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1.
Article de Anglais | WPRIM | ID: wpr-1006602

RÉSUMÉ

Background@#Pediatric cataract is one of the most common preventable cause of childhood blindness worldwide. Early and timely intervention of pediatric cataract is important to maximize the visual outcomes and start prompt visual rehabilitation.@*Objectives@#This study aimed to determine the average time from the day of initial consult at the outpatient clinic to the day of the cataract surgery and compare the effects of delayed surgery on visual outcomes of patients.@*Methods@#This is a retrospective chart review of medical records from January 2015 to June 2022. The dates of the different steps in the process up to the day of intervention were noted and the average interval duration and the total waiting time were determined. Patients operated on within 2 weeks from initial consult was defined as no delay while those operated >2 weeks had delayed surgery. Pre-operative and post-operative best corrected log MAR visual acuity were compared within each group to determine if delay in surgical intervention has a significant effect on the visual outcomes of patients.@*Results@#Median age at initial consult was 4.9 years while median age at surgery was 5.2 years. Ninety-nine (99) patients had developmental cataract and 123 patients had bilateral cataract. Leukocoria was the most common chief complaint (63.45%). Pre-operatively, 94 patients had strabismus, 49 had eye preference, 48 had nystagmus, and 43 had amblyopia in the diagnosis. There was significantly faster admission to cataract surgery during the pandemic compared to pre-pandemic period but there was no difference in the total waiting time. Patients with congenital cataract had the least total waiting time followed by developmental, and rubella cataract. There is no significant difference in visual outcomes between patients operated without delay and with delay.@*Conclusion@#There is delayed age at diagnosis and surgery of pediatric cataract patients in the Philippine General Hospital. Early surgery did not reflect better visual outcomes compared to delayed surgery probably due to delay in consultation of patients.


Sujet(s)
Cataracte
2.
Article de Chinois | WPRIM | ID: wpr-1009356

RÉSUMÉ

OBJECTIVE@#To analyze the clinical data and genetic characteristics of a child with CLN1 neuronal ceroid lipofuscinosis in conjunct with Hereditary hyperferritinemia cataract syndrome (HHCS).@*METHODS@#A child who was admitted to the PICU of the First Affiliated Hospital of Zhengzhou University in November 2020 was selected as the study subject. Clinical data of the child was collected. Genetic testing was carried out for the child, and the result was analyzed in the light of literature review to explore the clinical and genetic characteristics to facilitate early identification.@*RESULTS@#The patient, a 3-year-old male, had mainly presented with visual impairment, progressive cognitive and motor regression, and epilepsy. Cranial magnetic resonance imaging revealed deepened sulci in bilateral cerebral hemispheres, and delayed myelination. The activity of palmitoyl protein thioesterase was low (8.4 nmol/g/min, reference range: 132.2 ~ 301.4 nmol/g/min), whilst serum ferritin was increased (2417.70 ng/mL, reference range: 30 ~ 400 ng/ml). Fundoscopy has revealed retinal pigment degeneration. Whole exome sequencing revealed that he has harbored c.280A>C and c.124-124+3delG compound heterozygous variants of the PPT1 gene, which were respectively inherited from his father and mother. Neither variant has been reported previously. The child has also harbored a heterozygous c.-160A>G variant of the FTL gene, which was inherited from his father. Based on the clinical phenotype and results of genetic testing, the child was diagnosed as CLN1 and HHCS.@*CONCLUSION@#The compound heterozygous variants of the PPT1 gene probably underlay the disorders in this child. For children with CLN1 and rapidly progressing visual impairment, ophthalmological examination should be recommended, and detailed family history should be taken For those suspected for HHCS, genetic testing should be performed to confirm the diagnosis.


Sujet(s)
Enfant d'âge préscolaire , Humains , Mâle , Cataracte/génétique , Dépistage génétique , Mutation , Céroïdes-lipofuscinoses neuronales/anatomopathologie , Troubles de la vision/génétique
3.
Health Research in Africa ; 2(8): 60-65, 2024. figures, tables
Article de Français | AIM | ID: biblio-1563085

RÉSUMÉ

ntroduction.Après une opération par phaco-alternative chez les patients souffrantde cataracte,on peut observerune acuité visuelle non souhaitée. Une réfraction met en évidence souvent un astigmatisme important appelé astigmatisme induit. La qualité du résultat fonctionnel dépend en partie de ce dernier qu'il faut réduire à son minimum.Le but de notre étude était d'étudier l'astigmatisme induit après phacoalternative à Conakry et suggérer des recommandations pour l'amélioration de la qualité de la chirurgie.Méthodologie. Il s'agissait d'une étude transversale, descriptive et analytique d'une cohorte de patients opérés de la cataracte par phaco alternative de Juillet 2016 à Janvier 2017 (six mois)au CHU de Donka. Résultats.Nous avons inclusdans notre étude 100 yeux opérés par phaco-alternative avec un âge moyen de 62±12,18ans pour un sex ratio de 1. La tranche d'âge la plus représentée était cellede 61 -70 ans(38%). La femme ménagère était la plus touchée (39%).L'hypertension artérielleétait l'antécédent le plus retrouvée dans 23% des cas.L'œil gauche était le plus opéré (59%). L'acuité visuelle était réduite à la perception lumineuse dans 58% des cas en préopératoire, 95% des astigmatismes préopératoiresétaient inférieurs à 2D et 57% selon la règle. La puissance moyenne de l'implant après biométrie était de 19±2,38 dioptries et 50% des patientsont reçu l'implant calculé.L'œdème cornéen était la complication précoce la plus fréquenteConclusion.la phacoalternativeavec incision supérieure linéaire induit un astigmatisme contre la règle de 3,15 dioptries en moyenne


