scholarly journals Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Laureano A. Rementería-Capelo ◽  
Jorge L. García-Pérez ◽  
Juan Gros-Otero ◽  
Aida Morán ◽  
José M. Sánchez-Pina ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Private Practice ◽  
Outcome Data ◽  
Practice Setting ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Preoperative Information ◽  
The Difference ◽  
One Year ◽  
Spectrum Of Patients

Introduction. Currently available outcome data for cataract surgery include mostly patients from public health systems. The purpose of this study was to report the visual and refractive outcomes of cataract procedures performed during one year in a private practice center, which may include a different spectrum of patients. Methods. Our center’s database was used to identify all isolated cataract procedures performed during 2017. The electronic records were reviewed to collect the preoperative information, presence of intra- or postsurgical complications, and visual and refractive outcomes one month after surgery. Results. In 2017, 2714 eyes of 1543 patients underwent cataract surgery in our center. Mean patient age was 70.42 years. 775 eyes (28.55%) had prior ophthalmic pathologies, and 113 eyes (4.16%) had undergone previous surgical procedures. Surgical complications developed in 35 eyes (1.29%), including 9 posterior capsule tears (0.33%) and 3 cases of dropped lens fragments (0.11%). A toric or multifocal intraocular lens was implanted in 45.6% of eyes. As regards postoperative complications, 59 eyes (2.17%) required a return to the operating theater, including 29 eyes (1.07%) requiring reinterventions due to an unexpected refractive result. There were no cases of endophthalmitis. Mean LogMAR-corrected distance visual acuity (CDVA) improved from 0.25 (SD 0.34) preoperatively to 0.04 (SD 0.17) postoperatively; 86.5% of eyes achieved a CDVA ≤0.0, with 97.5% achieving ≤0.3. In 86.4% of eyes, the difference between target and residual spherical equivalent difference was of 0.50 D or lower; 88% of eyes had a spherical equivalent ±0.50 D. Conclusions. The visual and refractive outcomes of cataract surgery in a private practice setting were excellent, well over the benchmarks set by the ESCRS. The safety profile was also within expected standards. This study provides information for ophthalmologists in private practice on expected outcomes.

scholarly journals Refractive outcomes following cataract surgery in patients who have had myopic laser vision correction

2019 ◽  
Vol 4 (1) ◽  
pp. e000242 ◽  
Author(s):  
Chung Shen Chean ◽  
Boon Kang Aw Yong ◽  
Samuel Comely ◽  
Deena Maleedy ◽  
Stephen Kaye ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Refractive Error ◽  
Control Group ◽  
Prediction Errors ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Vision Correction ◽  
Laser Vision ◽  
The Mean ◽  
The Difference

ObjectivePrediction errors are increased among patients presenting for cataract surgery post laser vision correction (LVC) as biometric relationships are altered. We investigated the prediction errors of five formulae among these patients.Methods and analysisThe intended refractive error was calculated as a sphero-cylinder and as a spherical equivalent for analysis. For determining the difference between the intended and postoperative refractive error, data were transformed into components of Long's formalism, before changing into sphero-cylinder notation. These differences in refractive errors were compared between the five formulae and to that of a control group using a Kruskal-Wallis test. An F-test was used to compare the variances of the difference distributions.Results22 eyes post LVC and 19 control eyes were included for analysis. Comparing both groups, there were significant differences in the postoperative refractive error (p=0.038). The differences between the intended and postoperative refractive error were greater in post LVC eyes than control eyes (p=0.012), irrespective of the calculation method for the intended refractive error (p<0.01). The mean difference between the intended and postoperative refractive error was relatively small, but its variance was significantly greater among post LVC eyes than control eyes (p<0.01). Among post LVC eyes, there were no significant differences between the mean intended target refraction and between the intended and postoperative refractive error using five biometry formulae (p=0.76).ConclusionBiometry calculations were less precise for patients who had LVC than patients without LVC. No particular biometry formula appears to be superior among patients post LVC.

