Biomedical subjects

K P Stannard

Publications and source records attributed to K P Stannard.

5 recordsLinked to original sources

PubMed2006

Establishing ongoing quality assurance in a retinal screening programme.

AIM: To establish a clinically efficient, cost-effective quality assurance programme as part of a routine retinopathy screening service. METHODS: The operation of a quality assurance system as part of an ongoing retinal screening service is described. A random selection of 12% of images of all people reported to have retinopathy and of 2% reported to have no retinopathy are re-graded by a consultant ophthalmologist. Entry of the two sets of data into a purpose-designed excel spreadsheet allows automated calculation of sensitivity and specificity. RESULTS: The results of quality assurance from August 2001 to July 2003 are reported. Out of 8351 screening episodes, 498 were re-examined. Of the 62 cases identified by the ophthalmologist as having referable retinopathy, four false negatives for detection were identified. Three of these had been assigned to early re-screening by the retinal screener but were still regarded as false negative by the parameters of the quality assurance system. The sensitivity and specificity for detection of sight-threatening retinopathy were 93.5% (95% CI = 84.3-98.2%) and 97.8% (95% CI = 95.8-98.9%), respectively. CONCLUSION: A robust and cost-effective system has been developed to allow monitoring of performance of routine retinal screening which may be extended to meet current national recommendations.

Diabetic Retinopathy↗

PubMed2005

Does vitreoretinal surgery under local anaesthesia result in missed fellow eye pathology?

PURPOSE: There has been a significant increase in the number of vitreoretinal procedures being performed under local anaesthesia over the past few years. This trend is expected to continue. This study was performed to investigate whether by undertaking retinal detachment surgery under local anaesthesia fellow eye examination was compromised. DESIGN: This was a prospective, consecutive, blind, observational study. METHODS SETTING: This study was performed at a tertiary referral vitreoretinal unit in a teaching hospital. STUDY POPULATION: In all, 108 consecutive patients undergoing retinal detachment surgery under general anaesthesia were included. OBSERVATION PROCEDURES: Patients were examined independently by different retinal surgeons pre- and intraoperatively. MAIN OUTCOME MEASURES: The findings of the two examiners were compared and differences were analysed. RESULTS: There were 108 patients in this study, 57 of these were males and 51 females. The mean age was 59.01 years (range 16-91). Of these 108 eyes, 48/108 (49.08%) the preoperative examination was regarded as unsatisfactory by the examiner. Over 34% of eyes had fellow eye pathology when examined preoperatively but there were nine (8.33%) eyes in which additional lesions were found intraoperatively. CONCLUSION: General anaesthesia should be considered for patients in whom preoperative fellow eye examination is unsatisfactory.

Adolescent↗

PubMed2000

Referral delay and ocular surgical outcome in Terson syndrome.

BACKGROUND: In Terson syndrome, vitreous hemorrhage can result from intracranial hypertension associated with intracranial bleeding. The vitreous hemorrhage can cause a considerable visual handicap. The aim of this study was to determine the outcome of surgery in patients with Terson syndrome and any delay in referral to an ophthalmologist. METHODS: Retrospective case review of 25 eyes of 17 patients undergoing vitrectomy for Terson syndrome. Delay in presentation to an ophthalmologist, intraoperative and postoperative complications, and the final visual acuity were noted. RESULTS: The mean interval between visual symptoms and referral to an ophthalmologist was 5.2 months for the nine unilateral cases and 4.9 months for the eight bilateral cases. Intraoperative complications included retinal break (2) and retinal dialysis (3). Late complications included epiretinal membrane (4), ghost cell glaucoma (1), and cataract (8). Twenty-two of the 25 eyes achieved a final visual acuity of 20/30 or better. CONCLUSION: Vitrectomy for vitreous hemorrhage in Terson syndrome is a safe and effective procedure, offering a rapid and prolonged improvement in vision. There is good reason to consider early vitrectomy, particularly when the hemorrhage is bilateral and dense.

Adult↗

PubMed1989

Screening for retinopathy of prematurity in a regional neonatal intensive care unit.

Retinopathy of prematurity (ROP) is attracting renewed interest from ophthalmologists and neonatologists because of the improved survival of very low birthweight premature infants, some of whom develop blinding disease. Ophthalmologists may find increasing pressure from paediatric colleagues to provide a screening service for babies at risk. The results of the last twenty-two months of a continuing programme at this hospital demonstrate the benefits of active screening, but indicate some of the potential problems for ophthalmologists who are likely to become involved in this work now and in the future.

Blindness↗

PubMed1985

Argon laser iridotomy.

Argon laser iridotomy was successfully performed on 47 out of 52 eyes of 35 patients by the continuous wave argon laser. The technique of argon laser iridotomy is described in detail. A number of complications were observed. The reasons for these are discussed, and measures for the avoidance of complications are suggested.

Adult↗