scholarly journals Visual Outcome of Cataract Surgery Complications Repair at a Cataract Training Centre of Western Central India

Author(s):  
Mehul A. Shah ◽  
Shreya M. Shah ◽  
Ashit Desai

Introduction: Cataract is a major cause of blindness, but it can be eliminated by surgical management. The visual outcome depends upon the competency of the surgeon, and quality training can contribute to the creation of such skilled surgeons. Methods: This is a retrospective study in which we enrolled all the cataract cases operated between 2004 and 2018, any complication and its repair reported in pretested online form, and all documented post-operative data. All these data were exported to excel sheet from EMR and analysed using SPSS22. Results: Our cohort involved 2998(2.49%) cases out of 120,000 total cataract operated cases. Out of complications documented for45.5% did not require surgical intervention, 30% eyes required secondary implant and remaining cases required other surgeries. Intervention medical and surgical has made significant difference in visual outcome. (p=0.002) 43.9% complications reported during stage of cortical clean up. Primary surgery and trainee categories did not cause significant differences in the visual outcome. Conclusion: Cataract surgeries done by trainee surgeons caused complications at various stages. However, interventions by vitreo-retinal surgeons led to a significant difference in the final visual outcome.

2016 ◽  
Vol 7 (2) ◽  
pp. 198-201 ◽  
Author(s):  
Chandana Chakraborti ◽  
Udayaditya Mukhopadhya ◽  
Dayal Bandhu Mazumder ◽  
Partha Tripathi ◽  
Swapan Kumar Samanta

Background: Fishing is a popular rural recreational activity. Fortunately, penetrating ocular injuries with fish hooks are rare. These injuries are usually caused by fish hook prongs penetrating the ocular tissues. We report a rare case of penetrating fish hook injury to the globe and its successful surgical management.Case: A 12- year-old female child was referred to the causality with a fish hook embedded in her right eye. She sustained the injury while fishing with her father. The fish hook had penetrated the globe obliquely. The hook was removed via its entrance wound under general anesthesia. Subsequently the child developed traumatic cataract which was operated with a final visual outcome of 6/12. Conclusion: Visual prognosis can be profoundly affected by the initial management. Prompt surgical intervention as done in our case is recommended to prevent significant visual loss. 


2020 ◽  
Vol 9 (21) ◽  
pp. 1646-1648
Author(s):  
Bharti Badlani ◽  
Dharmendra Singh Saryyam ◽  
Anil Kumar Raichoor ◽  
Manisha Bhatt Dwivedi

Author(s):  
Dhanya V. S. ◽  
Manju Abraham ◽  
Radha Nair

Background: Ocular trauma is a major cause of visual impairment throughout the world, although little is known about the factors that affect the visual outcome in traumatic cataract in developing countries. The objective of the study was to find out the associated ocular injuries and the factors affecting final visual outcome of patients with traumatic cataract.Methods: This prospective-hospital based study was conducted on 50 patients of traumatic cataract in the department of ophthalmology government medical college, Ernakulam, from January 2009 to December 2011. Patients were managed with lens extraction and intraocular lens implantation. Regular follow up of patients was done and best corrected visual acuity (BCVA) and post-operative complications were assessed at the end of six months.Results: Our study showed that majority (64%) of patients were in the age group of <40 years with male preponderance. visual outcome was significantly better in younger age group (<20 years) than the older group (>20 years) (p=0.03). There was no significant difference in final visual outcome of traumatic cataracts caused by penetrating or blunt trauma (p=0.73). Corneal tear was most common associated ocular damage followed by uveitis, lens matter in anterior chamber.Conclusions: Age of the patient affects final visual outcome after surgical treatment of traumatic cataract but type of trauma (blunt/penetrating) had no significant effect on final visual outcome. Corneal tear was most common associated ocular damage.


Author(s):  
Dr. Mita V. Joshi ◽  
Dr. Sudhir Mahashabde

All patient coming to Index Medical College Hospital & Research Centre, Indore operated in Department of Ophthalmology for traumatic cataract due to various injuries Result: Of the 37 patients, 19 patients (51%) showed corneal/ corneal sclera injury. 10 cases had injury to iris in the form of spincter tear, traumatic mydriasis, iris incarceration, floppy iris, posterior and anterior synechiae. Subluxation of lens was seen in 2 cases and Dislocation of lens was in 1 cases. 3 cases had corneal opacity. Old retinal detachment was seen in 1 (3%) case. Out of 30 cases who had associated ocular injuries, 3 cases had vision of HM, 07 cases had vision of CF-ctf – CF-3’, 01 cases had vision of 5/60, 07 cases had vision of 6/60-6/36, 03 cases had vision of 6/24-6/18, 09 cases had vision of 6/12-6/6. Out of 7 cases without associated in injury, 2 cases had vision of 6/24-6/18, 05 cases had vision of 6/12-6/6. Conclusion: Corneal scarring obstructing the visual axis as well as by inducing irregular astigmatism formed an important cause of poor visual outcome in significant number of cases. Irreversible posterior segment damage lead to impaired vision case. The final visual outcome showed good result however the final visual outcome depends upon the extent of associated ocular injuries. Effective Intervention and management are the key points in preventing monocular blindness due to traumatic cataract. Keywords: Ocular, Tissues, Traumatic, Cataract & Surgery.


2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.


