RESUMO
Questionnaires have been used as research tools to provide a standardized approach to assess quality of life at various time periods and populations. However, literature shows only a few articles about self-reported color vision changes. Our aim was to evaluate the subjective patient feelings before and after cataract surgery and compare the results with a color vision test result. Our method was as follows: 80 cataract patients filled out a modified color vision questionnaire and performed the Farnsworth-Munsell 100 Hue Color Vision Test (FM100) before, two weeks, and six months after cataract surgery. We analyzed the correlations between these two types of results, which reveal that FM100 hue performance and subjective perception improved after surgery. Additionally, subjective patient questionnaire scores correlate well with the FM100 test results before and two weeks after the cataract surgery, but this effect decreased with longer follow-up times. We conclude that subjective color vision changes can only be noticed at longer periods after the cataract surgery. Health care professionals can use this questionnaire to better understand the subjective feelings of patients and monitor their color vision sensitivity changes.
Assuntos
Catarata , Visão de Cores , Humanos , Percepção de Cores , Qualidade de Vida , Testes de Percepção de Cores/métodosRESUMO
The article presents authors' original methods of phaco surgery that can be used in disorders of the capsular-zonular apparatus of the lens. The cataract surgery techniques for lens subluxation developed and introduced into clinical practice allow using the most physiologically correct intracapsular intraocular lens (IOL) fixation in the vast majority of cases. The introduction of femtosecond laser at key stages of phacoemulsification in complicated clinical situations reduces the dependence of the results on the human factor and allows performing removal of complicated cataracts at a qualitatively new level.
Assuntos
Extração de Catarata , Catarata , Cristalino , Lentes Intraoculares , Facoemulsificação , Humanos , Cristalino/cirurgia , Extração de Catarata/efeitos adversos , Extração de Catarata/métodos , Facoemulsificação/efeitos adversos , Facoemulsificação/métodos , Implante de Lente Intraocular/métodos , Catarata/complicações , Catarata/diagnósticoRESUMO
PURPOSE: To investigate the causes of bullous keratopathy (BK) in the Korean population and analyze the results of penetrating keratoplasty (PK) in BK eyes associated with the top two causes: pseudophakic bullous keratopathy (PBK) and glaucoma surgery-associated BK (GBK). METHODS: Medical records were reviewed of patients diagnosed with BK at a tertiary referral center between 2010 and 2020. The predisposing conditions, clinical characteristics and therapeutic outcomes after PK were analyzed and compared. RESULTS: Of total 340 BK eyes, 70% (238 eyes) were associated with ocular surgery; most commonly, cataract surgery (48%, 162 eyes) and glaucoma surgery/laser (21%, 70 eyes). The BK onset was faster following glaucoma surgery/laser (91.7 ± 94.4 months) than following cataract surgery (160.7 ± 138.0 months, p < 0.001). The median survival time of allografts was shorter in GBK than in PBK (24.0 vs 51.0 months, p = 0.020). Best-corrected logMAR visual acuities were lower in GBK than in PBK after PK (1.4 ± 0.7 vs 0.9 ± 0.6, p = 0.017 at one year; 1.8 ± 0.7 vs 1.1 ± 0.8, p = 0.043 at three years). CONCLUSIONS: Intraocular surgery is the major predisposing condition of BK in Korea. GBK developed earlier and its therapeutic outcome was poorer, compared to PBK.