scholarly journals Influence of anterior chamber depth on postoperative refractive outcome in Chinese eyes

2018 ◽  
Vol 16 (2) ◽  
pp. 79-85
Author(s):  
Rachel SH Wong ◽  
Keith Ong
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Demographic Variables ◽  
Refractive Outcomes ◽  
Positive Linear Correlation ◽  
The Mean ◽  
The Difference ◽  
Linear Correlations ◽  
Refractive Surprise

Aim or Purpose: This study aims to evaluate the refractive surprise (RS) after cataract surgery with various intraocular lens (IOL) formulas in eyes with very shallow or deep anterior chamber depth (ACD). Design: This is a prospective cohort study of patients from a private ophthalmology practice in Sydney. Methods: Thirty-one patients who had their cataract surgery in 2014 were included. The cohort consists of 20 eyes with ACD < 2.8 mm and 25 eyes with ACD > 3.2 mm. Patients’ demographic variables and their predicted refractive outcomes using the SRK-T, Haigis, Holladay 1, and Holladay 2 IOL formulas were collected. Actual refractive outcomes were obtained from consultations at least one-month postoperatively. RS was calculated from the difference between predicted refraction outcome of IOL formulas and the actual postoperative refraction achieved. Results: The linear correlations between ACD and RS were not significant (p > 0.05). In the group with ACD < 2.8 mm, the mean refractive surprise using SRK-T, Haigis, Holladay 1, and Holladay 2 formulas were -0.191 ± 0.541, -0.189 ± 0.444, -0.201 ± 0.449, and -0.154 ± 0.489 D, respectively. In the group with ACD > 3.2 mm, the mean refractive surprise using the IOL formulas were -1.364 ± 0.541, -1.420 ± 0.541, 0.027 ± 0.394, and -0.045 ± 0.343 D, respectively.  Conclusion: The positive linear correlation between ACD and RS was weak. In eyes with ACD < 2.8 mm, the least RS was found with the Holladay 2 formula, while in eyes with ACD > 3.2 mm, this was found with Holladay 1.

scholarly journals Comparison of 6.0 mm versus 6.5 mm Optical Zone on Visual Outcomes after LASIK

2021 ◽  
Vol 10 (17) ◽  
pp. 3776
Author(s):  
Majid Moshirfar ◽  
Rachel Huynh ◽  
Nour Bundogji ◽  
Alyson N. Tukan ◽  
Thomas M. Sant ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Laser System ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Optical Zone ◽  
The Difference

Previous studies have demonstrated safety and efficacy using 6.0 and 6.5 mm optical zones in the WaveLight EX500 Excimer Laser System but have not evaluated if differing optical zone sizes influence refractive outcomes. This study examines visual outcomes between two study populations undergoing LASIK with either a 6.0 mm (1332 patients) or 6.5 mm (1332 patients) optical zone. Outcomes were further stratified by severity of myopia (low, moderate, and high) and astigmatism (low and high). Patients were matched by age and preoperative manifest sphere and cylinder. Postoperative measurements were then compared. The 6.5 mm group demonstrated better postoperative manifest refractive spherical equivalent (MRSE), manifest sphere, and absolute value of the difference in actual and target spherical equivalent refraction (|∆ SEQ|), within the total population, moderate myopia, and low astigmatism groups, but this did not lead to improved postoperative uncorrected distance visual acuity (UDVA) or best corrected distance visual acuity (CDVA). Though astigmatic correction and postoperative angle of error were similar between optical zone sizes, they were significantly worse with high myopia. Overall, this study demonstrates differences in visual outcomes between the 6.0 and 6.5 mm optical zone sizes that may warrant consideration; however, essentially, the results are comparable between them.

scholarly journals Lenstar LS 900 versus Pentacam-AXL: analysis of refractive outcomes and predicted refraction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Henrique Aragão Arruda ◽  
Joana M. Pereira ◽  
Arminda Neves ◽  
Maria João Vieira ◽  
Joana Martins ◽  
...  
Keyword(s):  
Refractive Error ◽  
Prediction Error ◽  
Mean Absolute Error ◽  
Absolute Error ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Iol Calculation ◽  
Median Absolute Error ◽  
The Difference ◽  
Mean Prediction Error

