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Results for “CATARACT EXTRACTION”

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PubMed1993

The influence of patient-related variables in the timing of cataract extraction.

Data from a prospective study of quality of life after cataract extraction with intraocular lens implantation were used to examine associations between patient factors and the timing of cataract extraction. The 495 patients were drawn from 76 ophthalmologists' offices in three cities. Patients were categorized as waiting three months or less or four months or more to schedule their operations after their physicians' recommendations. Patients who delayed scheduling their operations were more likely to be younger, have higher incomes, be working full-time, have higher life satisfaction, have lower levels of depression and higher levels of vigor, have had a less than perfect previous operation, have lower scores for mid-range vision and higher scores for cataract symptoms, be fearful of nighttime driving, and be heavy drinkers. Conversely, patients who delayed their operations were less likely to be covered by Medicare and to expect excellent postoperative vision and a short recovery time. A discriminant analysis correctly classified 68.9% of the patients according to timing group.

Aged↗

PubMed2003

[Vision analysis of cataract extraction with intraocular lens implantation in venerable aged patients].

PURPOSE: To evaluate possible diseases affecting visual acuity in cataract extraction with intraocular lens implantation in venerable aged patients. METHODS: 387 patients (425 eyes) over 80 years old were performed cataract extraction and intraocular lens(IOL) implantation, The postoperative vision was observed and affecting factors were analysed. RESULTS: After the operation, there were 221 eyes (52.0%) of which corrected vision was better than 1.0, Ninty-eight eyes (23.8%) of which was 0.5-0.9, 106 eyes (24.9%) of which was less than 0.5. The main diseases that affect vision restoration were aged-related macular degeneration, glaucoma, retinal vein occlusion and optic atrophy. CONCLUSION: The vision of venerable aged patients who had the operation of cataract extraction and IOL implantation were greatly increased. The various fundus diseases in senile patients are mains reason affecting vision restoration.

Age Factors↗

PubMed2001

The population requirement for cataract extraction: a cross-sectional study.

PURPOSE: To examine the distribution in the population of indications for cataract extraction in order to relate demand for this procedure to the capacity for satisfying it. METHODS: An age-stratified random population sample of 2783 individuals aged 55 years and over was taken from inner-city, urban and rural areas of Avon and Somerset. The requirement for cataract extraction was estimated on the basis of measures of vision-related quality of life, refracted visual acuity, and application of the Oxford Clinical Cataract Classification and Grading System. Data were also collected concerning suitability for surgery, including relative contraindications to surgery and whether participants considered their eyesight bad enough to merit surgery. Three sets of composite indications were defined. RESULTS: Estimated prevalent requirements for cataract extraction for the three sets of composite criteria were: 29 per 1000 aged over 55 years (95% CI 20-41) for the most inclusive criterion; 17 per thousand (95% CI 10-27) for the intermediate criterion; and 7 per thousand (95% CI 3-14) for the most stringent criterion. These rates are equivalent to a national prevalent requirement for England of 384,000 for the most inclusive criterion. If the approximately 15% of individuals whose desire or fitness for surgery was questionable are removed from this estimate, the prevalent requirement, including the backlog from previous unsatisfied demand, becomes 325,000 individuals. CONCLUSIONS: The findings suggest only a modest imbalance between supply and demand for cataract surgery. In particular there was a very small prevalence of untreated severe cataract, less than the annual health service surgical capacity, suggesting that the current National Health Service surgical capacity is adequate for cases of severe cataract.

Age Distribution↗

PubMed1998

[Congenital cataract extraction with intraocular lens implantation in children].

OBJECTIVE: To evaluate the results of cataract extraction with intraocular lens (IOL) implantation in children. METHODS: Cataract extracapsular extraction with anterior vitrectomy and IOL implantation was performed on 104 eyes of 64 children with congenital cataract aged 1.5 - 14 years old. The visual acuity and possible complications were followed up for a mean period of 22 months. RESULTS: After operation 86.4% patients were relieved from blindness, 62.7% obtained corrected vision >or= 0.3, binocular vision and stereopsis were restored in 41.8% and 30.6% respectively. In 3 eyes secondary cataract developed and in 5 eyes slight iris capture occurred. CONCLUSIONS: Cataract extraction with anterior vitrectomy and IOL implantation is effective in pediatric cataract treatment. Most patients get remarkable improvement in visual acuity and visual function with minimal complications after surgery. The influence factors on the postoperative visual function need further study.