Assuntos
Catarata , Doenças da Córnea , Glaucoma , Oftalmologia , Humanos , Ceratoplastia Penetrante/efeitos adversos , Ceratoplastia Penetrante/métodos , Doenças da Córnea/etiologia , Doenças da Córnea/cirurgia , Acuidade Visual , Catarata/complicações , Glaucoma/cirurgia , Glaucoma/complicações , Estudos RetrospectivosRESUMO
PURPOSE: The purpose of this study was to report 1) demographic and clinical characteristics for US patients with keratoconus undergoing deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (PK) and 2) complication rates for the 2 procedures. METHODS: We performed a retrospective review of 2010 to 2018 health records for patients with keratoconus age younger than 65 years using the IBM MarketScan Database. A multivariable model adjusting for potential confounders was used to determine factors associated with receiving DALK over PK. Rates of complications 90 days and 1 year postoperatively were calculated. For select complications only (repeat keratoplasty, glaucoma surgery, and cataract surgery), Kaplan-Meier survival curves were additionally constructed over a period of up to 7 years. RESULTS: A total of 1114 patients with keratoconus (mean age: 40.5 ± 12.6 years) were included in the analysis. Hundred nineteen received DALK, and 995 received PK. Regional differences exist, with patients in the north central United States having greater odds of receiving DALK than northeastern patients (OR = 5.08, 95% confidence interval, 2.37-10.90). Rates of endophthalmitis, choroidal hemorrhage, infectious keratitis, graft failure, graft rejection, postoperative cataract, glaucoma, or retinal surgery were all low at 90 days and 1 year. Complication rates for DALK and PK were both low beyond 1 year for repeat keratoplasty, cataract, and glaucoma surgery. CONCLUSIONS: There are regional differences between DALK and PK utilization rates. In addition, DALK and PK complication rates in this nationally representative sample are low at 1 year and beyond, but further studies are needed to assess whether longer-term complications differ by procedure type.
Assuntos
Catarata , Transplante de Córnea , Glaucoma , Ceratocone , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Ceratoplastia Penetrante/métodos , Ceratocone/cirurgia , Resultado do Tratamento , Transplante de Córnea/métodos , Glaucoma/cirurgia , Estudos RetrospectivosRESUMO
BACKGROUND: Healthcare cost is increasing rapidly in Singapore. Moving towards a value-based healthcare framework enables a sustainable health system. The National University Hospital (NUH) implemented the Value Driven Outcome (VDO) Program for cataract surgery due to its high volume and cost variability. We aimed to evaluate the association between VDO program implementation and costs and quality outcomes for cataract surgery in NUH. METHODS: We conducted an interrupted time-series analysis for cataract surgery episodes between January 2015 and December 2018. Using segmented linear regression models, we estimate the changes in levels and trends of cost and quality outcomes post-program implementation. We adjusted for autoregression and various confounders. RESULTS: Following VDO program implementation, the total cost of cataract surgery had a significantly decreased by $327.23 (95% CI: -$421.04 to -$233.43; p < 0.01) and the trend significantly decreased by $13.75 per month (95% CI: -$23.19 to -$4.30 per month; p < 0.01). There was a small improvement in the combined quality outcome score (0.028, 95% CI: 0.016 to 0.040; p < 0.01), but the trend remained unchanged. CONCLUSION: The VDO program was associated with a reduction in cost without compromising on quality outcomes. The program provides a structured methodology to measure performances, and through these data, initiatives were implemented to improve value. There are benefits to providing a data reporting system to physicians to understand actual care costs and quality outcomes achieved by individual patients with defined clinical conditions.
Assuntos
Extração de Catarata , Catarata , Humanos , Análise de Séries Temporais Interrompida , Singapura , Custos de Cuidados de SaúdeRESUMO
Though technological advancements have transcended beyond expectation, phacoemulsification remains a challenge in uncooperative patients, where the procedure may be contemplated under general anesthesia, with simultaneous bilateral cataract surgery (SBCS) being the surgery of choice. In this manuscript, we have reported a novel two-surgeon technique of SBCS on a 50-year-old mentally subnormal patient. Under general anesthesia, two surgeons performed phacoemulsification simultaneously, using two separate microscopes, irrigation lines, phaco machines, instruments, and assistants. Intraocular lens (IOL) implantation was performed in both eyes (OU). The patient had a visual recovery from 5/60, N36 in OU preoperatively to 6/12, N10 in OU on post-operative day 3 and 1 month, with no complications. This technique can potentially reduce the risk of endophthalmitis, repeated and prolonged anesthesia, and the number of hospital visits. To the best of our knowledge, this two-surgeon technique of SBCS has never been reported in the literature.
