[Impact of cataract surgery on visual acuity and quality of life]. / Impacto de la cirugía de catarata: agudeza visual y calidad de vida.

OBJECTIVE: To evaluate visual acuity and quality of life improvement after cataract surgery. METHODS: Visual acuity and quality of life were assessed in patients undergoing phaco-emulsification. They were of both genders, ranged from forty-six to ninety-two years of age, and were able to understand the SF-36 quality of life questionnaire which explores the differences in quality of life before and after surgery. The questionnaire was completed before cataract surgery and again 6 and 18 months later. Visual acuity was measured with Snellen optotype. RESULTS: The answers of 150 patients were evaluated in this study. The average age was 74.32 years. After the surgery the body pain results increased, with this shown to be statistically significant. The social function, general health, perception, role limitation due to physical problems and physical function significantly improved between the first and third consultations. There were no significant differences in role limitation due to emotional problems, nor in vitality. The mental health dimension became worse between consultations although there was no statistically significant difference found. The average values for Visual Acuity were 18.39, 66.01 and 69.02 at the three timed assessments made. CONCLUSIONS: Cataract surgery performed by phacoemulsification has been proven to be effective in improving quality of life, especially in physical aspects, according to the improvement in role limitation due to physical problems. Visual acuity also improves after surgery. Disease specific instruments, such as the SF-36, should be used as the outcome measure in clinical practice after cataract surgery.

[Quality of life following cataract surgery]. / Calidad de vida en pacientes intervenidos de catarata.

OBJECTIVE: To evaluate quality of life improvement after cataract surgery. METHODS: Measurement of quality of life in 60-80-year-old patients undergoing phacoemulsification, both genders and able to comprehend the SF-36 quality of life questionnaire. The SF-36 explores the differences in quality of life before and after surgery. The questionnaire was completed prior to cataract surgery and six months after. RESULTS: The answers of 75 patients were evaluated in this study. The average age was 73.88 S.E. 5.27 years old. After the surgery physical function increased (p=0.001), as did role limitation due to physical problems (p=0.007) and social function (p=0.003). Body pain, role limitation due to emotional problems, vitality, energy or tiredness, general health perception and health improved after surgery compared to one month before, but these findings were not statistically significant. CONCLUSIONS: Quality of life can be measurably improved by cataract surgery. Disease-specific questionnaires, such as the SF-36, should be used whenever possible as an outcome measure in clinical practice. The phacoemulsification cataract surgery has proved to be effective in improving quality of life.

[Hyperhomocysteinemia as a risk factor for central retinal vein thrombosis in a young patient]. / Hiperhomocistinemia como un factor de riesgo para la trombosis de la vena central de la retina en un paciente joven.

INTRODUCTION: Central retinal vein thrombosis (CRVT) is a multifactorial disease and known risk factors include high blood pressure, diabetes mellitus, hypercholesterolemia and primary open-angle glaucoma. Yet in patients below the age of 60, a state of hyperviscosity and hypercoagulability in the absence of other vascular risk factors are important factors, as is hyperhomocysteinemia, an independent risk factor for venous thromboses. Homocysteine is an essential amino acid produced by the transmethylation of methionine. It can be remethylated using enzymes that require folate and cobalamin to re-form methionine or to catabolize for cystathionine beta-synthetase, which is dependent on pyridoxine to form cysteine. Hyperhomocysteinemia can give rise to a dysfunction in the endothelium of the vessel, with a proliferation of vascular smooth muscle and prothrombotic homostatic changes. CASE REPORT: A male, aged 33, with no vascular risk factors except cigarette smoking who presented a sharp drop in visual acuity in the right eye. An ophthalmological examination revealed the presence of CRVT, which was confirmed by fluorescein angiography. The results of all analytical and imaging studies conducted while the patient was in hospital were negative. Later analytical monitoring showed a moderate increase in homocysteine. CONCLUSION: From a survey of the literature we have found an important relation between CRVT and hyperhomocysteinemia, which has been noted as a potential risk factor and which requires therapy.

