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1.
PLoS One ; 17(9): e0274939, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36129906

RESUMO

This is a 5 years multicentre database study that recruited subjects from the Malaysian Ministry of Health Cataract Surgery Registry (MOH CSR), aimed to determine risk factors that affect cataract surgery visual outcome and evaluates post-cataract surgery vision. All age-related cataract surgeries with primary intraocular lens (IOL) implantation were included. Cases with secondary cataract, previous ocular surgeries and incomplete data were excluded. A total of 131425 cases were included in the study. Amongst all types of cataract surgery, 92.9% attained post-operative best-corrected visual acuity better than 6/18 and the outcome improved to 97.1% when ocular comorbidities were excluded. Factors with Odds Ratio (OR) >1.5 associated with an impaired visual outcome included: elderly patients of 80 years old and above; systemic disease such as renal failure; ocular co-morbidities; pre-operative vision worse than 6/60; general anaesthesia, retrobulbar anaesthesia or subconjunctival anaesthesia; extracapsular cataract extraction (ECCE), intracapsular cataract extraction (ICCE), anterior chamber intraocular lens (ACIOL) implantation or combined cataract surgery; the presence of intra- and post-operative complications. In conclusion, a good visual outcome was achieved after cataract surgery in most cases. This large multicentre study provides information about risk factors for poor visual outcome post-cataract surgery and may serve as a basis for evidence-based guidelines.


Assuntos
Opacificação da Cápsula , Extração de Catarata , Catarata , Lentes Intraoculares , Oftalmologia , Idoso , Idoso de 80 Anos ou mais , Opacificação da Cápsula/etiologia , Catarata/epidemiologia , Catarata/etiologia , Extração de Catarata/efeitos adversos , Humanos , Sistema de Registros , Fatores de Risco , Resultado do Tratamento , Acuidade Visual
2.
BMJ Open ; 12(8): e053560, 2022 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-35985773

RESUMO

OBJECTIVES: To describe the relationships between axial length and intraoperative complications in patients undergoing cataract surgery. DESIGN: Cohort analysis of the Royal College of Ophthalmologists' National Ophthalmology Database (RCOphth NOD). SETTING: 110 National Health Service Trusts in England, Health Boards in Wales, Independent Sector Treatment Centres and Guernsey. PARTICIPANTS: 820 354 patients, aged 18 years or older, undergoing cataract surgery. Eligible operations were those from centres with at least 50 operations with a recorded axial length measurement and age at surgery between 1 April 2010 and 31 August 2019. INTERVENTIONS: Phacoemulsification where the primary intention was cataract surgery alone. OUTCOME MEASURES: Posterior capsule rupture (PCR) and other recorded intraoperative complications. RESULTS: 1 211 520 eligible operations were performed by 3210 surgeons. The baseline axial length was <21 mm (short eyes) for 17 170 (1.4%) eyes, 21-28 mm (medium eyes) for 1 182 513 (97.6%) eyes and >28 mm (long eyes) for 11 837 (1.0%) eyes. The median age at surgery was younger for patients with long eyes than those with short or medium eyes. The rate of any intraoperative complication was higher for short eyes than medium or long with complication rates of 4.5%, 2.9% and 3.3%, respectively (p<0.001). PCR occurred in 1.40% surgeries overall, and in 1.53%, 1.40% and 1.61% of short, medium and long eyes, respectively (p=0.043, not significant at the 1% level). CONCLUSIONS: Overall PCR rates for cataract surgery in RCOphth NOD contributing centres are lower than previously reported and there is little change in PCR rates by axial length. Short eyes were more likely to have an intraoperative complication than medium or long eyes.