Assuntos
Extração de Catarata , Catarata , Facoemulsificação , Cirurgiões , Humanos , Pessoa de Meia-Idade , Implante de Lente Intraocular/métodos , Acuidade Visual , Extração de Catarata/métodos , Facoemulsificação/métodos , Catarata/complicações , Complicações Pós-OperatóriasRESUMO
This surgical technique describes a modification of the continuous curvilinear capsulorhexis (CCC) to achieve an adequate-sized capsulorhexis in pediatric cataracts with high intralenticular pressure. Performing CCC in pediatric cataracts is challenging, especially when the intralenticular pressure is high. This technique involves 30 G needle decompression of the lens to reduce positive intralenticular pressure and subsequent flattening of the anterior capsule. This minimizes the chances of extension of CCC without using any special equipment. This technique was used in two eyes of two patients (age 8 and 10 years) with unilateral developmental cataracts. Both surgeries were performed by a single surgeon (PKM). In both eyes, a well-centered CCC was achieved with no extension, and a posterior chamber intraocular lens (IOL) was placed in the capsular bag. Thus, our technique of 30 G needle aspiration could be extremely useful to achieve an adequately sized CCC in pediatric cataracts with high intralenticular pressure, especially for beginner surgeons.
Assuntos
Catarata , Cápsula do Cristalino , Facoemulsificação , Humanos , Criança , Capsulorrexe/métodos , Cápsula do Cristalino/cirurgia , Implante de Lente Intraocular/métodos , Facoemulsificação/métodos , Catarata/complicaçõesRESUMO
Purpose: To retrospectively study impact of preoperative posterior segment evaluation on surgical intervention in camp patients recruited for cataract surgery in Gujarat India. Methods: Retrospective analysis of six months data collected from hospital electronic medical record (EMR) system of 9820 admitted patients recruited from screening camp for cataract surgery from 1/10/2019 to 31/3/2020 in Tertiary Eye Hospital in Gujarat, India, has been done. Comprehensive clinical evaluation, of both anterior and posterior segment which included detailed history; best corrected visual acuity (BCVA); intraocular pressure measurement with non-contact tonometer (NCT) and when required with Goldman applanation tonometer; slit lamp examination; and fundus examination with + 90 diopter lens as well as indirect ophthalmoscope as and when indicated. In case there was no view of retina, a B-scan ultrasound was done to rule out any posterior segment pathology. Immediate surgical intervention done was assessed and results analyzed in percentage. Results: Cataract surgery was advised for 8390 patients (85.43%). Surgical intervention for management of glaucoma was done for 68 patients (0.692%). Retina intervention was done for 86 patients. Posterior segment evaluation changed immediate surgical plane of management for 154 (1.57%) patients. Conclusion: Comprehensive clinical evaluation is economical and should be mandatory especially in community services as comorbid conditions like glaucoma, diabetic retinopathy, retinal vein occlusion, and other varied posterior segment diseases contribute significantly to visual disability in elderly age group. It is difficult to follow these patients later if manageable comorbidity is not informed about and if indicated dealt simultaneously for visual rehabilitation of patient.
