Cataract surgery

Endophthalmitis, an ophthalmic condition characterized by an inflammation of the intraocular cavity, can have substantial implications for vision. However, little is known about the cost of treatment. The objective of this study was to estimate the direct medical cost of treatment for endophthalmitis in the United States. Retrospective data analysis using the 1997 through 2001 Medicare Beneficiary Encrypted Files. Beneficiaries who underwent cataract surgery were identified; baseline and clinical characteristics at the time of diagnosis were determined. Analyses stratified patients based on development of endophthalmitis in the year after surgery. Claims and reimbursements for cases (patients undergoing cataract extraction in whom endophthalmitis developed) and controls (patients who did not experience endophthalmitis) were determined and rates of resource use and costs were calculated from the perspective of Medicare. Annual Medicare payments and claims. A total of 417 beneficiaries with endophthalmitis occurring after cataract surgery were found; 139 558 had cataract surgery without subsequent endophthalmitis. Three fifths of beneficiaries were female and 89% were white. Ophthalmic claims and reimbursements were more than 1.45 times greater for cases than controls ($12 578 in higher claims and $3464 in higher reimbursements; P<0.0001). These findings demonstrate a substantial cost associated with endophthalmitis. With recent studies suggesting that prophylaxis is effective in preventing endophthalmitis, there is potential that inexpensive prophylaxis could result in cost and resource savings to Medicare.

To describe the complications related to cataract surgery performed by phacoemulsification technique by third-year ophthalmology residents at New Jersey Medical School, who are trained to perform phacoemulsification without any prior experience with extracapsular extraction. Retrospective, observational case series. A retrospective chart review of 755 patients who underwent cataract surgery by third-year residents between July 2000 and June 2005 at the Institute of Ophthalmology and Visual Science was performed. Details of intraoperative complications (posterior capsular rupture, vitreous loss, subluxation of lens fragments into the vitreous, extracapsular cases converted to phacoemulsification, retinal detachment, vitreous haemorrhage and haemorrhagic choroidals) of the cases done by phacoemulsification technique were recorded. Results were analysed and compared with complication rates reported from other residency programmes and from experienced ophthalmologists. Of 755 cataract s...

Age-related cataract accounts for more than 40% of cases of blindness in the world with the majority of people who are blind from cataract found in the developing world. With the increased number of people with cataract there is an urgent need for cataract surgery to be made available as a day care procedure.

PURPOSE: To compare the accuracy of Optiwave Refractive Analysis (ORA) intraoperative aberrometry (Alcon Laboratories, Inc., Fort Worth, TX) with preoperative biometry in predicting residual refractive error after cataract surgery in eyes that underwent radial keratotomy.
METHODS: This was a prospective consecutive case series of patients with cataract and prior radial keratotomy. Each patient underwent a preoperative intraocular lens (IOL) power calculation using partial coherence interferometry (IOLMaster version 5; Carl Zeiss Meditec, Jena, Germany). For each eye, the Barrett True-K formula was used to select an IOL targeting emmetropia. Residual refractive error was predicted preoperatively using the SRK/T, Hoffer Q, Haigis, and Holladay formulas 1 and 2, and the ORA intraoperatively. Between 8 and 12 weeks after cataract extraction with IOL implantation, the postoperative refraction was compared with the preoperative and intraoperative predictions.
RESULTS: The study comprised 52 eyes of 34 patients. The median absolute errors associated with each method were as follows: Barrett True-K formula (0.34), ORA aberrometer (0.53), and SRK/T (0.54), Hoffer Q (0.51), Haigis (0.54), SRK/T (0.57), and Holladay formulas 1 and 2 (0.44) (P = .08). The pro- portion of patients within ±0.50 diopters of the predicted error was 63.5%, 48.1%, 44.2%, 48.1%, 53.8%, 36.5%, and 57.7%, respectively (P = .03). No statistically significant difference was observed in the number of eyes with hyperopic outcomes (P = .68).
CONCLUSIONS: In eyes with prior radial keratotomy surgery, the ORA aberrometer performance was similar to the Bar- rett True-K formula and all of the other established formulas, with no significant difference between median absolute error and mean absolute error. The Barrett True-K formula pro- duced significantly more eyes within ±0.50 diopters than the SRK/T, Hoffer Q, and Holladay 1 formulas.