Assuntos
Extração de Catarata , Catarata , Oftalmologistas , Oftalmologia , Facoemulsificação , Catarata/epidemiologia , Extração de Catarata/efeitos adversos , Estudos de Coortes , Humanos , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/etiologia , Estudos Retrospectivos , Medicina Estatal , Acuidade Visual
3.
Artigo em Inglês | MEDLINE | ID: mdl-36012010

RESUMO

Cataracts are one of the most common causes of effective vision loss. Although most cases of cataracts are related to the ageing process, identifying modifiable risk factors can prevent their onset or progression. Many studies have suggested that micro and macroelement levels, not only in blood serum but also in the lens and aqueous humour, may affect the risk of the occurrence and severity of cataracts. This systematic review aims to summarise existing scientific reports concerning the importance of trace elements in cataractogenesis. Many authors have pointed out elevated or decreased levels of particular elements in distinct ocular compartments. However, it is not known if these alterations directly affect the increased risk of cataract occurrence. Further studies are needed to show whether changes in the levels of these elements are correlated with cataract severity and type. Such information would be useful for determining specific recommendations for micronutrient supplementation in preventing cataractogenesis.


Assuntos
Catarata , Cristalino , Oligoelementos , Humor Aquoso , Catarata/epidemiologia , Olho , Humanos
5.
JAMA Netw Open ; 5(8): e2227232, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35976646

RESUMO

Importance: Blue light-filtering (BLF) intraocular lenses (IOLs) have been widely used in clinical practice for more than 20 years and have been implanted in millions of patients with cataracts worldwide. However, little evidence on the association of BLF IOLs with injuries is available. Objective: To assess the association of BLF IOLs with all-cause and traffic accident-related injuries and quality of vision while driving after bilateral cataract surgery. Design, Setting, and Participants: This retrospective registry-based cohort study included patients who underwent bilateral cataract surgery between September 3, 2007, and December 14, 2018, and were followed until December 14, 2021. Surgery was performed at the Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland. The 4986 participants received non-BLF IOLs (n = 2609) or BLF IOLs (n = 2377) in both eyes. Patients undergoing bilateral surgery between 2015 to 2016 with non-BLF IOLs (n = 102) or BLF IOLs (n = 91) and currently driving a car were interviewed using a structured questionnaire for visual performance while driving. Exposures: Follow-up for a mean (SD) of 2166 (1110) days after second eye surgery. Main Outcomes and Measures: Kaplan-Meier and multivariable Cox proportional hazards regression analyses for the risk of all-cause and traffic accident-related injuries after surgery in the second eye obtained from the patient medical records were assessed. To improve follow-up precision, both death and the end of the follow-up were used as censoring events. Results: A total of 4986 patients were included in the analysis (1707 [34.2%] men and 3279 [65.8%] women; mean [SD] age, 73.2 [8.6] years at the first surgery and 74.3 [8.8] years at the second). Injury-free survival rates preceding the first eye surgery were comparable between the non-BLF and BLF IOL groups (hazard ratio adjusted for age and sex, 0.95 [95% CI, 0.81-1.13; P = .57]). In multivariable Cox proportional hazards regression analysis controlling for age and sex, the use of BLF IOLs showed no advantage in overall injuries compared with the use of non-BLF IOLs (hazard ratio, 0.99 [95% CI, 0.88-1.11]; P = .85) or in any injury subtype. Subjective visual performance parameters for driving were all comparable between the non-BLF and BLF IOL groups except for glare when driving in the dark (evening or night), which occurred among 9 of 80 patients with BLF IOLs compared with 0 of 83 non-BLF IOLs (P < .001). Conclusions and Relevance: The findings of this cohort study suggest that use of BLF IOLs was not associated with reduced risk of injuries, whereas glare during nighttime driving was significantly worse in the BLF IOL group with pseudophakia.


Assuntos
Catarata , Lentes Intraoculares , Acidentes de Trânsito , Idoso , Catarata/epidemiologia , Estudos de Coortes , Feminino , Finlândia/epidemiologia , Humanos , Masculino , Estudos Retrospectivos , Acuidade Visual
6.
Vestn Oftalmol ; 138(4): 41-47, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36004590