AbstractAnalysis of refractive outcomes, using biometry data collected with a new biometer (Pentacam-AXL, OCULUS, Germany) and a reference biometer (Lenstar LS 900, HAAG-STREIT AG, Switzerland), in order to assess differences in the predicted and actual refraction using different formulas. Prospective, institutional study, in which intraocular lens (IOL) calculation was performed using the Haigis, SRK/T and Hoffer Q formulas with the two systems in patients undergoing cataract surgery between November 2016 and August 2017. Four to 6 weeks after surgery, the spherical equivalent (SE) was derived from objective refraction. Mean prediction error (PE), mean absolute error (MAE) and the median absolute error (MedAE) were calculated. The percentage of eyes within ± 0.25, ± 0.50, ± 1.00, and ± 2.00 D of MAE was determined. 104 eyes from 76 patients, 35 males (46.1%), underwent uneventful phacoemulsification with IOL implantation. Mean SE after surgery was − 0.29 ± 0.46 D. Mean prediction error (PE) using the SRK/T, Haigis and Hoffer Q formulas with the Lenstar was significantly different (p > 0.0001) from PE calculated with the Pentacam in all three formulas. Percentage of eyes within ± 0.25 D MAE were larger with the Lenstar device, using all three formulas. The difference between the actual refractive error and the predicted refractive error is consistently lower when using Lenstar. The Pentacam-AXL user should be alert to the critical necessity of constant optimization in order to obtain optimal refractive results.

scholarly journals Optimizing the intraocular lens formula constant according to intraocular lens diameter

2021 ◽  
Vol 14 (5) ◽  
pp. 700-703
Author(s):  
Abdul R El-Khayat ◽  
Keyword(s):  
Intraocular Lens ◽  
Refractive Error ◽  
District General Hospital ◽  
Spherical Equivalent ◽  
Inclusion Criteria ◽  
Refractive Outcomes ◽  
Lens Diameter ◽  
The Difference ◽  
The Uk ◽  
Different Diameters

AIM: To determine whether the different diameters of a specific intraocular lens (IOL) have significantly different optimized SRK/T A constants and whether these new A constants can improve refractive outcomes. METHODS: Data were collected prospectively from Jan. 2011 to Dec. 2012 on all patients undergoing routine cataract surgery at a district general hospital in the UK. Patients were divided into three groups according to the size of the Akreos AO MI60 IOL used. A constants for the SRK/T formula were optimized according to the size of the IOL. These optimized A constants were then used to select future refractive outcomes. RESULTS: A total of 2398 cataract operations were performed during the study period of which 1131 met the inclusion criteria. The three optimized A constants for the different sized IOLs were 118.98, 119.13, 119.32. The difference between them was highly significant (P≤0.0001). Two optimized A constants for three sizes of IOL led to an improvement in refractive outcomes (from 93.4% to 94.6% of refractive outcomes within 1.00 D of predicted spherical equivalent). The optimized A constant for the largest IOL was based on a small number of cases and was not used. CONCLUSION: Optimizing the A constant for the three distinct sizes of the Bausch &#x0026; Lomb Akreos MI60 lens lead to three significantly different A constants. In our practice, using two different optimized A constants for three different sized IOLs give the least refractive error, however, using three optimized A constants may give better results with a larger dataset.