Introduction.After a phaco-alternative operation in patients suffering from cataracts, unwanted visual acuity may be observed. Refraction often reveals significant astigmatism called induced astigmatism. The quality of the functional result partly depends on the amount of induced astigmatism, which needs to be minimized. The aim of our study was to investigate induced astigmatism after phaco-alternative in Conakry and suggest recommendations for improving the quality of surgery. Methodology.This was a cross-sectional, descriptive, and analytical study of a cohort of cataract patients operated by phaco-alternative from July 2016 to January 2017 (six months) at Donka University Hospital. Results.We included 100 eyes operated by phaco-alternative with an average age of 62±12.18 years and a sex ratio of 1. The most represented age group was 61-70 years (38%). Homemakers were the most affected group (39%). Hypertension was the most commonly found history in 23% of cases. The left eye was the most operated on (59%). Visual acuity was reduced to light perception in 58% of cases preoperatively, 95% of preoperative astigmatism was less than 2D, and 57% were with-the-rule. The average power of the implant after biometry was 19±2.38 diopters, and 50% of patients received a calculated implant. Corneal edema was the most common early complication. Conclusion.Phaco-alternative with a linear superior incision nduces an astigmatism against-the-rule of 3.15 diopters on average.


Sujet(s)
Cataracte
4.
Health Research in Africa ; 2(7): 6-10, 2024. figures, tables
Article de Français | AIM | ID: biblio-1562052

RÉSUMÉ

Introduction.Le traitement de la cataracte est chirurgical par extraction du cristallin opacifié selon diverses techniquesd'extractions telles quela phaco-exérèse avec émulsification du noyau aux Ultrasons (PKE ou Phaco E) et la phaco-exérèse avec extraction par mini-incision sclérale ou Phaco-alternative (PKA ou Phaco-A..L'objectif de notre étude était de comparer les résultats des techniques opératoires Phaco-A etPhaco-E, en termes de complications peropératoires, ainsi que les complications postopératoires.Méthodologie. Il s'agissait d'une étude prospective, transversale sur une période de 8 mois allant de Mars à Octobre 2023, réalisée à l'hôpital ophtalmologique Makkah de Maradi sur tous les patients opéréspour une cataracteparles deux techniques opératoires, Phaco A versus Phaco E et suivisjusqu'à J30. Résultats.Nous avons recensé 500 patients opérés et suivis pour une cataractedont 250 patientsopérés par technique: Phaco A et 250 par Phaco E. L'âge moyen était de 60.71 ans pour un sex-ratio M/F de 1. 15. La complication préopératoire la plus retrouvée pour les deux techniques opératoires était l'hyphéma avec une prévalence de 7.20% dans la Phaco A contre 1.60% pour la Phaco E. La complication la plus retrouvée à J1 postopératoire était l'œdème cornéen soit 14,40%des patients pourla Phaco E contre 9,60% pour la Phaco A. De plus à J7 postopératoire nous avions noté 2,40% d'œdème de cornée pour la Phaco A contre 4,40%pour la Phaco E. A J30 postopératoire, l'hypertonie oculaire étaitla complication la plus retrouvéedans cette série, 2.00% pour la Phaco A contre 1,60%pour la Phaco E.Conclusion.Les principales complications de la chirurgie de la cataracte à Maradi sontl'hyphéma et l'œdème cornéen. L'hyphéma estplus retrouvée dans la Phaco A que dans la PhacoE tandis que l'œdème de la cornée est plus fréquent dans la Phaco E que dans la Phaco A


Introduction.The treatment of cataracts is surgical, involving the extraction of the clouded lens using various extraction techniques such as phacoemulsification with ultrasound (PKE or Phaco E) and phacoemulsification with scleral mini-incision extraction (PKA or Phaco-A). The aim of our study was to compare the results of these surgical techniques, Phaco-A and Phaco-E, in terms of perioperative complications as well as postoperative complications. Methodology.This was a prospective, cross-sectional study conducted over an 8-month period from March to October 2023 at the Makkah Eye Hospital in Maradi on all patients operated on for cataracts using both Phaco A and Phaco E techniques, and followed up until day 30. Results.We identified 500 patients who were operated on and followed up for cataracts, with 250 patients operated on using Phaco A and 250 using Phaco E. The average age was 60.71 years with a male to female ratio of 1.15. The most common preoperative complication for both surgical techniques was hyphema, with a prevalence of 7.20% in Phaco A compared to 1.60% in Phaco E. The most common postoperative complication at day 1 was corneal edema, with 14.40% of patients experiencing it in Phaco E compared to 9.60% in Phaco A. Additionally, at day 7 postoperative, we observed 2.40% corneal edema in Phaco A compared to 4.40% in Phaco E. By day 30 postoperative,ocular hypertension was the most common complication in this series, with 2.00% in Phaco A compared to 1.60% in Phaco E. Conclusion.The main complications ofcataract surgery in Maradi are hyphema and corneal edema. Hyphema ismore common in Phaco A than in Phaco E, while corneal edema ismore frequent in Phaco E than in Phaco A


Sujet(s)
Cataracte , Diagnostic
5.
Rev. bras. oftalmol ; 83: e0011, 2024. tab
Article de Portugais | LILACS | ID: biblio-1535606