RESUMO

OBJECTIVE: To determine the prevalence of senile cataracts and its detection rate among the population at the age of 40 and older with diseases of the cardiovascular system. MATERIAL AND METHODS: This observational cross-sectional study was based on the information extracted from electronic health records (EHR) of patients aged 40-99 years assigned for medical services to a city polyclinic. RESULTS: Among the population with essential hypertension (EH) senile cataract occurs with the frequency of 10.4±0.3% (95% CI 9.8-10.9%) of cases, in patients with cerebrovascular diseases (CVD) - 17.1±0.2% (95% CI 16.6-17.5%) of cases, with varicose veins of the lower extremities - 19.9±0.2% (95% CI 19.4-20.3%) of cases, with ischemic heart disease (IHD) - 15.8±0.2% (95% CI 15.4-16.2%) of cases. At the same time, senile cataract is associated with an increase in the likelihood of its detection in patients with hypertension by 6.8 times (OR 6.57; 95% CI 5.89-7.74), with CVD by 5 times (OR 5.02; 95% CI 4.64-5.44), with varicose veins by 3.7 times (OR 3.70; 95% CI 3.34-4.10), with IHD by 3.5 times (OR 3.53; 95% CI 3.20-3.90). Female gender is associated with an increased likelihood of developing senile cataracts in the presence of EH by 1.4 times (OR 1.420; 95% CI 1.299-1.553), in the presence of CVD by 1.2 times (OR 1.199; 95% CI 1.066-1.348), in the presence of varicose veins by 1.4 times (OR 1.355; 95% CI 1.064-1.725), in the presence of IHD by 1.5 times (OR 1.476; 95% CI 1.298-1.679). The detection rate of senile cataract is highest at the ages of 70-79 years, amounting to 18.1% of cases with hypertension, 24.0% of cases with CVD, 29.2% of cases with varicose veins, and 33.7% of cases with ischemic heart disease. CONCLUSION: Target population groups have been identified for more effective screening studies in order to detect senile cataracts among them.


Assuntos
Doenças Cardiovasculares , Catarata , Hipertensão , Isquemia Miocárdica , Varizes , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Catarata/complicações , Catarata/diagnóstico , Catarata/epidemiologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Isquemia Miocárdica/complicações , Isquemia Miocárdica/epidemiologia , Prevalência , Varizes/complicações , Varizes/diagnóstico , Varizes/epidemiologia
7.
BMC Ophthalmol ; 22(1): 340, 2022 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948897

RESUMO

BACKGROUND: This study is aimed to assess the association between asthma and cataract in a representative sample in the United States. METHODS: The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States. Ten years (2010-2019) of NHIS were analyzed in this study. Asthma and cataract status were collected from relevant questionnaires among participants aged 40 years and older. Multivariate regression analyses were applied to explore the association between asthma and cataract. RESULTS: From 40,457 participants included, those with asthma had higher prevalence of cataract than those without asthma (29.41% vs 25.87%, p < 0.001). Participants who had asthma had 40% higher odds of cataract compared to those without, after adjusting for potential confounding covariates (Odds Ratio [OR] = 1.40, 95% Confidence Interval [CI]: 1.29-1.52, p < 0.001). When viewing asthma as the outcome, participants who had cataract had 36% higher odds of asthma compared to those without, after adjusting for potential confounding covariates (Odds Ratio [OR] = 1.36, 95% Confidence Interval [CI]: 1.25-1.47, p < 0.001). CONCLUSIONS: With our study, we demonstrated that individuals with asthma were more likely to develop cataract compared with those without asthma. Further RCTs are needed to confirm this potential impact of asthma on cataract and to investigate the underlying mechanisms.


Assuntos
Asma , Catarata , Adulto , Asma/complicações , Asma/epidemiologia , Catarata/epidemiologia , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estados Unidos/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-35805310

RESUMO

This study aimed to evaluate the risk of cataract formation associated with radiation exposure from 18F-FDG PET/CT in oncology patients, using data from Taiwan's National Health Insurance Research Database. The exposed group (Group E) consisted of oncology patients receiving 18F-FDG PET/CT within the first year of a cancer diagnosis. The comparison group (Group C) included subjects who had never been exposed to 18F-FDG PET/CT radiation and were propensity score-matched by date of enrolment, age, sex, cancer type, associated comorbidities, and CT utilization. Multiple Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of cataract risk due to radiation exposure, while adjusting for potential confounding factors. A total of 703 patients and 1406 matched subjects were in Groups E and C, respectively. The incidence of cataract formation was not significantly higher among subjects in Group E (adjusted HR = 1.264; 95% confidence interval [CI] = 0.845-1.891). Our results revealed that 18F-FDG PET/CT was not a significant risk factor for developing cataracts in oncology patients.