Adolescent↗

PubMed2006

Cataract extraction in the collaborative initial glaucoma treatment study: incidence, risk factors, and the effect of cataract progression and extraction on clinical and quality-of-life outcomes.

OBJECTIVES: To study the incidence of and predictors for cataract extraction (CE) in patients with newly diagnosed glaucoma, the impact of CE on visual function, and changes in the time around CE. METHODS: Patients were randomized to medical or surgical treatments for glaucoma at 14 centers and followed up for a median of 7.7 years. Vision-specific quality of life (VS-QOL) data were collected by telephone interview during follow-up of 607 patients randomized to medical or surgical treatments for glaucoma. The occurrence of CE was the signal event. Risk factors were evaluated using survival analyses; changes from before to after CE were evaluated by paired t tests; and trends were estimated by loess regression. RESULTS: During follow-up of 607 patients, CE took place in 99 study eyes. Initial surgery, older age, a more negative spherical equivalent, and a diagnosis of pseudoexfoliative glaucoma conferred a higher risk of CE. Visual field testing before and after CE showed the mean deviation improved but the pattern standard deviation worsened. The VS-QOL improved on most subscales. CONCLUSIONS: Initial surgery places a patient with glaucoma at a higher risk of CE. The impact of CE on visual field indexes is mixed-the mean deviation improved but the pattern standard deviation worsened. Most, but not all, VS-QOL subscales were responsive to worsening of cataract prior to and acute improvement in vision after CE.

Aged↗

PubMed1990

[Progression of diabetic retinopathy following cataract extraction].

A progression of diabetic retinopathy (DR) has been noted following cataract surgery. The retrospective study reported here covered 219 eyes of diabetic patients on which cataract surgery was performed: in 122 cases with intracapsular cataract extraction (ICCE; Group A) without implantation of an intraocular lens (IOL), and in 97 cases with extracapsular cataract extraction and implantation of an intraocular lens (ECCE + IOL; Group B). The existence of diabetic retinopathy was established preoperatively, enabling the population to be divided into subgroups without DR (Groups A1 and B1) and with DR (Groups A2 and B2). Progression of DR was observed in 18% of the eyes in Group A, as opposed to 9.3% of those in Group B (P less than 0.05). Progression to background retinopathy was observed in 10% of the cases in Group A and in 1.3% of the cases in Group B (P less than 0.025). A deterioration was also observed in 33% of the cases in Group A2 and 40% of those in Group B2. Maculopathy progressed in 23% of the cases in Group A2 and 30% of those in Group B2. Rubeosis iridis occurred in 9% of the cases in Group A2 and 5% of those in Group B2. Vitreous hemorrhage following ICCE occurred in 12% of the cases in Group A2. As regards the incidence of neovascular glaucoma and vitreous hemorrhage, ICCE appears to carry a relatively higher risk than ECCE with IOL. This is not the cases if only the progression of maculopathy is considered.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1997

Comparative results of combined procedures for glaucoma and cataract: I. Extracapsular cataract extraction versus phacoemulsification and foldable versus rigid intraocular lenses.