RÉSUMÉ

RESUMO Objetivo: O objetivo deste estudo foi revisar os aspectos clínicos e patológicos da catarata congênita secundária às infecções por sífilis, toxoplasmose, rubéola, citomegalovírus e herpes simples. Métodos: Trata-se de uma revisão de literatura, na qual foram incluídos artigos de periódicos indexados às bases de dados PubMed®, Cochrane, Lilacs, Embase e SciELO de 2010 a 2023. Resultados: Foram encontrados 45 artigos, e, após seleção, restaram 9 artigos. Além disso, foram adicionados artigos para enriquecer a discussão. A infecção por sífilis está relacionada a alterações corneanas. O citomegalovírus e a toxoplasmose estão relacionados com a coriorretinite e/ou microftalmia. A rubéola é responsável por causar catarata, glaucoma, microftalmia e retinite em sal e pimenta. Conclusão: Foram abordadas as principais etiologias infecciosas e seu quadro clínico na CC. O melhor tratamento para CC é cirúrgico associado a acompanhamento clínico, mas a prevenção é a maneira mais eficaz de combater a CC de etiologia infecciosa. O diagnóstico precoce e o tratamento efetivo previnem alterações e sequelas visuais irreversíveis. Nesse contexto, mostram-se importantes as ações de políticas públicas para o melhor desfecho clínico e melhor qualidade de vida.


ABSTRACT Objective: To review the clinical and pathological aspects of CC secondary to infections by syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex. Methods: This is a literature review. Articles from journals indexed to PubMed, COCHRANE, LILACS, EMBASE and SCIELO from 2010 to 2023 were included. Results: A total of 45 articles were found, which, after selection, remained in 9 articles. Some articles were included to enrich the discussion in this topic. The infection caused by syphilis is related to corneal changes. Cytomegalovirus and Toxoplasmosis due to chorioretinitis and/or microphthalmia. Rubella is responsible for causing cataracts, glaucoma, microphthalmia, and salt and pepper retinitis. Conclusion: The main infectious etiologies and their clinical status in CC were addressed. The best treatment for CC is surgery associated with clinical follow-up, but prevention is the most effective way to combat CC of infectious etiology. Early diagnosis and effective treatment prevent irreversible visual changes and sequelae. In this context, public policy actions are important for the best clinical outcome and better quality of life.


Sujet(s)
Humains , Complications infectieuses de la grossesse , Rubéole/complications , Cataracte/congénital , Cataracte/étiologie , Syphilis/complications , Toxoplasmose/complications , Cytomegalovirus , Zona/complications
6.
Rev. bras. oftalmol ; 83: e0010, 2024. graf
Article de Anglais | LILACS | ID: biblio-1535605

RÉSUMÉ

ABSTRACT A 36-year-old black male presented with a progressive loss of visual acuity in both eyes for 7 years. He had a history of tractional retinal detachment in the right eye and vitreous hemorrhage followed by retinal detachment in the left eye. He denied any systemic illness, trauma, or drug abuse. After clinical investigation, he was diagnosed with SC hemoglobinopathy and proliferative sickle cell retinopathy stage V in both eyes.


RESUMO Paciente do sexo masculino, 36 anos, negro, apresentou baixa acuidade visual progressiva em ambos os olhos por 7 anos. Possuía antecedentes de descolamento tracional de retina no olho direito e hemorragia vítrea, seguida de descolamento de retina no olho esquerdo. Negava doenças sistêmicas, trauma ou abuso de drogas. Após investigação clínica, foi diagnosticado com hemoglobinopatia S-C e retinopatia falciforme proliferativa estágio V em ambos os olhos.


Sujet(s)
Humains , Mâle , Adulte , Décollement de la rétine/étiologie , Drépanocytose SC/complications , Rétinopathies/diagnostic , Cataracte/diagnostic , Hémorragie du vitré , Décollement de la rétine/diagnostic , Acuité visuelle , Biomicroscopie , Néovascularisation pathologique
8.
Article de Espagnol | LILACS, CUMED | ID: biblio-1559886

RÉSUMÉ

La lidocaína es el anestésico local más utilizado a nivel mundial para la cirugía de catarata. También se usa de manera común en otras intervenciones quirúrgicas oftalmológicas del segmento anterior, la superficie del globo ocular, los párpados y vías lagrimales, así como en el segmento posterior del ojo. Esta revisión pretende brindar una actualización sobre las principales características, los efectos y vías de administración de la lidocaína usada en la oftalmología. Se realizó una búsqueda sistemática sobre el tema en publicaciones científicas indexadas en bases de datos, cuya información recopilada se resumió en este trabajo. La lidocaína se presenta en múltiples formas farmacéuticas, con variedad en concentración y formulación. Por lo general, para inyección se usan las concentraciones al 0,5 por ciento, 1 por ciento y 2 por ciento, para anestesia tópica en gel al 2 por ciento y en solución oftálmica al 4 por ciento. Su efecto como anestésico local es bien conocido, a nivel ocular se puede conseguir a través de inyecciones perioculares e intraoculares o mediante su aplicación tópica. Este efecto anestésico de la lidocaína ofrece cierta capacidad de dilatación pupilar, el cual se ha estudiado y aprovechado con frecuencia en los últimos años. Hoy día se encuentran en estudio otros efectos de la lidocaína a nivel local y sistémico. Los usos de la lidocaína en la oftalmología actual, están respaldados fundamentalmente por su eficacia y seguridad comprobadas en el tiempo(AU)