Assuntos
Catarata , Neoplasias , Catarata/epidemiologia , Catarata/etiologia , Estudos de Coortes , Fluordesoxiglucose F18 , Humanos , Neoplasias/complicações , Pontuação de Propensão
10.
Saudi Med J ; 43(7): 665-677, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35830987

RESUMO

OBJECTIVES: To evaluate the risk of developing eye lens opacities and cataracts among physicians and healthcare workers occupationally exposed to radiation. METHODS: Our literature search captured articles published in Embase, Web of Science, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar databases until September 2021. Then, we retrieved articles reporting cataracts and eye lens opacities induced by radiation exposure among healthcare professionals. The outcomes of interest were cataracts, nuclear opacity, cortical opacity, posterior subcapsular opacity, and any lens opacity. RESULTS: Of the 4123 articles identified, 15 studies met the inclusion criteria. Healthcare workers exposed to radiation had a significantly greater risk of posterior subcapsular cataracts (PSCs), cataracts, and any lens opacities than those of the non-exposed participants (p<0.05). The cortical opacity was not significantly different between the exposed and non-exposed participants (p>0.05). Radiation was not determined to be a risk factor for nuclear opacity as it was significantly greater in the control group than the exposed participants. Subgroup analysis revealed that nurses had the highest risk for PSCs (risk ratio = 4.00), followed by interventional cardiologists (risk ratio = 3.85). CONCLUSION: The risk of posterior subcapsular opacities and cataracts is significantly higher in healthcare workers with occupational radiation exposure than in non-exposed workers, highlighting the necessity to enhance and promote the wearing of protective measures with high safety levels.


Assuntos
Catarata , Cristalino , Médicos , Lesões por Radiação , Catarata/epidemiologia , Catarata/etiologia , Pessoal de Saúde , Humanos , Lesões por Radiação/epidemiologia , Lesões por Radiação/etiologia
11.
Ann Med ; 54(1): 1988-1993, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35833752

RESUMO

PURPOSE: To investigate the age at recognition and presentation for surgery for congenital and developmental cataract at Kazakh Eye Research Institute in Kazakhstan. METHODS: A retrospective review of children aged 0-18 years, who presented with congenital and developmental cataract between January 1, 2010 and December 31, 2020. All medical records were reviewed. Gender, age at recognition, age at surgery, laterality, residential location (rural/urban) were recorded. RESULTS: The study population included 897 patients of children presented with congenital and developmental cataract over a 10-year study period, 58% of them were boys and 44.6% were from rural areas. Cataract was bilateral in 621 (69.2%) and unilateral in 276 (30.8%) of patients. Median age at recognition for patients with congenital/developmental cataract was 12 months. Median age at surgery for congenital/developmental cataract was 51 months. Only 14.7% of children underwent surgery within first year of life. The urban citizens underwent surgery earlier than patients from rural areas. The median delay in presentation for surgery was 15 months. CONCLUSION: The average age at cataract surgery in the population of Kazakhstan is much older than in developed countries. It is essential to study barriers that associated with delayed presentation to build strategies to overcome them.Key messagesIt is known that cataract surgery in children early in life provides favourable visual outcome.Children with congenital and developmental cataract in Kazakhstan experience delay in surgical treatment.Children from rural areas undergo cataract surgery later than urban citizens.