Impacto de la cirugía de catarata: agudeza visual y calidad de vida / Impact of cataract surgery on visual acuity and quality of life

Objetivo: Medir el impacto de la cirugía de catarata sobre la calidad de vida y agudeza visual. Métodos: Se mide la calidad de vida en pacientes intervenidos de Catarata de cuarenta y seis a noventa y dos años de edad, de ambos géneros y con un nivel intelectual que les permitiera comprender el cuestionario (SF-36). Se completó el cuestionario antes del acto quirúrgico seis y dieciocho meses después. La agudeza visual se mide con el optotipo de Snellen. Resultados: Se realizaron 150 cuestionarios. La edad media fue de 74,32 años (DE 6,44). El dolor corporal fue mejorando de forma significativa. La función social, salud general, evolución declarada de la salud, rol físico y función física tienen una evolución similar, manteniendo una mejoría significativa entre la primera y tercera consulta. No existieron diferencias significativas en el rol emocional ni en la vitalidad. La salud mental ha ido empeorando en las sucesivas consultas con diferencias significativas entre ellas. Los valores medios de agudeza visual son 18,39%, 66,01% y 69,02%. Conclusiones: La facoemulsificación es un método efectivo y seguro para mejorar la calidad de vida, sobre todo en los aspectos físicos. La disminución de la limitación de roles debido a problemas de salud físicos tras la cirugía es concordante con la mejora física. La agudeza visual aumenta claramente tras la cirugía. Los cuestionarios genéricos de calidad de vida como el SF-36 se pueden utilizar como medida de resultado de la cirugía de catarata

Objective: To evaluate visual acuity and quality of life improvement after cataract surgery. Methods: Visual acuity and quality of life were assessed in patients undergoing phaco-emulsification. They were of both genders, ranged from forty-six to ninety-two years of age, and were able to understand the SF-36 quality of life questionnaire which explores the differences in quality of life before and after surgery. The questionnaire was completed before cataract surgery and again 6 and 18 months later. Visual acuity was measured with Snellen optotype. Results: The answers of 150 patients were evaluated in this study. The average age was 74.32 years. After the surgery the body pain results increased, with this shown to be statistically significant. The social function, general health, perception, role limitation due to physical problems and physical function significantly improved between the first and third consultations. There were no significant differences in role limitation due to emotional problems, nor in vitality. The mental health dimension became worse between consultations although there was no statistically significant difference found. The average values for Visual Acuity were 18.39, 66.01 and 69.02 at the three timed assessments made. Conclusions: Cataract surgery performed by phacoemulsification has been proven to be effective in improving quality of life, especially in physical aspects, according to the improvement in role limitation due to physical problems. Visual acuity also improves after surgery. Disease specific instruments, such as the SF-36, should be used as the outcome measure in clinical practice after cataract surgery (Arch Soc Esp Oftalmol 2008; 83: 237-248)

Calidad de vida en pacientes intervenidos de catarata / Quality of life following cataract surgery

Objetivo: Medición del impacto de la cirugía de catarata en la calidad de vida.Metodos: Medición de la calidad de vida en pacientes intervenidos de Catarata de sesenta a ochenta años de edad, de ambos géneros y con un nivel intelectual que les permitiera comprender el cuestionario de calidad de vida (SF-36). Se utiliza el SF-36 para medir las diferencias en calidad de vida pre y postcirugía, de tal manera que se completa el cuestionario ANTES del acto quirúrgico y SEIS MESES después.Resultados: Se realizaron 75 cuestionarios. La edad media fue de 73,88 años D.E. 5,27 años. Se ha encontrado una mejora significativa tanto de la función física (p=0,001) , cómo de la limitación de roles por problemas físicos (p=0,007) así cómo de la función social (p=0,003). Las dimensiones dolor corporal, limitación de roles debido a problemas emocionales, vitalidad, energía ó fatiga, percepción de la salud general y salud comparada con la de hace un mes, mejoraron en el periodo postcirugía, si bien no se encontraron diferencias significativas entre ambos periodos.Conclusiones: La Facoemulsificación e implante de lente intraocular ha demostrado que es un método efectivo para mejorar la calidad de vida, sobre todo en los aspectos físicos. La disminución de la limitación de roles debido a problemas de salud físicos tras la cirugía es concordante con la mejora física. La mejora en las relaciones sociales confirma la importancia de la medición de aspectos de calidad de vida en los resultados de cualquier intervención médica

