corrected visual acuities (BCVAs) were recorded. A cohort of patients without glaucoma who were operated for cataract extraction was also evaluated. Results In all, 320 patients were reviewed. There were significant results in mean age difference between the beta-antagonist and the PG group [3.05 years, 95% confidence interval (CI) 1.54-4.57] and between the beta-antagonist group with the patients receiving a combined therapy (3.02 years, 95% CI 1.14-4.91). No significant difference was found between the PG and the combination group. All the three treated groups had a significant lower mean age than the control group at the time of cataract surgery. Conclusion Based on our study, we concluded that there might be a possible association between chronic treatment with beta-antagonist agents and earlier cataract surgical time in the treated eye. Clinical significance Intraocular pressure control is often usually achieved using ophthalmic agents. Their topical and systemic effects should be monitored precisely. Earlier cataract formation might be an important side effect which the physician has to keep in mind before choosing the suitable medication. How to cite this article Bontzos G, Agiorgiotakis M, Detorakis ET. Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case—control Study. J Curr Glaucoma Pract 2017;11(3):107-112.

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Safety and efficacy of microinvasive glaucoma surgery with cataract extraction in patients with normal-tension glaucoma

Scientific Reports ◽

10.1038/s41598-021-88358-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Enchi Kristina Chang ◽

Sanchay Gupta ◽

Marika Chachanidze ◽

Nathan Hall ◽

Ta Chen Chang ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Success Probability ◽

Cataract Extraction ◽

Glaucoma Surgery ◽

Normal Tension Glaucoma ◽

Mechanisms Of Action ◽

Safety And Efficacy

AbstractThis study assesses the safety and efficacy of microinvasive glaucoma surgery (MIGS) with cataract extraction in patients with normal-tension glaucoma (NTG). In our sample of 45 NTG patients, mean intraocular pressure (IOP) decreased from 13.7 to 12.3 mmHg at 2.5 years, and mean medication burden decreased from 2.0 to 1.1 at 1.5 years. For success defined as IOP reduction ≥ 30% from baseline IOP with medication burden reduction from preoperative levels, success probability was 5.4% at 1.5 years. For success defined as medication burden reduction with an IOP reaching goal IOP as determined by the glaucoma specialist, success probabilities were 67.2% at 1.5 years and 29.4% at 2.5 years. At the last follow-up visit, eyes with two MIGS procedures with different mechanisms of action achieved successful medication reduction 68.8% of the time versus 35.7% achieved by a single MIGS procedure (p = 0.052). At their last visit, visual acuity was unchanged or improved in all eyes (100%). MIGS with cataract surgery results in modest reductions in IOP and medication burden in NTG patients, which may lead to lower costs and better therapeutic compliance. A combination of two MIGS procedures with different mechanisms of action may potentially be more effective in reducing medication burden than a single MIGS procedure in NTG patients. Further research is necessary to ascertain whether MIGS for NTG patients may help decrease medication burden while helping achieve goal IOP.

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The Language of New Terrorism: Differences in Psychological Dimensions of Communication in Dabiq and Inspire

10.31234/osf.io/xg4f3 ◽

2017 ◽

Author(s):

Matteo Vergani ◽

Ana-Maria Bliuc

Keyword(s):

Experimental Study ◽

English Language ◽

Terrorist Attacks ◽

Al Qaeda ◽

Positive Attitudes ◽

Terrorist Groups ◽

The Usa ◽

Psychological Dimensions ◽

New Terrorism

We investigate differences in the psychological aspects underpinning Western mobilisation of two terrorist groups by analysing their English-language propaganda. Based on a computerized analysis of the language used in two English-language online magazines circulated by ISIS and al-Qaeda (i.e., Dabiq and Inspire), we found significant differences in their language - the ISIS’ language being higher in authoritarianism and its level of religiousness. In a follow-up experimental study, we found that being high in religiousness and authoritarianism predicts more positive attitudes towards the language used by ISIS, but not towards the language used by al-Qaeda. The results suggest that ISIS’ propaganda may be more effective in mobilising individuals who are more authoritarian and more focused on religion than that of al-Qaeda. These findings are consistent with the behaviour observed in recent homegrown terrorist attacks in the USA and Europe.

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