Outcomes in Hepatocellular Carcinoma Liver Transplantation before and after the Mandated Six-Month Wait Time

2019 ◽  
Vol 85 (8) ◽  
pp. 900-903
Author(s):  
Venkat Sumanth Potluri ◽  
Julio Sokolich ◽  
Jacentha Buggs ◽  
William Mcclellan ◽  
Ebonie Rogers ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Resource Utilization ◽  
Wait Time ◽  
Outcome Data ◽  
Continuous Variables ◽  
Before And After ◽  
The Difference ◽  
One Year ◽  
United Network

The United Network for Organ Sharing (UNOS) implemented a policy that requires patients with hepatocellular carcinoma seeking liver transplantation to wait six months before being granted Model for End-Stage Liver Disease exception points. We investigated the difference in resource utilization between patients who underwent liver transplantation before and after the present policy. We conducted a retrospective cohort study of adult liver transplants from 2013 to 2018. Patients were classified into prepolicy or postpolicy groups based on 964 days before or after the wait-time policy. We also retrieved national survival outcome data from United Network for Organ Sharing. Differences across compared groups for continuous variables were assessed using the independent sample t test, and the chi-squared test was used for binary variables. We found statistical differences in recipient age ( P = 0.005), days on wait-list ( P = 0.001), sustained viro-logical response ( P < 0.001), and hepatocellular carcinoma recurrence one year posttransplant ( P = 0.04). There were statistically significant differences in the number of treatment days pretransplant and length of transplant admission stay, indicating an increase in resource utilization in the postpolicy group. No statistically significant differences were found between groups in one-year graft or patient survival despite an observed increase in resource utilization by the hepatocellular carcinoma postpolicy group.

scholarly journals Consequences of Mismatch, Misalignment, and Rotation of Toric Intraocular Lenses in Refractive Cataract Surgery Part 2. Avoiding Flip Flops

2020 ◽  
Author(s):  
Samir I Sayegh
Keyword(s):  
Cataract Surgery ◽  
Private Practice ◽  
Analytical Study ◽  
Intraocular Lenses ◽  
Percent Reduction ◽  
Toric Intraocular Lens ◽  
Optimal Method ◽  
The Difference ◽  
Selection Of ◽  
The Ideal

Purpose: To show current approaches for overcorrecting astigmatism and "flipping" its axis need be reconsidered in light of methods we introduce that take into account both mismatch and misalignment of the toric intraocular lens (tIOL) with respect to the astigmatism to be corrected at the time of cataract surgery. Setting: Private Practice and Research Center. The EYE Center. Champaign, IL, USA. Design: Formal Analytical Study Methods: In the most common surgical situation where both mismatch and misalignment exist, we present an analysis of the point at which overcorrection and undercorrection residuals coincide, yielding a simple but powerful methodology to predict the optimal degree of overcorrection with a tIOL. The method is illustrated for tIOLs used in surgical practice. Results : The minimum astigmatism appropriate to overcorrect with a tIOL is given by, A_min= m/cos⁡2χ , where m is the midpoint threshold used by "split-the-difference" algorithms and χ is the estimate of tIOL misalignment due to all causes. Correspondingly, the maximum overcorrection, Ω_max, that should be attempted is Ω_max= α/2 [1-γ(2 n-1)] ) where α=σ/τ is the dioptric step at the corneal plane, with σ = H - B, where H = n σ is the cylinder of the overcorrecting tIOL and B = (n - 1)σ is the cylinder of the undercorrecting tIOL, both at the IOL plane, τ is the toricity ratio and γ relates to the angle of misalignment χ by γ = 1/cos⁡2χ - 1 which can be approximated by γ ≈ (χ_deg/40)^2. Ω_max factors elegantly in the product of α/2, the (ideal) midpoint correction for perfect alignment, by the bracketed term, representing the percent reduction of the ideal value in a realistic surgical situation with estimated misalignment χ. To illustrate: an eye of average dimensions (τ ~ 3/2) and tIOLs from major manufacturers (σ = 3/4), with A = 2.35 D dictating n = 5. For a misalignment of 10 degrees Ω_max ≅ 0.10 D is the maximum overcorrection that should be accepted, significantly smaller than the midpoint α/2 = σ/2τ = 0.25 D, recommended by many current tIOL calculators. Conclusion: An optimal method is presented for the selection of an overcorrecting tIOL at the time of refractive cataract surgery with improvement over current tIOL calculators' methods.