Lidocaine is the most widely used local anesthetic worldwide for cataract surgery. It is also commonly used in other ophthalmic surgical procedures of the anterior segment, surface of the eyeball, eyelids and lacrimal ducts, as well as in the posterior segment of the eye. This review aims to provide an update on the main characteristics, effects and ways of administering lidocaine used in ophthalmology. A systematic search on the subject was carried out in scientific publications indexed in databases, the information collected was summarized in this work. Lidocaine comes in multiple pharmaceutical forms, with a variety of concentrations and formulations. Generally, 0.5 percent, 1 percent and 2 percent concentrations are used for injection, 2 percent for topical anesthesia in gel and 4% in ophthalmic solution. Its effect as a local anesthetic is well known, at ocular level it can be achieved through periocular and intraocular injections or by topical application. This anesthetic effect of lidocaine offers some pupillary dilation capacity, which has been frequently studied and exploited in recent years. Other local and systemic effects of lidocaine are currently under study. The uses of lidocaine in ophthalmology today are supported primarily by its time-tested efficacy and safety(AU)


Sujet(s)
Humains , Cataracte/étiologie , Anesthésiques locaux/usage thérapeutique , Lidocaïne/administration et posologie , Littérature de revue comme sujet
9.
Rev. cuba. oftalmol ; 36(1)mar. 2023.
Article de Espagnol | LILACS, CUMED | ID: biblio-1522002

RÉSUMÉ

El síndrome de distensión de la bolsa capsular es una rara complicación de la cirugía de catarata. El objetivo principal fue exponer los principales hallazgos oftalmológicos de esta enfermedad, y las diferentes alternativas de diagnóstico y tratamiento para afrontar esta infrecuente y tardía complicación de la cirugía de catarata. Consiste en la adhesión del borde de la capsulorrexis al lente intraocular, colocado en un saco capsular. Tal aposición dificulta que el líquido fluya a través de la apertura de la cápsula anterior y se acumule en el saco capsular. Se presenta un paciente masculino de 71 años con antecedentes de cirugía de catarata por facoemulsificación en el ojo derecho. Refirió que desde hace 11 meses ha notado disminución de la visión. En el examen oftalmológico del ojo derecho se constató agudeza visual sin corrección de 0,3 por cartilla de Snellen, la cual mejoró a 1,0 con una corrección de -1,00 dioptría D. La exploración con lámpara de hendidura descartó cualquier tipo de inflamación del segmento anterior. Su presión intraocular fue de 18 mmHg. Mostró una cámara anterior poco profunda, con un desplazamiento anterior del iris y un saco capsular distendido. La cápsula posterior estaba separada de la superficie posterior del LIO con contenido líquido transparente. Se diagnosticó síndrome de distensión de la bolsa capsular. Se sometió a una capsulotomía posterior con láser Nd: YAG. En la evaluación posterior, el paciente mostró agudezas visuales no corregidas de 1,0 por cartilla de Snellen en ambos ojos. El síndrome de distensión de la bolsa capsular es una complicación tardía e infrecuente de cirugía de catarata con múltiples factores de riesgo, pero de rápida solución(AU)


Capsular bag distension syndrome is a rare complication of cataract surgery. The main objective was to expose the main ophthalmological findings of this disease and the different diagnostic and treatment alternatives to deal with this infrequent and late complication of cataract surgery. It consists of adhesion of the capsulorhexis rim to the intraocular lens, placed in a capsular bag. Such apposition makes it difficult for fluid to flow through the anterior capsule opening and accumulate in the capsular sac. We present a 71-year-old male patient with a history of cataract surgery by phacoemulsification in the right eye who 11 months ago reported decreased vision in the same eye. The ophthalmologic examination of the right eye showed an uncorrected visual acuity of 0.3 by Snellen chart, which improved to 1.0 with a correction of -1.00 D diopter. Slit lamp examination ruled out any type of anterior segment inflammation. His intraocular pressure was 18 mmHg. She showed a shallow anterior chamber, with an anterior displacement of the iris and a distended capsular sac. The posterior capsule was separated from the posterior surface of the IOL with clear fluid content. Capsular bag distension syndrome was diagnosed. He underwent posterior capsulotomy with Nd: YAG laser. On further evaluation, the patient had uncorrected visual acuities of 1.0 by Snellen chart in both eyes. Capsular bag distension syndrome is a late and infrequent complication of cataract surgery with multiple risk factors, but with rapid resolution(AU)


Sujet(s)
Humains , Cataracte/complications
10.
Rev. cuba. oftalmol ; 36(1)mar. 2023.
Article de Espagnol | LILACS, CUMED | ID: biblio-1530152

RÉSUMÉ

Introducción: La endoftalmitis posquirúrgica es la complicación más temida de la cirugía de catarata. Resulta potencialmente devastadora, puede amenazar seriamente la visión y tiene una incidencia estimada de entre 0,02 y 0,71 por ciento. Objetivo: Determinar la incidencia de endoftalmitis poscirugía de catarata y su comportamiento clínico. Métodos: Se realizó un estudio observacional, descriptivo y de corte transversal. Se revisaron 13 850 cirugías consecutivas de catarata realizadas en el Centro Oftalmológico del Hospital Universitario Clínico Quirúrgico "Arnaldo Milián Castro" de Villa Clara, Cuba. Resultados: La incidencia de endoftalmitis poscirugía de catarata en esta serie fue de 0,17 por ciento (IC 95 por ciento: 0,10-0,24 por ciento); 0,18 por ciento (IC 95 por ciento 0,11-0,25 por ciento) para extracción extracapsular del cristalino y sin incidencia en la facoemulsificación. La forma de presentación aguda fue más frecuente que la crónica; 0,13 por ciento (IC 95 por ciento: 0,07-0,19 por ciento) y 0,04 por ciento (IC 95 por ciento: 0,01-0,07 por ciento), respectivamente. Los hombres fueron más afectados que las mujeres y la edad media fue de 71,8 años. La forma aguda se presentó con una media de 5,1 días entre la cirugía y el inicio de los síntomas y la crónica con una media de 21,2 semanas. El 39,1 por ciento de los pacientes tuvo agudeza visual de percepción luminosa al momento del diagnóstico. Se reportó un crecimiento bacteriano en el 44,7 por ciento de las muestras, con una positividad en humor acuoso y vítreo del 42,1 por ciento y 47,4 por ciento, respectivamente. El Staphylococcus coagulasa negativo fue el germen más frecuente. Los antibióticos intravítreos más vitrectomía plana precoz fue la conducta terapéutica más empleada. Conclusiones: La incidencia de endoftalmitis poscirugía de catarata en esta serie está en el rango de lo reportado a nivel mundial. Se presenta comúnmente de forma aguda y con pobre agudeza visual. El agente etiológico aislado con más frecuencia fue el Staphylococcus coagulasa negativa(AU)