Assuntos
Extração de Catarata , Catarata , Glaucoma , Humanos , Idoso , Estudos Retrospectivos , Acuidade Visual , Extração de Catarata/métodos , Catarata/complicações , Catarata/diagnósticoRESUMO
Purpose: To study the epidemiological pattern, prevalence, types, and correlates of age-related cataracts in a tertiary care center in central India. Methods: This hospital-based single-center cross-sectional study was conducted on 2,621 patients diagnosed with cataracts for 3 years. Data pertaining to demography, socio-economic profile, cataract grading, cataract types, and associated risk factors were evaluated. Statistical analysis using unadjusted odds ratio (OR) and multivariate logistic regression was performed, with P-value <0.05 considered significant with the power of the study being 95%. Results: The commonest age group affected was 60-79 years, closely followed by the 40-59 years age group. The prevalence of nuclear sclerosis (NS), cortical (CC), and posterior subcapsular cataract (PSC) was found to be 65.2% (3,418), 24.6% (1,289), and 43.4% (2,276), respectively. Among mixed cataracts, (NS + PSC) had the highest prevalence of 39.8%. Smokers were found to have 1.17 times higher odds of developing NS than non-smokers. Diabetics had 1.12 times higher odds of developing NS cataracts and 1.04 times higher odds of developing CC. Patients with hypertension showed 1.27 times higher odds of developing NS and 1.32 times higher odds of developing CC. Conclusion: The prevalence of cataracts in the pre-senile age group (<60 years) was found to have increased significantly (35.7%). A higher prevalence of PSC (43.4%) was found in studied subjects, as compared to the data of previous studies. Smoking, diabetes, and hypertension were found to have a positive association with a higher prevalence of cataracts.
Assuntos
Catarata , Diabetes Mellitus , Hipertensão , Humanos , Pessoa de Meia-Idade , Idoso , Estudos Transversais , Prevalência , Fatores de Risco , Catarata/etiologiaRESUMO
Purpose: To evaluate the visual and surgical outcomes of cataract surgery in patients with posterior polar cataract (PPC) and to evaluate the benefits of preoperative anterior segment optical coherence tomography (AS-OCT). Methods: This was a retrospective, single-center study. Case records of patients diagnosed with PPC who underwent cataract surgery either by phacoemulsification or manual small-incision cataract surgery (MSICS) from January to December 2019 were analyzed. Data collected include demographic details, preoperative best corrected visual acuity (BCVA), AS-OCT, type of cataract surgery, intraoperative and postoperative complications, and visual outcome at 1-month follow-up. Results: One hundred patients were included in the study. Preoperative posterior capsular defect was noted on AS-OCT in 14 patients (14%). Seventy-eight underwent phacoemulsification and 22 underwent MSICS. Intraoperatively, posterior capsular rupture (PCR) was seen in 13 patients (13%) and cortex drop was noted in one among them (1%). Out of 13 PCRs, 12 were found to have posterior capsular dehiscence preoperatively in AS-OCT. The sensitivity of AS-OCT for detecting posterior capsule dehiscence was 92.3% and specificity was 97.7%. The positive predictive value and negative predictive value were 85.7% and 98.8%, respectively. There was no significant difference in the incidence of PCR between phacoemulsification and MSICS (P = 0.475). The mean BCVA at 1 month was found to be better with phacoemulsification than MSICS (P = 0.004). Conclusion: Preoperative AS-OCT has excellent specificity and negative predictive value in identifying posterior capsular dehiscence. It thus helps to plan the surgery and counsel patients appropriately. Both phacoemulsification and MSICS provide good visual outcome with similar complication rates.
Assuntos
Extração de Catarata , Catarata , Facoemulsificação , Ferida Cirúrgica , Humanos , Tomografia de Coerência Óptica , Estudos Retrospectivos , Acuidade Visual , Extração de Catarata/métodos , Facoemulsificação/métodos , Catarata/complicações , Catarata/diagnóstico , Ferida Cirúrgica/complicaçõesRESUMO
Purpose: To determine the morphology of pediatric cataracts and assess the status of the anterior and posterior capsules preoperatively on swept-source anterior segment optical coherence tomography (ASOCT) and compare the findings to those of intraoperative examination. Secondly, we aimed to obtain biometric measurements on ASOCT and compare them to those obtained on A-scan/optical methods. Methods: This was a prospective and observational study carried out at a tertiary care referral institute. ASOCT scans for anterior segment were obtained preoperatively for all patients, aged <8 years, scheduled for paediatric cataract surgery. The morphology of the lens and capsule and biometry were performed on ASOCT and the same were assessed intraoperatively. The main outcome measures were comparison of ASOCT findings to intraoperative findings. Results: The study included 33 eyes of 29 patients (range 3 months-8 years). The morphological characterization of cataract on ASOCT was accurate in 31/33 (94%) cases. ASOCT accurately identified fibrosis and rupture of the anterior and posterior capsules in 32/33 (97%) cases each. In 30% of eyes, ASOCT gave additional information preoperatively compared to the slit lamp. Intraclass correlation coefficient (ICC) calculation revealed a good agreement between the keratometry values obtained on ASOCT and those obtained preoperatively with a handheld/optical keratometer (ICC = 0.86, P = 0.001). Conclusion: ASOCT is a valuable tool that could provide complete preoperative information of the lens and capsule in pediatric cataract cases. In children as young as 3 months of age, intraoperative risks and surprises could be diminished. The keratometric readings are highly dependent on patient cooperation but show good agreement with the handheld/optical keratometer readings.