BACKGROUND AND OBJECTIVES: The refinements of small-incision cataract surgery by phacoemulsification with foldable intraocular lens (IOL) implantation have recently permitted new options for combined trabeculectomy with cataract extraction. The objectives of this study were to compare the long-term intraocular pressure (IOP) control and visual outcome between trabeculectomies combined with extracapsular cataract extraction (ECCE) versus those with phacoemulsification, and to analyze these same factors for foldable versus rigid IOLs. PATIENTS AND METHODS: The authors retrospectively reviewed the charts of 311 patients (397 eyes) who underwent combined trabeculectomy with cataract extraction and posterior chamber IOL implantation. In all of the surgeries, releasable scleral flap sutures were used. The mean follow-up was 22.9 +/- 15.1 months, with a minimum follow-up of 12 months. RESULTS: Trabeculectomy combined with phacoemulsification had a lower postoperative complication rate and was more effective than trabeculectomy combined with ECCE in reducing IOP to less than 20 mm Hg with or without medication (95% vs 82%) and in improving vision to levels of 20/40 or better (71% vs 52%) (P < .001). Regarding IOLs, foldable silicone lenses were found to be an effective alternative to polymethylmethacrylate lenses in combined surgeries in terms of a controlled IOP of less than 20 mm Hg (97% vs 97%) and visual recovery to 20/40 or better (78% vs 63%). CONCLUSION: The combination of trabeculectomy with releasable scleral flap sutures and small incision cataract surgery with foldable IOL implantation has improved postoperative IOP control and visual rehabilitation.

Aged↗

PubMed1999

A prospective study of carotenoid intake and risk of cataract extraction in US men.

BACKGROUND: Dietary antioxidants, including carotenoids, are hypothesized to decrease the risk of age-related cataracts by preventing oxidation of proteins or lipids within the lens. However, prospective epidemiologic data concerning this phenomenon are limited. OBJECTIVE: Our objective was to examine prospectively the association between carotenoid and vitamin A intakes and cataract extraction in men. DESIGN: US male health professionals (n = 36644) who were 45-75 y of age in 1986 were included in this prospective cohort study. Others were subsequently included as they became 45 y of age. A detailed dietary questionnaire was used to assess intake of carotenoids and other nutrients. During 8 y of follow-up, 840 cases of senile cataract extraction were documented. RESULTS: We observed a modestly lower risk of cataract extraction in men with higher intakes of lutein and zeaxanthin but not of other carotenoids (alpha-carotene, beta-carotene, lycopene, and beta-cryptoxanthin) or vitamin A after other potential risk factors, including age and smoking, were controlled for. Men in the highest fifth of lutein and zeaxanthin intake had a 19% lower risk of cataract relative to men in the lowest fifth (relative risk: 0.81; 95% CI: 0.65, 1.01; P for trend = 0.03). Among specific foods high in carotenoids, broccoli and spinach were most consistently associated with a lower risk of cataract. CONCLUSIONS: Lutein and zeaxanthin may decrease the risk of cataracts severe enough to require extraction, although this relation appears modest in magnitude. The present findings add support for recommendations to consume vegetables and fruit high in carotenoids daily.

Adult↗

PubMed1997

[The incidence of retinal detachment after extracapsular cataract extraction in high myopia].

PURPOSE: A retrospective study was performed to determine the incidence of retinal detachment after extracapsular cataract extraction in high myopia and the risk factors associated with the occurrence of retinal detachment. METHODS: Of the 463 patients (463 eyes) who had undergone extracapsular cataract extraction with or without intraocular lenses implant between July 1993 and January 1994, 90 patients companied with high myopia and the others were senior cataract. All patients had been followed up for 27 to 33 months. RESULTS: One (1.11%) developed retinal detachment in the patients with high myopia, and no retinal detachment occurred in the patients with senior cataract. The difference of the incidence of retinal detachment between two groups were no significant (P > 0.05), More myopic patients underwent Nd:YAG laser capsulotomy (P < 0.05). CONCLUSION: Comparing with intracapsular method, extracapsular cataract extraction decreased the risk of retinal detachment even in the high myopic patients. The risk factors for retinal detachment were young patients, long eye axis and posterior capsulotomy.

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PubMed2004

Effect of cataract extraction and intraocular lens implantation on nerve fibre layer thickness measurements by scanning laser polarimeter (GDx) in glaucoma patients.

