Evaluating the accuracy of a cataract surgery simulation video in depicting patient experiences under conscious anesthesia.

PURPOSE: To evaluate the accuracy of a point-of-view cataract surgery simulation video in representing different subjective experiences of patients undergoing the procedure. METHODS: One hundred consecutive post-cataract-surgery patients were shown a short simulation video of the surgery obtained through a porcine eye model during the first postoperative week. Patients then answered a multiple-choice questionnaire regarding their visual and tactile intraoperative experiences and how those experiences matched the simulation. RESULTS: Of the patients surveyed (n = 100), 78% (n = 78) recalled visual experiences during surgery, 11% recalled pain (n = 11), and 6.4% (n = 5) recalled frightening experiences. Thirty-six percent of patients (n = 36) were interviewed after their second cataract surgery; there was no statistically significant difference between anxiety scores reported before the first eye surgery and second eye surgery (p = 0.147). Among all patients who recalled visual experiences (n = 78), nearly half (47.4%) reported that the video was the same/similar to their experience. Forty-eight percent of the patients recommended future patients to watch the video before their procedures, and more than a third (36%) agreed that watching the video before surgery would have helped them to relax. CONCLUSIONS: Our model reflects the wide range of subjective patient experiences during and after surgery. The high percentage of patients who found the video accurate in different ways suggests that, with more development, point-of-view cataract simulation videos could prove useful for educational or clinical use. Further research may be done to confirm the simulation's utility, by screening the video for subjects before operations.

Intense Pulsed Light Therapy with Optimal Pulse Technology as an Adjunct Therapy for Moderate to Severe Blepharitis-Associated Keratoconjunctivitis.

PURPOSE: To evaluate the intense pulsed light (IPL) therapy with optimal pulse technology (OPT, M22™, Lumenis, USA) as an adjunct therapy for the prevention of recurrences in moderate to severe blepharokeratoconjunctivitis (BKC). METHODS: This open-label nonrandomized clinical trial evaluated 33 patients diagnosed with BKC. Twenty-one patients received four bilateral OPT therapy sessions with Meibomian gland expression (MGX) (treatment group), and 11 patients received MGX alone (controls). This trial was initiated after a four-week pharmacotherapy for BKC in both groups and was scheduled at four-week intervals. Efficacy outcome measures included meibum quality, Meibomian gland (MG) secretion function, eyelid margin signs, corneal fluorescein staining (CFS) score, noninvasive keratography breakup time (NIKBUT), ocular surface disease index (OSDI) score, Schirmer I test (SIT), classification of tear film lipid layer (TFLL), and Meibomian gland dropout (MGDR). Safety outcome measures included visual acuity, intraocular pressure, eye structure damage, and facial skin appearance at each visit. RESULTS: Quality of meibum, MG expressibility, eyelid margin signs, and OSDI score showed a statistically significant greater improvement in the treatment group after one to three treatment sessions, compared to controls (p < 0.05). While these improved in both groups in comparison to baseline, the NIKBUT and upper and lower eyelid MGDRs significantly improved only in the treatment group (p < 0.05). No adverse events occurred in both groups. No BKC recurrences were noted in the treatment group. CONCLUSIONS: IPL is a safe and effective adjuvant treatment for BKC and possibly more effective in reducing eyelid margin inflammation and prevents recurrences than MGX alone. This trial is registered with ChiCTR-ONN-17013864.

Nutritional effect on age-related cataract formation and progression.

PURPOSE OF REVIEW: To provide a comprehensive summary of the latest evidence-based data on nutrients linked to the pathogenesis of cataract formation and progression. RECENT FINDINGS: This summary of peer-reviewed publications emphasizes the ongoing effort to modulate the cataractogenous process through nutrition, and points at an only weak evidence for the contribution of a specific nutrient to this process. Although observational studies successfully demonstrated a positive correlation between specific nutrients intake and age-related cataract, such evidence was usually lacking in following interventional studies. Three metanalyses point towards a beneficial effect of high intake of vitamin C, vitamin E and vitamin A on the risk of age-related cataract. New studies point at a protective effect of a high intake of vitamin K1 and vitamin D but negate the influence of Mediterranean diet or an overall high dairy consumption on the progression of cataract in a subgroup of patients. Sterols are candidate nutrients for future investigation. SUMMARY: Nutrition rich in fruits and vegetables, and a high dietary intake of vitamins A, C, D, E and K1 may be inversely associated with the risk of age-related cataract. More studies involving patients in a wide range of nutritional status are required to establish the long-term benefit of nutritional supplements.