Assuntos
Extração de Catarata , Catarata , Humanos , Criança , Tomografia de Coerência Óptica/métodos , Estudos Prospectivos , Cápsulas , Catarata/diagnóstico , Biometria/métodos , Reprodutibilidade dos TestesRESUMO
Purpose: To evaluate safety profile and surgical outcomes of loop myopexy with concurrent intra-ocular lens implantation in cases of myopic strabismus fixus (MSF). Methods: A retrospective chart review of patients who underwent loop myopexy with concurrent small incision cataract surgery with intra-ocular lens implantation between January 2017 and July 2021 for MSF at a tertiary eye care centre was undertaken. A minimum of 6 months of follow-up after surgery was required for inclusion. The main outcome measures were improvement in alignment postoperatively, improvement in extra-ocular motility postoperatively, intraoperative and postoperative complications and post-operative visual acuity. Results: 12 eyes of 7 patients (male (6): female (1)) underwent modified loop myopexy at a mean age of 46.86 years (range 32-65 years). 5 patients underwent bilateral loop myopexy with intra-ocular lens implantation whereas 2 patients underwent unilateral loop with intra-ocular lens implantation. All eyes underwent additional medial rectus (MR) recession with lateral rectus (LR) plication. At the last follow-up, mean esotropia improved to 16 prism dioptres (PD) (Range: 10-20 PD) from 80 PD (Range:60-90PD), P = 0.016; and success (deviation ≤20PD) was achieved in 73% (95% CI 48 to 89%). Mean hypotropia at presentation was 10 PD (range 6-14 PD), which improved to 0 PD (range 0-9 PD), P = 0.063. Mean BCVA improved from 1.08 LogMar to 0.3 LogMar units. Conclusion: Loop myopexy combined with intra-ocular lens implantation is a safe and effective procedure in the management of patients who have Myopic Strabismus Fixus with visually significant cataract and improves both visual acuity and ocular alignment significantly.
Assuntos
Catarata , Esotropia , Miopia , Estrabismo , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Implante de Lente Intraocular/efeitos adversos , Estudos Retrospectivos , Procedimentos Cirúrgicos Oftalmológicos/métodos , Estrabismo/cirurgia , Miopia/complicações , Miopia/cirurgia , Esotropia/cirurgia , Músculos Oculomotores/cirurgia , Catarata/complicaçõesRESUMO
Purpose: The ideal formula for intraocular lens (IOL) power calculation following cataract surgery in pediatric eyes till date has no answer. We compared the predictability of the Sanders-Retzlaff-Kraff (SRK) II and the Barrett Universal (BU) II formula and the effect of axial length, keratometry, and age. Methods: This was a retrospective analysis of children who were under eight years of age and who underwent cataract surgery with IOL implantation under general anesthesia between September 2018 and July 2019. The prediction error of SRK II formula was calculated by subtracting the target refraction and the actual postoperative spherical equivalent. Preoperative biometry values were used to calculate the IOL power using the BU II formula with the same target refraction that was used in SRK II. The predicted spherical equivalent of the BU II formula was then back-calculated using the SRK II formula with the IOL power obtained with the BU II formula. The prediction errors of the two formulae were compared for statistical significance. Results: Seventy-two eyes of 39 patients were included in the study. The mean age at surgery was 3.8 ± 2 years. The mean axial length was 22.1 ± 1.5 mm, and the mean keratometry was 44.7 ± 1.7 D. The group with an axial length >24 mm showed a significant and strong positive correlation (r = 0.93, P = 0) on comparison mean absolute prediction errors using the SRK II formula. There was a strong negative correlation between the mean prediction error in the overall keratometry group using the BU II formula (r = -0.72, P < 0.000). There was no significant correlation between age and refractive accuracy using the two formulae in any of the subgroups of age. Conclusion: There is no perfect answer to an ideal formula for IOL calculation in children. IOL formulae need to be chosen keeping in mind the varying ocular parameters.