PURPOSE: To assess the influence of visually significant cataract on the measurement of nerve fibre layer thickness by scanning laser polarimetry (GDx) in glaucoma patients undergoing phacoemulsification cataract extraction. METHOD AND SUBJECTS: All subjects with primary glaucoma participating in a prospective trial of glaucoma surgery who subsequently underwent cataract extraction were eligible. A single trained observer using the GDx nerve fibre layer analyser (LDT) performed pre- and post-operative measurements of nerve fibre layer thickness (NFLT). NFLT parameters, best-corrected LogMAR visual acuity, and automated visual fields were assessed before and after phacoemulsification cataract extraction with implantation of an acrylic intraocular lens. RESULTS: A total of 49 subjects were assessed: 22 (45%) had POAG and 29 (55%) PACG; all were Asian (36 (73%) were Chinese), with mean age 67.1 (+/-7.6 SD) and mean 'LOCS III' lens opacity grading 11.4 (+/-3.1 SD). Visual acuity significantly improved (mean LogMAR 0.5 vs 0.15, P<0.0001). Corrected pattern standard deviation (6.1 vs 6.4, P=0.2) and mean deviation (-17.7 dB vs -17.0 P=0.91) were little changed after cataract removal. Pseudo-phakic measurements of NFLT were significantly different from pre-op values. Measures of absolute thickness (including the average thickness, ellipse, ellipse average, superior and inferior averages, superior integral) were significantly greater than preoperative values (all P<0.01), whereas ratios and measures of symmetry (symmetry, superior/nasal) were unchanged (all P>0.1) and 'the number' was smaller (P=0.04). Differences in measured NFLT were most strongly correlated with posterior subcapsular cataract (average thickness, P=0.01). CONCLUSIONS: Removal of cataract resulted in greater absolute measurements of NFLT but ratio values were unchanged. Scanning laser polarimetry measurements can change significantly after cataract extraction. New baseline measurements may be required.

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PubMed1979

Combined thermotrabeculocanalotomy cataract extraction.

The results of combined thermotrabeculocanalotomy-cataract extraction are reported on 9 cases, 7 of which are glaucoma cases controlled by medical therapy, one secondary glaucoma following chronic angle-closure, and one secondary glaucoma following trauma. The results were satisfactory both in terms of visual acuity and lessening reliance on medical therapy of the glaucoma following surgery. More importantly, the safety of the procedure is emphasized, which further indicates that the combined procedure should be considered as the procedure of choice when a cataract must be extracted in a patient with glaucoma.

Acetazolamide↗

PubMed1997

Bacterial endophthalmitis following extracapsular cataract extraction: recommendations for early detection.

OBJECTIVE: To determine the time between the onset of symptoms of endophthalmitis after cataract extraction and presentation to an ophthalmologist and to determine the spectrum of organisms responsible for postoperative endophthalmitis. DESIGN: Case series. SETTING: Tertiary care vitreoretinal service in Toronto. PATIENTS: Thirty-three patients with early (presentation within 2 weeks of surgery) endophthalmitis following extracapsular cataract extraction and intraocular lens implantation performed between January 1989 and December 1992. OUTCOME MEASURES: Time to presentation to an ophthalmologist, duration of symptoms, culture results. RESULTS: Twenty-two patients (66.7%) were documented to experience identifiable symptoms of endophthalmitis before presentation to their ophthalmologist; the mean time of onset of symptoms was 3.6 (standard deviation [SD] 1.7) days after surgery. Of the 22 patients 16 (72.7%) became symptomatic by the fourth postoperative day, and 21 (95.4%) experienced symptoms by the fifth postoperative day. The mean delay between onset of symptoms and presentation was 1.9 (SD 1.6) days. Bacteria were identified in 27 cases (81.8%), confirmed by culture in 23 cases (69.7%). The organisms were gram-positive in 25 (92.6%) of the 27 cases, and coagulase-negative Staphylococcus predominated. CONCLUSIONS: In our series a considerable delay existed between the development of symptoms of endophthalmitis following extracapsular cataract extraction and clinical diagnosis. This delay could be minimized by scheduling routine postoperative visits at 1 and 4 days following cataract surgery.

Adult↗

PubMed2002

[Cataract extraction through no-sitch small incision combined with intraocular lens implantation].

