Outcomes Of Cataract Surgery In Patients Research Articles

Cataract Surgery Outcomes in Patients with Non-ocular Autoimmune Disease.

While phacoemulsification cataract extraction is generally highly effective and safe, patients with a history of uveitis are at higher risk for postoperative complications and often require a modified perioperative medication regimen. No data exists on risks of postoperative complications and persistent anterior uveitis (PAU) in patients with non-ocular autoimmune disease. Medical records were reviewed of patients who underwent phacoemulsification cataract surgery with intraocular lens implantation between January1, 2014 and December31, 2019 at the University of Colorado Hospital (UCH) as part of a retrospective cohort study. Exclusion criteria included patient history of ocular inflammation and cataract surgery combined with another intraocular surgery. Patients were only included as having autoimmune disease if the diagnosis was confirmed by a relevant specialist at UCH. Patients with autoimmune disease were then stratified into systemic versus organ-specific autoimmune disease, and patients with systemic autoimmune disease were further stratified into immunosuppressed and not immunosuppressed at the time of cataract surgery. Patients with PAU were identified according to the Standardization of Uveitis Nomenclature Working Group. Data including sex, race/ethnicity, intraoperative cumulative dissipated energy (CDE), and postoperative best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were obtained. A total of 422 eyes from 248 patients had confirmed autoimmune disease, compared to a control group of 10,201 eyes. The autoimmune and systemic autoimmune disease groups were not more likely to have postoperative complications or PAU compared to the control group. Immunosuppression status among the systemic autoimmune disease group was also not associated with postoperative complications or PAU. Patients with non-ocular autoimmune disease do not appear to be at higher risk for postoperative complications, including worse BCVA or increased rates of IOP elevation and PAU, following phacoemulsification cataract surgery. These patients do not appear to require modification of the typical perioperative medication regimen.

Comparison of Cataract Surgery Outcomes in Patients with Type 1 versus Type 2 Diabetes and Patients without Diabetes.

To report outcomes of cataract surgery in type 1 diabetes (T1DM) compared to type 2 diabetes (T2DM) and patients without diabetes (DM). Academic tertiary referral university hospital eye center, Aurora, CO, USA. Retrospective chart review using the University of Colorado Cataract Outcomes Database for all cataract surgeries between 2014-2020. Demographics, ocular history, and postoperative outcomes were compared across groups using general linear and logistic regression modeling with estimating equations to account for some patients having two eyes included. A total of 8117 patients and 13,383 eyes were included. Compared to T2DM eyes undergoing cataract surgery (n=3115), T1DM eyes (n=233) were more likely to have a history of diabetic retinopathy (DR) (60.5% vs 23.6%), p<0.0001), of which proliferative DR was the most common (63.1% vs 42.4%, p<0.0001). T1DM eyes were also more likely to have a history of retinal detachment (RD) (9.0% vs 2.9%, p<0.0001) and prior vitrectomy surgery (12.9% vs 4.0%, p<0.0001). Despite having similar preoperative best-corrected visual acuity (BCVA) as T2DM eyes (logMAR 0.52 vs. 0.44, p=0.092), T1DM eyes had worse BCVA following cataract surgery (logMAR 0.27 vs 0.15, p=0.0003). In a multivariable analysis, a history of proliferative DR and prior RD were significant predictors of worse postoperative BCVA (p<0.0001) but type of DM was not (p=0.894). T1DM eyes have worse visual outcomes after cataract surgery compared to T2DM eyes. Worse postoperative visual acuity was associated with worse preoperative diabetic retinopathy and history of retinal detachment rather than type of DM.

Cataract surgery outcomes in patients with lenticonus

Cataract surgery in lenticonus is challenging because of increased fragility of the lens capsule. In this case series, we report three different modes of cataract surgery in 15 eyes of ten patients with lenticonus. Six patients had Alport syndrome, out of which two were diagnosed after ophthalmic examination. Two patients had posterior lenticonus, among which one had persistent fetal vasculature. There was a significant improvement in visual acuity following cataract surgery. Therefore, cataract surgery can be safely performed in patients with lenticonus, and ophthalmologists can retard the progression of renal failure by early diagnosis.