Assuntos
Catarata , Lentes Intraoculares , Facoemulsificação , Humanos , Criança , Lactente , Pré-Escolar , Implante de Lente Intraocular , Acuidade Visual , Estudos Retrospectivos , Óptica e Fotônica , Refração Ocular , Comprimento Axial do Olho , BiometriaRESUMO
Purpose: Pediatric cataract is a major cause of preventable childhood blindness worldwide. Although genetic mutations or infections have been described in patients, the mechanistic basis of human cataract development remains poorly understood. Therefore, gene expression of structural, developmental, profibrotic, and transcription factors in phenotypically and etiologically distinct forms of pediatric cataracts were evaluated. Methods: This cross-sectional study included 89 pediatric cataract subjects subtyped into 1) prenatal infectious (cytomegalovirus, rubella, and combined cytomegalovirus with rubella infection), 2) prenatal non-infectious, 3) posterior capsular anomalies, 4) postnatal, 5) traumatic, and 6) secondary, and compared to clear, non-cataractous material of eyes with the subluxated lenses. Expression of lens structure-related genes (Aqp-0, HspA4/Hsp70, CrygC), transcription factors (Tdrd7, FoxE3, Maf, Pitx 3) and profibrotic genes (Tgfß, Bmp7, αSmA, vimentin) in surgically extracted cataract lens material were studied and correlated clinically. Results: In cataract material, the lens-related gene expression profiles were uniquely associated with phenotype/etiology of different cataracts. Postnatal cataracts showed a significantly altered FoxE3 expression. Low levels of Tdrd7 expression correlated with posterior subcapsular opacity, whereas CrygC correlated significantly with anterior capsular ruptures. The expression of Aqp0 and Maf was elevated in infectious cataracts, particularly in CMV infections, compared to other cataract subtypes. Tgfß showed significantly low expression in various cataract subtypes, whereas vimentin had elevated gene expression in infectious and prenatal cataracts. Conclusion: A significant association between lens gene expression patterns in phenotypically and etiologically distinct subtypes of pediatric cataracts suggests regulatory mechanisms in cataractogenesis. The data reveal that cataract formation and presentation is a consequence of altered expression of a complex network of genes.
Assuntos
Catarata , Cristalino , Humanos , Criança , Vimentina/genética , Vimentina/metabolismo , Estudos Transversais , Transcriptoma , Catarata/genética , Catarata/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Fator de Crescimento Transformador beta/genética , Ribonucleoproteínas/genética , Ribonucleoproteínas/metabolismoRESUMO
Purpose: This study aimed to describe visual outcomes in cases of pediatric uveitis in an Indian population and to analyze various factors affecting these outcomes. Methods: Single-center, retrospective chart review of 277 cases of uveitis in patients under the age of 18 years. Variables assessed included age and sex distribution, anatomical location of uveitis, systemic associations, complications, and various treatment strategies used, including long-term immunomodulation and surgical management of complications if required. The main outcome was the final visual acuity. Results: At the final visit, 51.5% of the eyes showed improvement in the final visual acuity, while vision remained stable in 28.7% and 19.7% of the eyes showed worsening of vision at the final follow-up. A total of 19.4% of patients were blind in at least one eye at the final visit, and 16 patients (5.77%) remained bilaterally blind at the final follow-up. The presence of cataract (p = 0), posterior uveitis (p = 0.005), and retinal detachment (p = 0.014) were the most significant risk factors for predicting worse visual outcomes. More than half (65.7%) of patients reported a complication at some point in their follow-up, and the most common complication was cataract. In total, 50.9% of patients required long-term immunomodulatory therapy. Conclusion: Pediatric uveitis remains a challenging condition to treat and follow-up, and the visual outcome remains guarded for most patients.