Introduction: Postoperative endophthalmitis is the most feared complication of cataract surgery. It is potentially devastating, can seriously threaten vision and has an estimated incidence of between 0.02 and 0.71 percent. Objective: To determine the incidence of endophthalmitis after cataract surgery and its clinical behavior. Methods: An observational, descriptive, cross-sectional, descriptive study was performed. Thirteen 850 consecutive cataract surgeries performed at the Ophthalmologic Center of the Clinical Surgical University Hospital "Arnaldo Milián Castro" of Villa Clara were reviewed. Results: The incidence of endophthalmitis after cataract surgery in this series was 0.17 percent (95 percent CI: 0.10-0.24 percent); 0.18 percent (95 percent CI: 0.11-0.25 percent) for extracapsular extraction of the crystalline lens and no incidence in phacoemulsification. The acute form of presentation was more frequent than the chronic form; 0.13 percent (95 percent CI: 0.07-0.19 percent) and 0.04 percent (95 percent CI: 0.01-0.07 percent), respectively. Males were more affected than females and the mean age was 71.8 years. The acute form occurred with a mean of 5.1 days between surgery and symptom onset and the chronic form with a mean of 21.2 weeks. Thirty-nine.1 percent of patients had visual acuity of light perception at the time of diagnosis. Bacterial growth was reported in 44.7 percent of the specimens, with positivity in aqueous and vitreous humor of 42.1 percent and 47.4 percent, respectively. Coagulase-negative Staphylococcus was the most frequent germ. Intravitreal antibiotics plus remission for early flat vitrectomy was the most commonly employed therapeutic behavior. Conclusions: The incidence of post cataract surgery endophthalmitis in this series is in the range of that reported worldwide. It commonly presents acutely and with poor visual acuity. The most frequently isolated etiologic agent was coagulase-negative Staphylococcus(AU)


Sujet(s)
Humains , Femelle , Sujet âgé , Vitrectomie/méthodes , Cataracte/étiologie , Endophtalmie/épidémiologie , Antibactériens/usage thérapeutique , Staphylococcus , Épidémiologie Descriptive , Études transversales , Études observationnelles comme sujet
11.
Rev. méd. Chile ; 151(3): 306-312, mar. 2023. graf
Article de Espagnol | LILACS | ID: biblio-1530255

RÉSUMÉ

BACKGROUND: Endophthalmitis is a serious infectious complication of cataract surgery, which may lead to vision loss. Aim: To evaluate the effectiveness of intracameral moxifloxacin in reducing endophthalmitis after cataract surgery in Chilean patients. MATERIAL AND METHODS: We reviewed all phacoemulsification surgeries performed between 2012 and 2020 at a public hospital. The use of intraoperative intracameral moxifloxacin and possible surgical complications were recorded. In patients with postoperative endophthalmitis, we reviewed their risk factors and clinical characteristics. RESULTS: In the study, 22,869 phacoemulsification surgeries were registered, with an annual average of 2,541. The use of prophylactic intracameral moxifloxacin started progressively in 2014. In 2018 it was used in 88% of the surgeries. Fifteen eyes evolved with postoperative endophthalmitis, but none of these surgeries used intracameral moxifloxacin. Five and seven cases occurred in 2012 and 2013, respectively. There was a trend favoring moxifloxacin use, as a preventive measure for endophthalmitis, but the difference between groups was not significant (p = 0.56). In the group with endophthalmitis, 33.3% of the eyes were from patients with type 2 diabetes mellitus, in 13.3% there was rupture of the posterior capsule and 60% of the eyes corresponded to female patients. Since 2018 there is no record of endophthalmitis after cataract surgery performed in this center. Conclusions: Intracameral moxifloxacin showed a tendency to reduce the frequency of endophthalmitis after phacoemulsification surgery, but a longer observation period is required to reach statistical significance, due to the low frequency of this complication.


Sujet(s)
Humains , Cataracte/traitement médicamenteux , Endophtalmie/étiologie , Endophtalmie/prévention et contrôle , Endophtalmie/traitement médicamenteux , Complications postopératoires/prévention et contrôle , Antibioprophylaxie , Fluoroquinolones/usage thérapeutique , Moxifloxacine , Antibactériens/usage thérapeutique
12.
Acta Medica Philippina ; : 41-46, 2023.
Article de Anglais | WPRIM | ID: wpr-980235