Assuntos
Extração de Catarata , Catarata , Catarata/congênito , Catarata/epidemiologia , Criança , Feminino , Seguimentos , Humanos , Lactente , Cazaquistão/epidemiologia , Masculino , Estudos Retrospectivos , Acuidade Visual
12.
PLoS One ; 17(7): e0271736, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35862402

RESUMO

INTRODUCTION: Avoidable blindness is a significant public health problem in India. Nationally representative RAAB surveys (Rapid Assessment of Avoidable Blindness) are being conducted periodically in the country to know the current status of blindness in the country. The current study describes the findings from the RAAB survey conducted during 2015-19 in India. METHODOLOGY: A cross-sectional, population-based survey was conducted across the entire country among persons aged 50 years and above using RAAB version 6 methodology. Presenting and pinhole visual acuity was recorded followed by lens examination using a torchlight. In order to estimate the prevalence of blindness and visual impairment in overall population in India, district weights were assigned to each of the 31 surveyed districts and the prevalence was standardized using the RAAB software. RESULTS: The overall weighted, age-gender standardized, prevalence of blindness (presenting visual acuity <3/60 in better eye) in population aged ≥50 years was 1.99% (95% CI 1.94%, 2.13%) and of visual impairment (VI) (presenting visual acuity <6/12 in better eye) was 26.68% (95% CI 26.57-27.17%). On multivariate analysis, adjusted odds ratio showed that blindness was associated with age ≥ 80 years (OR = 20.3, 95% CI: 15.6-26.4) and being illiterate (OR = 5.6, 95% CI: 3.6-8.9). Blindness was not found to be significantly associated with either gender or locality. CONCLUSION: The results of the survey demonstrate that currently more than one fourth of persons aged 50 years and above are visually impaired (PVA<6/12 in better eye) in India. The prevalence of blindness among them is 1.99%, and older age and illiteracy are significantly associated with blindness. Major causes of blindness included cataract (66.2%), corneal opacity (CO) (8.2%), cataract surgical complications (7.2%), posterior segment disorders (5.9%) and glaucoma (5.5%). The proportion of blindness and visual impairment that is due to avoidable causes include 92.9% and 97.4% respectively.


Assuntos
Catarata , Baixa Visão , Pessoas com Deficiência Visual , Cegueira/diagnóstico , Cegueira/epidemiologia , Cegueira/etiologia , Catarata/complicações , Catarata/epidemiologia , Estudos Transversais , Humanos , Índia/epidemiologia , Prevalência , Baixa Visão/etiologia
13.
Indian J Ophthalmol ; 70(6): 2084-2089, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35647987

RESUMO

Purpose: To report clinical features, antibiotic susceptibility profile, management, and outcomes of a cluster outbreak of post-cataract surgery Pseudomonas stutzeri endophthalmitis. Methods: This was a hospital-based case series in which 14 patients with acute postoperative endophthalmitis who underwent cataract surgery on the same day were included. Based on severity of presentation, they either underwent pars plana vitrectomy (PPV) with intraocular antibiotics (IOAB) or vitreous tap with IOAB. Vitreous aspirates and environmental surveillance samples were inoculated on culture media and further processed by MALDI-TOF MS for identification and Vitek3 for susceptibility profile. Results: There were 8 females and 6 males with a mean age of 62.14 ± 8.08 years. Presenting signs included corneal folds (100%), hypopyon (57.1%) and fibrin (50%). Ten patients with mild presentation underwent vitreous tap with IOAB. Four patients with severe presentation underwent PPV with IOAB. Pseudomonas stutzeri was isolated from the vitreous samples and was pan-sensitive. Six eyes required multiple interventions. Favorable outcome was obtained in 12 eyes, one eye developed phthisis, and one patient was lost to follow-up. Conclusion: We report the first ever cluster outbreak of Pseudomonas stutzeri endophthalmitis following phacoemulsification with IOL implantation in a single surgeon setting. Majority of the patients had a mild presentation and responded well to targeted anti-microbial treatment.