OBJECTIVE: To investigate the method and clinical effect of cataract extraction through no-sitch small incision combined with intraocular lens (IOL) implantation. METHODS: Ninety-three cases of cataract were divided into two groups at random. Cataract extraction combined with IOL implantation through no-sitch small incision was performed on one group, and cataract extraction combined with IOL implantation through conventional large incision was performed on the other group as controls. Follow-up was carried out regularly. RESULTS: The average uncorrected visual acuity of the small incision group at 1 week, 1 month, 3 months, 6 months and 1 year after the operation were significantly higher than those of the conventional large incision group. CONCLUSION: The small incision of cataract surgery results in a rapid and better rehabilitation of visual acuity. It needs no expensive instruments, costs less, and is suitable to be popularized.

Adult↗

PubMed2001

Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial.

BACKGROUND: Cataract extraction constitutes the largest surgical workload in ophthalmic units throughout the world. Extracapsular cataract extraction (ECCE), through a large incision, with insertion of an intraocular lens has been the most widely used method from 1982 until recently. Technological advances have led to the increasing use of phacoemulsification (Phako) to emulsify and remove the lens The technique requires a smaller incision, but requires substantial capital investment in theatre equipment. In this randomised trial we assessed the clinical outcomes and carried out an economic evaluation of the two procedures. METHODS: In this two centre randomised trial, 232 patients with age related cataract received ECCE, and 244 received small incision surgery by Phako. The main comparative outcomes were visual acuity, refraction, and complication rates. Resource use was monitored in the two trial centres and in an independent comparator centre. Costs calculated included average cost per procedure, at each stage of follow up. RESULTS: Phako was found to be clinically superior. Surgical complications and capsule opacity within 1 year after surgery were significantly less frequent, and a higher proportion achieved an unaided visual acuity of 6/9 or better (<0.2 logMAR) in the Phako group. Postoperative astigmatism was more stable in Phako. The average cost of a cataract operation and postoperative care within the trial was similar for the two procedures. With the input of additional spectacles for corrected vision at 6 months after surgery, the average cost per procedure was pound359.89 for Phako and pound367.57 for ECCE. CONCLUSION: Phako is clinically superior to ECCE and is cost effective.

Aged↗

PubMedDate not supplied

Retinal tears and retinal detachment as factors affecting visual outcome after cataract extraction complicated by posteriorly dislocated lens material.

PURPOSE: To evaluate the incidence and effect on visual acuity of complicating factors such as retinal tears (RTs) and rhegmatogenous retinal detachment (RRD) in eyes with posteriorly dislocated lens fragments after cataract extraction. METHODS: Retrospective consecutive series of patients presenting at a referral vitreoretinal practice with posteriorly dislocated lens material after cataract extraction over a period of 8 years. The presence of RT, RRD, endophthalmitis, and choroidal hemorrhage was noted, and their effect on visual outcome was studied. RESULTS: A total of 307 eyes with posteriorly dislocated lens material after cataract extraction were identified. Fifty-eight eyes (19%) were managed medically (Group I), whereas the other 249 eyes (81%) underwent pars plana vitrectomy for removal of the lens material (Group II). Indications for surgical management included uncontrolled inflammation, elevated intraocular pressure, and large lens fragments. No eyes in Group I developed RT or RRD. Of the 249 Group II eyes, 13 (5%) were found to have RT, and 25 (10%) developed RRD. In Group II, choroidal hemorrhage and endophthalmitis were noted in 12 (5%) and 4 (2%) eyes, respectively. Fifty-one (88%) of 58 eyes in Group I and 138 (55%) of 249 eyes in Group II achieved a final visual acuity of 20/40 or better. Seven (54%) of the 13 eyes with RT and 9 (36%) of the 25 eyes with RRD achieved a final visual acuity of 20/40 or better. In the RRD group, 9 (56%) of the 16 macula-on eyes achieved a final visual acuity of 20/40 or better, whereas none of the 9 macula-off eyes had a final visual acuity of 20/40 or better. None of the 4 eyes with endophthalmitis and only 1 (8%) of the 12 eyes with choroidal hemorrhage had a final visual acuity of 20/40 or better. Five (62%) of eight eyes with retinal detachment treated with pneumatic retinopexy needed further treatment with scleral buckle to achieve anatomical reattachment. CONCLUSION: A good visual outcome (20/40 or better) is possible in eyes with posteriorly dislocated lens fragments after cataract extraction, even when retinal tears or macula-on retinal detachment is present. The presence of a macula-off retinal detachment, however, has a significant adverse effect on the visual outcome. Pneumatic retinopexy is not associated with retinal reattachment in many cases and is not preferred.