RÉSUMÉ

Background@#Infants with congenital rubella syndrome (CRS) often require multiple diagnostic procedures and interventions that include cataract surgery and procedures for congenital heart abnormalities. CRS is a vaccine preventable disease.@*Objective@#This study aimed to determine the costs incurred by the parents, Philippine Health Insurance Corporation (PHIC), hospital's medical social service (MSS), and non-governmental organization (NGO) in the management of CRS.@*Methods@#This is a costing study of five children diagnosed with probable CRS who were managed in a tertiary government hospital in Northern Luzon, Philippines. The parents or guardians of the patients were interviewed on the cost incurred particularly on non-medical related expenses during their outpatient department consultations and admissions. Hospital bills from our institutions and those from the previous institutions, if available, were retrieved. Expenses incurred from procedures or medical supplies relating to known complications of CRS were included in the computation.@*Results@#All five patients diagnosed with CRS had cardiac, ear, and eye manifestations. Two patients had postnatal complications. The average cost spent by the five patients' early years of life (mean age of patients was 16 ± 14 months) was ₱409,740.84. A quarter of the cost was out-of-pocket expenses while a third was covered by the hospital's MSS where the patients were seen. Another third was shouldered by an NGO. Most expenses were from the treatment of cardiac complications at 42% of the cost and had the highest average cost at ₱116,586.59. Case 1 had the highest financial cost at ₱833,514.24 mainly from the cardiac complications of CRS.@*Conclusion@#The cost of CRS in the early years of life is high. This is a significant financial burden to parents, PHIC, hospital's MSS, and NGO.


Sujet(s)
Syndrome de rubéole congénitale , Cataracte
13.
Acta Medica Philippina ; : 38-43, 2023.
Article de Anglais | WPRIM | ID: wpr-980255

RÉSUMÉ

Objectives@#Video-based learning of surgical skills is a useful complement in training programs. This is more evident where direct patient exposure is limited due to multiple factors. In ophthalmic surgery, access to high quality ocular surgery videos such as for cataract operations, can provide significant learning points for trainees in an institutional program. Creation therefore of a local, curated, and indexed library of cataract surgery would support alternative means to maximize training of new ophthalmic surgeons. The objective of the project was to develop a local library of cataract surgery videos as an adjunct teaching tool for resident trainees in a Philippine tertiary eye care center. @*Methods@#A collection of cataract surgery videos from 2013-2020 were compiled into a single workstation. Videos were reviewed and catalogued using set keywords for easy searchability and labelling. @*Results@#256 videos of cataract surgeries were compiled into the library. 6 main headings for the keywords, with 159 total subheadings were established to provide robust tagging and search options to index the video.@*Conclusion@#Particularly in Ophthalmic surgery, refinement of surgical technique is essential in ensuring better postoperative visual outcomes. This is achieved through repetition and careful dissection of operative technique. The use of a library with multiple videos of a similar procedure allows trainees more exposure to certain cases. This ultimately affords trainees, better experience and confidence in their own surgeries.


Sujet(s)
Cataracte , Bibliothèques , Chirurgie générale
14.
Article de Chinois | WPRIM | ID: wpr-971060

RÉSUMÉ

A full-term female infant was admitted at 5 hours after birth due to heart malformations found during the fetal period and cyanosis once after birth. Mmultiple malformations of eyes, face, limbs, and heart were noted. The whole-exome sequencing revealed a pathogenic heterozygous mutation, c.2428C>T(p.Arg810*), in the BCOR gene. The infant was then diagnosed with oculo-facio-cardio-dental syndrome. He received assisted ventilation to improve oxygenation and nutritional support during hospitalization. Right ventricular double outlet correction was performed 1 month after birth. Ocular lesions were followed up and scheduled for elective surgery. The possibility of oculo-facio-cardio-dental syndrome should be considered for neonates with multiple malformations of eyes, face, and heart, and genetic testing should be performed as early as possible to confirm the diagnosis; meanwhile, active ophthalmic and cardiovascular symptomatic treatment should be given to improve the prognosis.


Sujet(s)
Femelle , Humains , Nourrisson , Nouveau-né , Mâle , Malformations multiples/thérapie , Cataracte/génétique , Cyanose , Protéines proto-oncogènes , Protéines de répression/génétique , Cardiopathies congénitales/génétique
15.
Article de Chinois | WPRIM | ID: wpr-981413

RÉSUMÉ

Gigantol is a phenolic component of precious Chinese medicine Dendrobii Caulis, which has many pharmacological activities such as prevent tumor and diabetic cataract. This paper aimed to investigate the molecular mechanism of gigantol in transmembrane transport in human lens epithelial cells(HLECs). Immortalized HLECs were cultured in vitro and inoculated in the laser scanning confocal microscopy(LSCM) medium at 5 000 cells/mL. The fluorescence distribution and intensity of gigantol marked by fluorescence in HLECs were observed by LSCM, and the absorption and distribution of gigantol were expressed as fluorescence intensity. The transmembrane transport process of gigantol in HLECs were monitored. The effects of time, temperature, concentration, transport inhibitors, and different cell lines on the transmembrane absorption and transport of gigantol were compared. HLECs were inoculated on climbing plates of 6-well culture plates, and the ultrastructure of HLECs was detected by atomic force microscopy(AFM) during the transmembrane absorption of non-fluorescent labeled gigantol. The results showed that the transmembrane absorption of gigantol was in time and concentration-dependent manners, which was also able to specifically target HLECs. Energy and carrier transport inhibitors reduced gigantol absorption by HLECs. During transmembrane process of gigantol, the membrane surface of HLECs became rougher and presented different degrees of pits, indicating that the transmembrane transport of gigantol was achieved by active absorption of energy and carrier-mediated endocytosis.