Cataract Surgery Considerations for Diabetic Patients.

Given the epidemiology and demographic trends of diabetes mellitus and cataracts, ophthalmologists are likely to encounter patients with both comorbidities at an increasing frequency. Patients with diabetes represent a higher risk population than healthy patients for cataract surgery. In this review, we discuss key risks and risk-mitigation practices when performing cataract surgery on these patients. Patients with diabetes continue to represent a high-risk surgical population: Nagar et al. suggest a dose-dependent relationship may exist between number of intravitreal injections and likelihood of posterior capsular rupture. However, novel treatments are improving outcomes for patients with diabetes. Several studies have reported intracameral phenylephrine/ketorolac may reduce the incidence of post-operative cystoid macular edema while others have discussed the efficacy of pre-treatment and post-treatment with intravitreal bevacizumab on improving cataract surgery outcomes in patients with diabetic retinopathy. Pre-operatively, ophthalmologists should perform an enhanced evaluation, consider timing and lens selection decisions, and complete any appropriate pre-operative treatment. Peri-operatively, surgeons should be aware of pupillary dilation adjustments, combination surgery options, and potential complications. Post-operatively, clinicians should address pseudophakic cystoid macular edema, diabetic macular edema, diabetic retinopathy, and posterior capsular opacification.

&lt;p&gt;Selective serotonin reuptake inhibitors may lead to improved cataract surgery outcomes in patients with amblyopia&lt;/p&gt;

PurposeTo evaluate the effects of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) medications in combination with cataract surgery in treating amblyopia in adult patients.Patients and methodsA retrospective chart review study was conducted on patients who had undergone cataract surgery at the Johns Hopkins Hospital Wilmer Eye Institute. Six inclusion criteria were used to assess patient eligibility: 1) >18 years of age, 2) diagnosis of amblyopia, 3) diagnosis of cataract and treatment with surgery, 4) electronic medical record contains pre-surgery and post-surgery visual acuity (VA) measurements, 5) electronic medical record contains information on whether the patient was ever prescribed a SSRI/SNRI and the treatment duration, and 6) interocular VA difference of two lines or more on Snellen chart prior to cataract surgery. From each record, preoperative VA, postoperative VA, date of surgery, date at which postoperative VA was measured, and age at surgery were collected.ResultsA total of 237 patients were included, with 38 of them being on SSRI/SNRI. The mean improvement in VA after surgery was not significantly greater in patients on SSRI/SNRI (SSRI/SNRI: −0.276 logMAR, control: −0.192 logMAR, p=0.15). Multivariable regression was subsequently performed and while holding all other variables constant, demonstrated a statistically significant improvement in VA in patients on SSRI/SNRI (95% CI: −0.194, −0.0116, p=0.03). The regression analysis further demonstrated that advanced age has an adverse effect on the change in post-op VA (CI: 3.34×10−3 logMAR, 9.77×10−3 logMAR, p<0.005). Worse baseline VA is associated with a greater improvement in post-op VA (95% CI: −0.659 logMAR, −0.463 logMAR, p<0.005) but adverse effect on the absolute post-op VA (95% CI: 0.341 logMAR, 0.544 logMAR, p<0.005).ConclusionThis study suggests that patients with amblyopia undergoing cataract surgery may potentially have a greater visual improvement when treated with SSRI/SNRIs.

Kornea Opasiteli ve Penetran Keratoplastili Olgularda Katarakt Cerrahisi Sonuçları

Kornea Opasiteli ve Penetran Keratoplastili Olgularda Katarakt Cerrahisi Sonuçları

Kronik veya Tekrarlayan Üveitik Hastalarda Katarakt Cerrahisi Sonuçlarımız

Kronik veya Tekrarlayan Üveitik Hastalarda Katarakt Cerrahisi Sonuçlarımız