Assuntos
Endoftalmite , Infecções Oculares Bacterianas , Facoemulsificação , Infecções por Pseudomonas , Pseudomonas stutzeri , Doença Aguda , Idoso , Antibacterianos/uso terapêutico , Catarata/epidemiologia , Surtos de Doenças , Endoftalmite/diagnóstico , Endoftalmite/tratamento farmacológico , Endoftalmite/epidemiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Infecções por Pseudomonas/epidemiologia
14.
Indian J Ophthalmol ; 70(6): 2153-2157, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35648002

RESUMO

Purpose: To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic. Methods: This was a prospective, cross-sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID-19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed. Results: One thousand four hundred seventy two patients were recruited with advanced cataracts. Absence of ophthalmic care nearby (44.2%), lack of awareness regarding elective surgeries (42.6%), lack of public transportation (37%), fear of contracting COVID-19 (23.4%), and waiting for outreach camps (20.4%) were found to be the reasons behind the delay in cataract surgery. 53.7% of the patients had worsening of defective vision and 55.3% of them had difficulty in carrying out activities of family living. 30.8% of the patients faced difficulty in commuting and 8.4% of the patients suffered a fall during this pandemic due to worsening of the visual acuity. Conclusion: The lockdown imposed during the pandemic has created a significant backlog of patients who are progressing to advanced cataracts due to lack of ophthalmic care nearby, lack of awareness regarding elective surgeries, lack of public transportation, and no outreach camps. Proactive measures to deal with this backlog are of utmost need to prevent blindness due to cataract.


Assuntos
COVID-19 , Catarata , COVID-19/epidemiologia , Catarata/complicações , Catarata/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Pandemias , Estudos Prospectivos
15.
N Z Med J ; 135(1553): 19-26, 2022 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-35728201

RESUMO

AIMS: The 'Impact on Life' (IoL) questionnaire is a patient reported quality-of-life assessment tool used to prioritise cataract surgery in New Zealand (NZ). This study evaluated the association between ethnicity and IoL questionnaire responses. METHODS: This is a retrospective cohort study of patients prioritised for public-funded cataract surgery between November 2014 and March 2019 in New Zealand. Data were extracted from the New Zealand Ministry of Health National Prioritisation Web Service database. Ethnic, demographic and IoL data for all patients who were prioritised for surgery were analysed after controlling for age, gender, visual acuity and cataract type. RESULTS: Of the 58,648 prioritisation events, over the four-and-a-half-year period, 46,352 prioritisation events had documented scores for the IoL questionnaire. The study population had a mean age of 74.4 years and had a female preponderance (74%). The average IoL score was 22.5/36 (SD 7.8). After controlling for age, gender, visual acuity (VA) and cataract type, there was only a marginal difference between Maori and non-Maori IoL scores (22.8/36 vs 22.4/36) despite statistical significance for the difference (p=0.001). Maori and Pacific people presented at a younger age (68.5 years and 66.7 years, respectively) with worse visual acuity than other ethnic groups (mean range 70.1-76.7 years). Mean IoL scores were 23.0/36 for Maori and Pacific people and 22.4/36 for other ethnic groups. CONCLUSIONS: Maori and Pacific people present younger with worse VA and more advanced cataracts at time of surgical prioritisation when compared with other ethnic groups. Despite these differences, after controlling for confounding factors, the mean IoL score did not differ to a level that was clinically significant between different ethnic groups in New Zealand at time of prioritisation for cataract surgery. These results suggest that there are no meaningful ethnic specific differences in patient reported quality of life for patients with cataract in New Zealand after controlling for other factors. Alternatively, the IoL tool may lack the sensitivity to detect meaningful ethnic disparities that may exist for quality of life in this cohort of patients.


Assuntos
Catarata , Etnicidade , Idoso , Catarata/epidemiologia , Feminino , Humanos , Nova Zelândia/epidemiologia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários
16.
N Z Med J ; 135(1553): 91-98, 2022 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-35728208

RESUMO

Cataract surgery is a highly cost-effective treatment, but the surgical intervention rate in New Zealand ranks poorly compared with other high-income countries. The combination of a growing and ageing population, lost operating time due to the COVID-19 pandemic, and geographical disparities, is driving up an unmet demand for cataract surgery. We present several evidence-based strategies with overlapping benefits in access, equity, efficiency and sustainability. Key strategies include that Health New Zealand mandate a national prioritisation threshold for surgical access, and that PHARMAC leverage cheaper access to surgical supplies using nationally agreed equipment standards, establishing high-throughput cataract units, offering same day bilateral cataract surgery when appropriate, and rationalising post-operative care.