Sujet(s)
Humains , Cristallin/anatomopathologie , Cataracte/prévention et contrôle , Bibenzyles/pharmacologie , Cellules épithéliales , Cellules cultivées , Apoptose
16.
Article de Anglais | WPRIM | ID: wpr-1007845

RÉSUMÉ

OBJECTIVE@#To investigate the clinical efficacy of dexamethasone vitreous cavity implants (Ozurdex) for the treatment of macular edema (Irvine-Gass Syndrome) after cataract surgery.@*METHOD@#Eight patients (eight eyes) with Irvine-Gass syndrome were enrolled for vitreous injections with Ozurdex. The patients included six men (six eyes) and two women (two eyes) with a mean age of 67.12 ± 11.92 years. Changes in the patients best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure were compared before and after treatment.@*RESULT@#The mean visual acuity BCVA of the patients was 0.81 ± 0.26 before implantation, which improved to 0.20 ± 0.12, 0.13 ± 0.09, and 0.15 ± 0.13 at 2 weeks, 1 month, and 3 months after implantation, respectively ( P < 0.001). The patient's mean CMT before implantation was 703.00 ± 148.88 μm, and it reduced to 258.87 ± 37.40 μm, 236.25 ± 28.74 μm, and 278.00 ± 76.82 μm at 2 weeks, 1 month, and 3 months after implantation, respectively ( P < 0.001).@*CONCLUSION@#The dexamethasone vitreous cavity implant (Ozurdex) is a safe and effective treatment, which can effectively improve patient's visual acuity and reduce macular edema associated with cataract surgery.


Sujet(s)
Mâle , Humains , Femelle , Adulte d'âge moyen , Sujet âgé , Oedème maculaire/étiologie , Dexaméthasone/usage thérapeutique , Pression intraoculaire , Prothèses et implants , Cataracte
17.
Rev. bras. oftalmol ; 82: e0050, 2023. graf
Article de Portugais | LILACS | ID: biblio-1521785

RÉSUMÉ

RESUMO Ao longo da vida, o cristalino produz novas fibras dispostas de forma concêntrica, que aumentam seu diâmetro anteroposterior e peso, tornando seu núcleo mais compacto e endurecido. A catarata hipermadura é uma forma de progressão avançada dessa proliferação de fibras, que pode desencadear uma variedade de complicações. A ruptura espontânea da cápsula anterior do cristalino, evoluindo com deslocamento anterior do núcleo, é uma complicação rara e com poucos casos publicados na literatura. Descrevemos o caso de uma paciente do sexo feminino, 68 anos, que apresentou ruptura espontânea da cápsula anterior do cristalino com deslocamento anterior do núcleo em olho esquerdo sem histórico de trauma ocular. A paciente foi submetida à facoemulsificação do cristalino e ao controle da pressão intraocular, evoluindo com melhora do quadro clínico.


ABSTRACT Throughout life, the lens produces new fibers arranged concentrically, which increase its anteroposterior diameter and weight, making its nucleus more compact and hardened. Hypermature cataract is an advanced stage of this fiber proliferation, which can trigger a variety of complications. Spontaneous rupture of the anterior lens capsule evolving with anterior displacement of the nucleus is a rare complication, with few cases published in the literature. We describe the case of a 68-year-old female patient, who presented spontaneous rupture of the anterior lens capsule with anterior displacement of the nucleus in the left eye, without a history of ocular trauma. The patient underwent phacoemulsification and clinical control of intraocular pressure, improving her condition.


Sujet(s)
Humains , Femelle , Sujet âgé , Cataracte/complications , Subluxation du cristallin/diagnostic , Subluxation du cristallin/étiologie , Capsule antérieure du cristallin/anatomopathologie , Rupture spontanée/chirurgie , Cataracte/thérapie , Glaucome néovasculaire , Subluxation du cristallin/chirurgie , Échographie , Phacoémulsification/méthodes , Biomicroscopie , Pression intraoculaire , Noyau du cristallin/anatomopathologie , Chambre antérieure du bulbe oculaire/anatomopathologie
18.
Arch. pediatr. Urug ; 93(2): e308, dic. 2022. ilus
Article de Espagnol | LILACS, UY-BNMED, BNUY | ID: biblio-1383654

RÉSUMÉ

Las cataratas son una causa importante de discapacidad visual en la población pediátrica en todo el mundo y pueden afectar significativamente el neurodesarrollo de un niño. Constituyen un problema fundamental en cuanto a su manejo y una de las causas más relevantes de ceguera tratable en los países desarrollados y en vías de desarrollo. La trisomía 21 es la cromosomopatía más frecuente, de características fenotípicas determinadas con un 60% de anormalidades oculares, entre las que se destacan las ametropías, queratocono y las cataratas. El diagnóstico clínico y la identificación temprana del tipo de cataratas, junto con intervenciones clínicas y tratamientos precoces, son claves para lograr resultados óptimos. Se presenta el caso de un recién nacido con síndrome de Down y catarata congénita bilateral y su manejo inicial.


Cataracts are a major cause of visual impairment in the pediatric population worldwide and can significantly affect a child's neurobiological development. Congenital cataract management can become a very important problem and is one of the most important causes of blindness in developed and developing countries. Trisomy 21 is the most common chromosomal disease and it has certain phenotypic characteristics and 60% ophthalmic abnormalities, such as, ametropia, keratoconus and cataracts. The diagnosis is fundamentally clinical. Early identification, diagnosis, and appropriate clinical care are key to achieve optimal results. We present the case of a newborn with Down syndrome who was diagnosed with an early bilateral congenital cataract.


A catarata é uma das principais causas de deficiência visual na população pediátrica no mundo e pode afetar significativamente o neurodesenvolvimento de uma criança, além de constituir um problema fundamental em termos de sua gestão e é uma das causas mais relevantes de cegueira tratável em países desenvolvidos e em desenvolvimento. Trissomia 21 é a cromossomopatia mais frequente e tem determinadas características fenotípicas com 60% de alterações oculares, como a ametropia, ceratocone e catarata. O diagnóstico clínico e a identificação precoce do tipo de catarata, juntamente com intervenções clínicas e tratamento precoces, são fundamentais para alcançar os melhores resultados. Apresentamos o caso de um recém-nascido com síndrome de Down e catarata congênita bilateral e seu manejo inicial.