Outcomes of refractive error correction in pseudophakic patients using a sulcus piggyback intraocular lens

2020 ◽  
pp. 112067212090356
Author(s):  
Eliya Levinger ◽  
Michael Mimouni ◽  
Yaron Finkelman ◽  
Yossi Yatziv ◽  
Jonathan Shahar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity

Purpose: The purpose of this study was to assess the results of a sulcus intraocular lens (Sulcoflex) for pseudophakic refractive errors following phacoemulsification cataract surgery. Methods: This retrospective clinical observational cohort study included consecutive eyes in which a Sulcoflex was implanted. Uncorrected distance visual acuity and corrected distance visual acuity as well as refractive outcomes were assessed. The minimum follow-up time required for inclusion was 3 months. Results: In total, 15 eyes ( n = 15) were evaluated. The mean follow-up was 14 months (range: 3–18 months). The Sulcoflex aspheric (653L) was implanted in 13 eyes and the Sulcoflex toric (653T) in two eyes. The preoperative mean logMAR (Snellen) uncorrected distance visual acuity and corrected distance visual acuity were 0.88 (20/150) and 0.27 (20/40), respectively. The postoperative mean logMAR (Snellen) corrected distance visual acuity was 0.15 (20/30). The preoperative mean spherical equivalent was −0.22 ± 5.95 D and the postoperative mean spherical equivalent was −1.59 ± 1.45 D. There was a significant and strong correlation ( r = 0.64, p < 0.001) between the attempted and the achieved spherical equivalent. Conclusion: The Sulcoflex is a safe and viable option for patients with residual refractive error following cataract surgery.

Refractive predictability and visual outcomes of an extended range of vision intraocular lens in eyes with previous myopic laser in situ keratomileusis

2018 ◽  
Vol 29 (6) ◽  
pp. 593-599 ◽  
Author(s):  
Carlos Palomino-Bautista ◽  
David Carmona-González ◽  
Rubén Sánchez-Jean ◽  
Alfredo Castillo-Gómez ◽  
Marta Romero-Domínguez ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Laser In Situ Keratomileusis ◽  
Spherical Equivalent ◽  
Average Value ◽  
Refractive Outcomes ◽  
Intraocular Lens Power ◽  
Extended Range ◽  
Lens Power

Purpose: To evaluate the refractive predictability obtained with an extended range of vision intraocular lens in eyes with previous myopic laser in situ keratomileusis, confirming which intraocular lens power formula provides the most accurate calculation. Methods: The study enrolled 71 eyes with previous successful myopic laser in situ keratomileusis surgery of 43 patients undergoing cataract surgery with implantation of the extended range of vision intraocular lens TECNIS Symfony (Johnson and Johnson Vision). Intraocular lens power was calculated using all American Society of Cataract and Refractive Surgeons formulas, and their average value was selected for implantation. Refractive outcomes were evaluated at 3 months postoperatively. Results: Postoperative spherical equivalent within ±0.50 and ±1.00 D was found in 61.6% and 86.3% of eyes, respectively. In eyes with pre-laser in situ keratomileusis data available, no significant correlation was found between pre-laser in situ keratomileusis spherical equivalent and post-cataract surgery spherical equivalent (r = 0.237, p = 0.114). A postoperative spherical equivalent within ±0.50 D was found in 65.2% and 55.6% of eyes in the subgroups with and without pre-laser in situ keratomileusis data available, respectively (p = 0.480). Statistically significantly higher differences between the intraocular lens power implanted and the calculation provided by the Potvin–Hill (p = 0.028) and Barrett True K No History formulas (p = 0.022) were found in those eyes with postoperative spherical equivalent > 0.50 D. Conclusion: The extended range of vision intraocular lens evaluated can provide a predictable refractive correction in eyes with previous laser in situ keratomileusis surgery. The Potvin–Hill and Barrett True K No History are the most adequate formulas to perform intraocular lens power calculations in these cases.

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