Assuntos
Artrite Juvenil , Catarata , Uveíte , Criança , Humanos , Adolescente , Estudos Retrospectivos , Seguimentos , Artrite Juvenil/complicações , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/epidemiologia , Catarata/complicaçõesRESUMO
Introduction: Intensive immunosuppressant therapy after renal transplantation has found to cause systemic and ocular side effects among them is cataracts. Studies on a similar topic have still remained explored in our setting. The aim of the study was to find out the prevalence of cataract among patients with renal transplantation in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among patients of renal transplantation at tertiary care centres from 1 May 2021 to 31 October 2021. The data was collected after the ethical approval from Institutional Review Committee [Reference number: 397(6-11) e2077/078]. Study proforma recorded the number of patients with cataracts, duration of steroid use, mean age and other comorbidities. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of 31 renal transplant patients, 10 (32.26%) (15.80-48.72, 95% Confidence Interval) had cataract. Conclusions: The prevalence of cataract among renal transplantation patients was found to be lower than similar studies done in similar settings. Keywords: cataract; prevalence; renal transplantation; steroid.
Assuntos
Catarata , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Transplante de Rim , Humanos , Centros de Atenção Terciária , Estudos Transversais , Catarata/epidemiologiaRESUMO
Ocular coloboma is a rare congenital disability. If involving the macula, it affects the patient's vision and subsequently affects childhood development and quality of life in the future. Appropriate low vision aid and timely rehabilitation can provide the best possible quality of life for visually impaired children. We report a 9-year-old boy who presented with a diminution of vision in both eyes, and who was just enrolled in pre-school. He was diagnosed with bilateral iridochorioretinal coloboma associated with nystagmus and unilateral cataract. After all the necessary evaluation, a telescope was prescribed for distance and a dome magnifier for near. Furthermore, a peaked cap and photo grey lens were given for outdoor activities. This case highlights the importance of low vision intervention in a visually impaired child. Appropriate low vision aid and rehabilitation can improve patients' lifestyle and academic performance who are diagnosed with iridochorioretinal coloboma. Keywords: case reports; coloboma; ocular; rehabilitation; training.
Assuntos
Catarata , Coloboma , Baixa Visão , Masculino , Criança , Humanos , Pré-Escolar , Coloboma/complicações , Coloboma/diagnóstico , Baixa Visão/etiologia , Baixa Visão/complicações , Qualidade de Vida , Catarata/complicaçõesRESUMO
BACKGROUND: We report a case with two connected stents ejected simultaneously during an iStent inject W surgery, a modified second-generation iStent Trabecular Micro-Bypass System. CASE PRESENTATION: A 57-year-old woman with primary open-angle glaucoma underwent a combined cataract and iStent inject W surgery in her left eye. After the trabecular meshwork/Schlemm's canal was pierced by the trocar of injector, the delivery button was pressed a first time, but the stent was not ejected. After the button was pressed a second time, connected two stents were ejected. After removing the dislocated stents from the anterior chamber, two stents were implanted into the desired places using another injector. Except for mild hyphema, no postoperative complication occurred. Stereomicroscopic observation showed that the two stents were connected by a broken trocar shaft. An X-ray showed that the trocar shaft was broken at the part referred to as the "sprayed trocar". Scanning electron microscopy showed that the surface features of the broken trocar and trocar tip represented tensile failure. CONCLUSIONS: Although rare, considering that the damage was seen at the structurally weak part (i.e., sprayed trocar), the same phenomenon can happen. For patient safety, surgeons are recommended to inspect the device when the deployment of either the first or second stent is unsuccessful during the iStent inject surgery.