2021 ◽  
pp. 219256822110308
Author(s):  
Andrew Platt ◽  
Mostafa H. El Dafrawy ◽  
Michael J. Lee ◽  
Martin H. Herman ◽  
Edwin Ramos

Study Design: Systematic review and meta-analysis. Objectives: Indications for surgical decompression of gunshot wounds to the lumbosacral spine are controversial and based on limited data. Methods: A systematic review of literature was conducted to identify studies that directly compare neurologic outcomes following operative and non-operative management of gunshot wounds to the lumbosacral spine. Studies were evaluated for degree of neurologic improvement, complications, and antibiotic usage. An odds ratio and 95% confidence interval were calculated for dichotomous outcomes which were then pooled by random-effects model meta-analysis. Results: Five studies were included that met inclusion criteria. The total rate of neurologic improvement was 72.3% following surgical intervention and 61.7% following non-operative intervention. A random-effects model meta-analysis was carried out which failed to show a statistically significant difference in the rate of neurologic improvement between surgical and non-operative intervention (OR 1.07; 95% CI 0.45, 2.53; P = 0.88). In civilian only studies, a random-effects model meta-analysis failed to show a statistically significant difference in the rate of neurologic improvement between surgical and non-operative intervention (OR 0.75; 95% CI 0.21, 2.72; P = 0.66). Meta-analysis further failed to show a statistically significant difference in the rate of neurologic improvement between patients with either complete (OR 4.13; 95% CI 0.55, 30.80; P = 0.17) or incomplete (OR 0.38; 95% CI 0.10, 1.52; P = 0.17) neurologic injuries who underwent surgical and non-operative intervention. There were no significant differences in the number of infections and other complications between patients who underwent surgical and non-operative intervention. Conclusions: There were no statistically significant differences in the rate of neurologic improvement between those who underwent surgical or non-operative intervention. Further research is necessary to determine if surgical intervention for gunshot wounds to the lumbosacral spine, including in the case of retained bullet within the spinal canal, is efficacious.


Author(s):  
Po-Kai Yang ◽  
Chien-Chou Su ◽  
Chih-Hsin Hsu

AbstractIn Taiwan, the outcomes of acute limb ischemia have yet to be investigated in a standardized manner. In this study, we compared the safety, feasibility and outcomes of acute limb ischemia after surgical embolectomy or catheter-directed therapy in Taiwan. This study used data collected from the Taiwan’s National Health Insurance Database (NHID) and Cause of Death Data between the years 2000 and 2015. The rate ratio of all-cause in-hospital mortality and risk of amputation during the same period of hospital stay were estimated using Generalized linear models (GLM). There was no significant difference in mortality risk between CDT and surgical intervention (9.5% vs. 10.68%, adjusted rate ratio (95% CI): regression 1.0 [0.79–1.27], PS matching 0.92 [0.69–1.23]). The risk of amputation was also comparable between the two groups. (13.59% vs. 14.81%, adjusted rate ratio (95% CI): regression 0.84 [0.68–1.02], PS matching 0.92 [0.72–1.17]). Age (p < 0.001) and liver disease (p = 0.01) were associated with higher mortality risks. Heart failure (p = 0.03) and chronic or end-stage renal disease (p = 0.03) were associated with higher amputation risks. Prior antithrombotic agent use (p = 0.03) was associated with a reduced risk of amputation. Both surgical intervention and CDT are effective and feasible procedures for patients with ALI in Taiwan.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Monique Chambers ◽  
MaCalus Hogan ◽  
Dukens LaBaze

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Hallux rigidus is a degenerative disease of the first metatarsophalangeal joint. Severe, end-stage hallux rigidus can become debilitating with surgical intervention becoming necessary once conservative measures and shoe modifications have failed. Joint salvage procedures include metatarsal phalangeal (MTP) arthrodesis and MTP arthroplasty. The purpose of this study was to assess for differences in patient reported outcomes in two cohorts who underwent fusion or joint reconstruction. Methods: This study was a retrospective review of prospectively collected data of 385 patients from an academic medical institution. Patients who underwent surgical intervention from July 2015 to November 2016 were identified based on CPT codes for MTP arthrodesis (28750) and arthroplasty (28293). We extracted outcome scores including SF12-M, SF12-P, FAAM, and VAS scores. Exclusion criteria included poly-trauma, revision procedures, and lack of pre and post-operative outcome scores. Mann- Whitney t-test was performed using GraphPad Prism version 7.0b for Mac to compare procedure groups, with significance define by a p-value of 0.05. Results: A total of eighteen patients met the inclusion criteria, with 6 who underwent arthroplasty and 12 arthrodesis. The average age was 63.7 amongst the cohort, with a total of 16 female and 2 males. Patients who underwent arthrodesis had better outcomes across all parameters. When comparing preoperative and postoperative scores, arthrodesis patients showed greater improvement of SF12-M (arthrodesis 9 vs arthroplasty -2, p=0.05), and SF12-P (9 vs -16, respectively p=0.05) scores. Arthroplasty patients were more likely to have a decrease in their SF-12 scores. VAS scores and FAAM scores showed no statistical difference between the two cohorts. Postoperative VAS scores were worse in 33% of arthroplasty patients despite surgical intervention, compared to 10% of arthrodesis patients. Conclusion: Our results suggests that both procedures provide a statistically significant difference in pain with several patients having a Global Rate of Change that is “very much better”. However, fusion of the metatarsophalangeal joint results in improved pain and functional outcomes for patients with severe hallux rigidus. These findings are consistent with current reports in the literature, which are mostly case series reports. Larger studies are needed to provide appropriate power and better support the findings of this study.


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