Background: According to World Health Organization (WHO), cataract is the leading cause of blindness and visual impairment throughout the world. WHO target is to eliminate cataract as one of blinding disease by 2020. Most age related cataract surgery outcomes are poor in sub-Saharan Africa due to patient selection, poor surgical techniques or uncorrected refracted errors among others. At Lions, there are a lot of cataract surgeries being done. As time goes, the number of patients waiting for cataract surgery is predicted to increase. It’s therefore necessary to conduct a study on the outcome of age-related cataract. The main purpose was to determine the risk factors associated with cataract among patients seeking eye services at Lions Medical Center.
Method: A retrospective descriptive hospital based case series Study population: Any patient related cataract cases at Lions Medical Center within the study period. Data was extracted from theatre registers and from the files of patients with related cataract cases. All the necessary socio- demographic and clinical data of the patient will be captured using a standardized structured questionnaire and analyzed using SPSS Version20.0 Descriptive analysis was used to determine means, frequencies and proportions of the various variables. Proportionate test was used to compare proportions. Chi-square was used to test factors associated with poor outcome. Results are presented in form of tables and graphs.
Results: The overall prevalence of cataract was higher in older adults. It shows to increase with age in 2/3 of cases being diagnosed at an age over 45 years. Sex-specific cataract prevalence was higher in women than in men, although not all of the reviewed studies were consistent in this aspect. Several studies on cataract confirmed that age was directly proportional.
Conclusion: This study showed that cataract is a result of oxidative stress induced by light penetrating into the intraocular space and consequent photochemical reactions is a condition that commonly frequent old people.

To investigate the association between cataract surgery and the rate of photodynamic therapy (PDT) for age-related macular degeneration (AMD). Observational population-based retrospective case-control study. All members in a district of the largest health maintenance organization (HMO) in Israel > 50 years old on January 1, 2001, who did not terminate their membership through May 31, 2005 (139 894 members). All PDT procedures for AMD performed in the study population between January 1, 2001 and May 31, 2005 (283 patients) and all cataract surgeries performed between January 1, 2001 and December 31, 2003 (5913 patients) were documented. We extracted clinical information from the chronic disease registry of the HMO as well as demographic and socioeconomic information. For each patient that underwent cataract surgery, 5 HMO members matched in age, gender, chronic diseases (systemic hypertension, diabetes, hyperlipemia, and ischemic heart disease), place of residence, country of birth and socioeconomic status, who did not undergo cataract surgery, were randomly chosen as controls (n = 29 565). The rate for undergoing PDT at different time periods after cataract surgery. Fifty (0.85%) cataract patients and 94 control cases (0.32%) underwent PDT after cataract surgery (P<0.0001, chi-square test). A significant rise in PDT rate was noticed in cataract patients compared to controls during the first 6 months after surgery (P = 0.004, chi-square test). Between 6 and 12 months postoperatively, the PDT rates were similar in both groups. However, a more significant rise in PDT rates occurred between 1 and 1.5 years after surgery (P<0.0001, chi-square test). The Kaplan-Meier PDT-free survival curve of cataract patients was significantly worse than that of the controls (P<0.0001, chi-square test; P = 33.7, log-rank test). The hazard ratio for cataract patients compared to controls to undergo PDT after surgery was 2.7 (confidence interval = 2.4-5.7). The most significant factors to reduce the time to PDT were advanced age followed by having had cataract surgery, place of birth, socioeconomic status, and hyperlipidemia (Cox proportional hazards survival regression). We identified an increased rate of PDT, presumably for subfoveal AMD, 1 to 1.5 years after cataract surgery.