Adult↗

PubMed1990

Penetrating keratoplasty combined with cataract extraction.

The authors report the results of penetrating keratoplasty combined with cataract extraction in 50 cases. The rate of transparent grafts was 62% after an average follow-up of 19 months. 60% of the patients restored their vision to 0.1 and better. The rate of transparent grafts and visual improvement did not correlate with the mode of cataract extraction; however, the extracapsular procedure had less vitreous during operation than the intracapsular modality did. The authors recommend that the combined operation be adopted for patients with corneal opacity and cataract, and preferably using the extracapsular mode.

Adolescent↗

PubMed2003

[Results of cataract extraction with IOL implantation in children aged 17 months to 8 years old].

PURPOSE: To evaluate anatomical and functional results of cataract extraction and IOL implantation, together with posterior capsulectomy and anterior vitrectomy in children. MATERIALS AND METHODS: Cataract extraction and IOL implantation with posterior capsulectomy and anterior vitrectomy was performed in 32 eyes of children between 17 months and 8 years old. Patients were followed up for a mean period 36 months (from 6 months to 5.5 years). RESULTS: Good anatomical results were achieved in all, except 2 cases. One eye required removal of opacifications located posterior to the IOL In the second eye membrane from the anterior surface of the lens were excised. Final postoperative visual acuity in eyes with bilateral cataract was 0.59, whereas in unilateral cataract 0.25. Half of the children with bilateral cataract has significantly worse BCVA in one eye. CONCLUSIONS: Cataract extraction and IOL implantation with posterior capsulectomy and anterior vitrectomy in young children gives good anatomical results. Functional results are better in bilateral congenital cataract, comparing to unilateral cases. To achieve good functional results, visual rehabilitation is necessary.

Cataract↗

PubMed2001

Traumatic wound dehiscence after cataract extraction.

PURPOSE: To study the visual outcome and factors associated with it in patients with traumatic dehiscence of a cataract surgery wound. SETTING: Department of Ophthalmology and the Brown School of Public Health and Community Medicine, The Hebrew University-Hadassah Medical School, Jerusalem, Israel. METHODS: A retrospective observational study of 37 eyes of 37 consecutive patients with traumatic wound dehiscence of a cataract surgery wound was conducted. A complete ophthalmic evaluation was performed in all patients. Statistical analysis was done to identify factors associated with the best corrected visual acuity at the end of follow-up. RESULTS: Patients had extracapsular cataract extraction (n = 29), intracapsular cataract extraction (n = 4), or lensectomy (n = 4). No patient had phacoemulsification via a small incision. A univariate analysis showed that factors associated with a worse visual outcome included the presence at presentation of hyphema (P = .05), intraocular lens dislocation or loss (P = .006), vitreous hemorrhage (P = .0002), scleral rupture (P = .001), a long interval from surgery to trauma (P < .0001), and fall as the cause of trauma (P < .0001). In a multivariate model, only a surgery-to-trauma interval longer than 8 weeks was associated with a worse visual outcome (P < .0001). Visual acuity immediately after trauma was a poor predictor of final visual acuity. CONCLUSIONS: Visual outcome after traumatic wound dehiscence of a cataract surgery wound was strongly associated with the interval from surgery to trauma. Other factors were less reliable predictors of visual outcome. Traumatic wound dehiscence only moderately affected visual outcome after cataract surgery in most cases.

Adolescent↗