Sujet(s)
Humains , Mâle , Nouveau-né , Cataracte/congénital , Extraction de cataracte , Syndrome de Down/complications
19.
Rev. cuba. oftalmol ; 35(4)dic. 2022.
Article de Espagnol | LILACS, CUMED | ID: biblio-1441771

RÉSUMÉ

La silicona líquida es usada intravítrea cuando se requiere un taponamiento prolongado intraocular para mantener la retina aplicada. A pesar de sus ventajas, su uso se ha asociado a algunas complicaciones como catarata, queratopatía, hipertensión ocular, glaucoma entre otras. La hipertensión ocular secundaria por aceite de silicona aparece por varios mecanismos, la migración de partículas a la malla trabecular junto con el proceso inflamatorio que genera es un reto para los cirujanos, de ahí los diferentes criterios de tratamiento que existen para su completa resolución. A continuación, se presenta un paciente operado de desprendimiento de retina recidivado con hipertensión ocular secundario a aceite de silicona 9 meses después de su primera intervención. Llevó tratamiento con hipotensores oculares tópicos, orales y no resolvió por lo que se decide realizar ciclocrioterapia en dos cuadrantes. A pesar que este tratamiento no es el de elección en estos casos, podemos decir que en este paciente se logra controlar la presión intraocular luego de una sola sesión(AU)


Liquid silicone is used intravitreally when prolonged intraocular insulation is required to keep the retina applied. Despite its advantages, its use has been associated with some complications such as cataract, keratopathy, ocular hypertension, glaucoma, among others. Secondary ocular hypertension due to silicone oil appears by several mechanisms. The migration of particles to the trabecular meshwork, together with the inflammatory process it generates, represents a challenge for surgeons, hence the different treatment criteria that exist for its complete resolution. The following is a patient operated on for recurrent retinal detachment with ocular hypertension secondary to silicone oil 9 months after the first operation. He was treated with topical and oral ocular hypotensors and it did not resolve, so it was decided to perform cyclocriotherapy in two quadrants. Although this treatment is not the treatment of choice in these cases, we can say that in this patient intraocular pressure control was achieved after only one session(AU)


Sujet(s)
Humains , Cataracte/complications , Huiles de silicone/usage thérapeutique , Décollement de la rétine/étiologie , Hypertension oculaire , Glaucome/complications
20.
Rev. cuba. oftalmol ; 35(4)dic. 2022.
Article de Espagnol | LILACS, CUMED | ID: biblio-1441764

RÉSUMÉ

Objetivo: Determinar la relación de los planos anatómicos del cristalino con la posición real de la lente intraocular en pacientes con diagnóstico de catarata atendidos en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología durante el período de enero del 2018 a enero 2021. Métodos: Se realizó un estudio observacional, descriptivo, prospectivo longitudinal en 89 ojos de 67 pacientes operados de catarata con implante de lente intraocular (LIO) por técnica de facoemulsificación. Se empleó para el cálculo del poder de la lente el IOL Master 700 y la fórmula de SRK/T. Se utilizó la imagen de OCT ofrecida por el IOL Máster 700 para determinar el plano ecuatorial y plano central del cristalino, así como la posición real de la lente intraocular. Resultados: Predominó el grupo de edad entre 60 - 79 años, el sexo femenino representó el 53 por ciento. Los ojos tamaño promedio y las medidas biométricas oculares en valores promedios estándar fueron los más representativos. El plano ecuatorial mostró menos diferencia con la posición real de la lente intraocular en comparación con la diferencia evidenciada entre el plano central y la posición real de la lente. La adecuada posición del lente intraocular calculado en la bolsa capsular independiente a la longitud axial, permitió obtener un resultado refractivo en correspondencia al esperado previo a la cirugía. Conclusión: Los parámetros anatómicos del cristalino (plano ecuatorial, plano central) constituyen variables importantes a tener en cuenta para el desarrollo y perfeccionamiento de las fórmulas para el cálculo del lente intraocular(AU)


Purpose: To determine the relationship of the anatomical planes of the crystalline lens with the actual position of the intraocular lens in patients with a diagnosis of cataract seen at the Ocular Microsurgery Center of the Cuban Institute of Ophthalmology during the period January 2018 and January 2021. Methods: An observational, descriptive, prospective longitudinal study was performed in 89 eyes of 67 patients operated on for cataract with intraocular lens implantation (IOL) by phacoemulsification technique. The IOL Master 700 and the SRK/T formula were used to calculate lens power. The OCT image provided by the IOL Master 700 was used to determine the equatorial plane and central plane of the crystalline lens, as well as the actual position of the intraocular lens. Results: The age group 60-79 years was predominant, female gender represented 53 percent. Average eye size and ocular biometric measurements in standard average values were the most representative. The equatorial plane showed less difference with the actual intraocular lens position compared to the difference evidenced between the central plane and the actual lens position. The adequate position of the intraocular lens calculated in the capsular bag independent to the axial length, allowed to obtain a refractive result in correspondence to the one expected before surgery. Conclusion: The anatomical parameters of the crystalline lens (equatorial plane, central plane) are important variables to be taken into account for the development and improvement of the formulas for the calculation of the intraocular lens(AU)


Sujet(s)
Femelle , Sujet âgé , Cataracte/diagnostic , Épidémiologie Descriptive , Études prospectives , Études observationnelles comme sujet
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