Objective: To evaluate quality of life improvement after cataract surgery. Methods: Measurement of quality of life in 60-80-year-old patients undergoing phacoemulsification, both genders and able to comprehend the SF-36 quality of life questionnaire. The SF-36 explores the differences in quality of life before and after surgery. The questionnaire was completed prior to cataract surgery and six months after. Results: The answers of 75 patients were evaluated in this study. The average age was 73.88 S.E. 5.27 years old. After the surgery physical function increased (p=0.001), as did role limitation due to physical problems (p=0.007) and social function (p=0.003). Body pain, role limitation due to emotional problems, vitality, energy or tiredness, general health perception and health improved after surgery compared to one month before, but these findings were not statistically significant. Conclusions: Quality of life can be measurably improved by cataract surgery. Disease-specific questionnaires, such as the SF-36, should be used whenever possible as an outcome measure in clinical practice. The phacoemulsification cataract surgery has proved to be effective in improving quality of life

Hiperhomocistinemia como un factor de riesgo para la trombosis de la vena central de la retina en un paciente joven / Hyperhomocysteinemia as a risk factor for central retinal vein thrombosis in a young patient

Introducción. La trombosis de la vena central de la retina (TVCR) es una enfermedad multifactorial: la hipertensión arterial, la diabetes mellitus, la hipercolesterolemia y el glaucoma primario de ángulo abierto son factores conocidos de riesgo. En pacientes menores de 60 años, sin embargo, los estados de hiperviscosidad e hipercoagulabilidad, sin otros factores de riesgo vasculares, son importantes, como la hiperhomocistinemia, un factor de riesgo independiente para las trombosis venosas. La homocisteína es un aminoácido esencial, producto de la trasmetilación de la metionina. Puede remetilarse mediante enzimas que requieren folato y cobalamina, para formar de nuevo metionina o catabolizarse mediante la cistioninab-sintetasa, dependiente de la piridoxina, para formar cisteína. La hiperhomocisteinemia puede causar una disfunción en el endotelio del vaso, con una proliferación del músculo liso vascular y cambios hemostáticos protombóticos. Caso clínico. Varón de 33 años, sin factores de riesgo vascular excepto tabaquismo, que presentó de forma brusca una disminución de la agudeza visual del ojo derecho. En la exploración oftalmológica se observó la presencia de una TVCR, que se confirmó con una angiofluoresceingrafía. Todos los estudios analíticos y de imagen que se realizaron durante su ingreso resultaron negativos. Los posteriores controles analíticos demostraron un aumento moderado de homocisteína. Conclusión. Tras revisar la bibliografía, hemos encontrado una importante relación entre la TVCR y la hiperhomocisteinemia, y se ha señalado como un factor de riesgo potencial y susceptible de tratamiento (AU)

Central retinal vein thrombosis (CRVT) is a multifactorial disease and known risk factors include high blood pressure, diabetes mellitus, hypercholesterolemia and primary open-angle glaucoma. Yet in patients below the age of 60, a state of hyperviscosity and hypercoagulability in the absence of other vascular risk factors are important factors, as is hyperhomocysteinemia, an independent risk factor for venous thromboses. Homocysteine is an essential amino acid produced by the transmethylation of methionine. It can be remethylated using enzymes that require folate and cobalamin to re-form methionine or to catabolize for cystathionine beta-synthetase, which is dependent on pyridoxine to form cysteine. Hyperhomocysteinemia can give rise to a dysfunction in the endothelium of the vessel, with a proliferation of vascular smooth muscle and prothrombotic homostatic changes. Case report. A male, aged 33, with no vascular risk factors except cigarette smoking who presented a sharp drop in visual acuity in the right eye. An ophthalmological examination revealed the presence of CRVT, which was confirmed by fluorescein angiography. The results of all analytical and imaging studies conducted while the patient was in hospital were negative. Later analytical monitoring showed a moderate increase in homocysteine. Conclusion. From a survey of the literature we have found an important relation between CRVT and hyperhomocysteinemia, which has been noted as a potential risk factor and which requires therapy (AU)