AIMS: A prospective randomised clinical trial was set up to compare the effect of hydroxypropyl methylcellulose (Ocucoat) and sodium hyaluronate (Healonid) on pupil size and reactivity following their use in cataract surgery. METHODS: Pupil measurements were recorded before and 6 weeks after surgery. RESULTS: There was no significant difference between the two groups with respect to pupil size (p = 0.69, Mann-Whitney U test) nor with respect to reactivity (p = 0.99, Fischer's exact test). Ninety six per cent of the surgery was performed using phacoemulsification. CONCLUSION: This trial suggests that both viscoelastic materials have similar effects on the pupil after their use in cataract surgery.

Adult↗

PubMed1993

Cataract surgery in South West Thames Region: an analysis of age-adjusted surgery rates and length of stay by district.

Although the frequency of cataract surgery has increased in the UK, the demand is still not being met. There is no evidence of whether Regional Health Authorities are meeting the national target of 150 cataract operations per 100,000 population. This paper describes variations in age-standardised rates of cataract surgery and lengths of hospital stay (LOS) between the 13 health districts in South West Thames Regional Health Authority (SWTRHA). A retrospective analysis of cataract surgery performed on South West Thames (SW Thames) residents during 1990 was undertaken using the Korner hospital activity data system. The residents of SW Thames Region had 6,729 cataract operations in 1990, producing an overall surgery rate of 266 per 100,000 resident population. Two-thirds of the operations were performed on women, and the greatest number of operations were in the 75-79 and 80-84 year age bands. Women aged over 75 had significantly higher age-specific surgery rates than their male counterparts. The mean age for women was 76.6 years and for men 71.9 years; 12% of cases had a length of stay less than a day (day cases) and 49% were discharged within two days. There were substantial variations in LOS between health districts. Age-adjusted rates revealed significant variations between districts, four of which had rates below the regional average. The crude cataract surgery rate for SW Thames residents has increased threefold since 1975. Women have a significantly higher rate of surgery, which may be due to social factors. Variations in LOS between districts cannot be explained by difference in age structure and may be caused by local custom and practice. It is possible for national, regional and district cataract rates to be calculated, and they are a useful indicator of how the need for cataract surgery is being met in the population.

Age Factors↗

PubMed1993

Scleral perforations during peribulbar anaesthesia.

Scleral perforation is a recognised but uncommon complication of retrobulbar and peribulbar anaesthesia; most of the reported cases have required further intervention. We report 5 cases from our department that occurred between October 1991 and June 1992. Surgery was performed in all 5 cases without complications. Vitreous haemorrhage was noted on the first post-operative day in all patients; none of the patients required further intervention. Four of 5 patients achieved a final visual acuity of 6/9 and the fifth case was an amblyopic eye with a final acuity of 6/18.

Aged↗

PubMed1993

Phacoemulsification during the learning curve: risk/benefit analysis.

To assess prospectively the complications and outcomes in a single-surgeon series during the phacoemulsification learning curve a prospective analysis of 400 phacoemulsification procedures in 358 patients was carried out. The main outcome measures were capsular tear, vitreous and nuclear loss, best corrected post-operative visual acuity and refractive cylinder. Capsular tears occurred in 6.3% of phacoemulsification procedures, with vitreous loss in 1.5%. One nucleus was lost into the vitreous. Best corrected visual acuity, including pre-existing pathology, was 6/9 or better in 83.6% of eyes. There was 1 dioptre or less change of astigmatism from pre-operative to 6 weeks in 91% of eyes. It is concluded that phacoemulsification with careful patient selection can be a safe procedure even during the learning curve.

Aged↗

PubMed1984

Posterior capsulotomy and retinal detachment following extracapsular lens surgery.

A retrospective analysis of the results of extracapsular cataract surgery with and without implant is presented. Surgery was performed by a group of consultants and registrars from 1975 to 1982, and minimum patient follow-up was 12 months (mean 26.2 months). The incidence of postoperative capsulotomy was 14.3%, but the need for this procedure declines, becoming negligible after 3.5 years. Of 242 eligible eyes, aphakic retinal detachment occurred in only one.

Adult↗