Assuntos
COVID-19 , Extração de Catarata , Catarata , COVID-19/epidemiologia , Catarata/epidemiologia , Humanos , Nova Zelândia/epidemiologia , Pandemias/prevenção & controle
17.
Med J Aust ; 217(2): 94-99, 2022 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-35702892

RESUMO

OBJECTIVE: To compare fall incidence, and visual acuity and refractive status, before surgery and after first and second eye cataract surgery. DESIGN, SETTING: Prospective observational study in eight tertiary referral ophthalmology clinics in public hospitals in Sydney, Melbourne, and Perth. PARTICIPANTS: People aged 65 years or more referred for bilateral age-related cataract surgery during 2013-16, followed for maximum of 24 months after study entry or until six months after second eye surgery, whichever was shorter. MAIN OUTCOME MEASURES: Primary outcome: age- and sex-adjusted incidence of falls. SECONDARY OUTCOMES: visual acuity and refractive error. RESULTS: The mean age of the 409 included participants was 75.4 years (SD, 5.4 years); 220 were women (54%). Age- and sex-adjusted fall incidence prior to surgery was 1.17 (95% CI, 0.95-1.43) per year, 0.81 (95% CI, 0.63-1.04) per year after first eye surgery, and 0.41 (95% CI, 0.29-0.57) per year after second eye surgery. For the 118 participants who underwent second eye surgery and participated in all follow-up visits, age- and sex-adjusted incidence before (0.80 [95% CI, 0.55-1.15] falls per year) and after first eye surgery (0.81 [95% CI, 0.57-1.15] falls per year) was similar, but was lower after second eye surgery (0.32 [95% CI 0.21-0.50] falls per year). Mean habitual binocular visual acuity (logMAR) was 0.32 (SD, 0.21) before surgery, 0.15 (SD, 0.17) after first eye surgery, and 0.07 (SD, 0.15) after second eye surgery. CONCLUSIONS: First eye surgery substantially improves vision in older people with cataract, but second eye surgery is required to minimise fall incidence. Timely cataract surgery for both eyes not only optimises vision in older people with cataract, but also reduces their risk of injury from falls.


Assuntos
Extração de Catarata , Catarata , Acidentes por Quedas , Idoso , Catarata/epidemiologia , Extração de Catarata/efeitos adversos , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino
19.
J Int Med Res ; 50(6): 3000605221104761, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35698450

RESUMO

OBJECTIVE: In this study, we aimed to determine the prevalence of visually significant cataract and associated factors among older people attending community ophthalmic services in the central Gondar Zone, Northwest Ethiopia. METHODS: We conducted a community outreach-based cross-sectional study among adults aged ≥40 years in the central Gondar Zone from 30 May to 15 June 2021. We used systematic random sampling to select study participants. Interviewer-administered questionnaires and ocular examinations were performed and the data recorded. We applied binary logistic regression to identify factors associated with visually significant cataract. RESULTS: A total of 821 participants were included, with median age 57 years. The prevalence of visually significant cataract was 29.1% (95% CI: 26.1-32.0). Age ≥80 years (adjusted odds ratio [AOR] = 16.9; 95% CI: 7.5-38.4), rural residence (AOR = 1.7; 95% CI: 1.02-2.7), unmarried status (AOR = 1.9; 95% CI: 1.2-3.2), illiteracy (AOR = 2.9; 95% CI: 1.4-6.1), unemployed status (AOR = 1.7; 95% CI: 1.1-2.7), and sunlight exposure ≥5 hours per day (AOR = 1.6; 95% CI: 1.04-2.4) were significantly associated with visually significant cataract. CONCLUSION: In this study, visually significant cataract was found to be high, which requires immediate public health intervention.


Assuntos
Catarata , Adulto , Idoso , Catarata/epidemiologia , Estudos Transversais , Etiópia/epidemiologia , Humanos , Pessoa de Meia-Idade , Razão de Chances , Prevalência
20.
J Am Heart Assoc ; 11(12): e025361, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35703387

RESUMO

Background Results from animal models and observational studies have raised concerns regarding the potential cataractogenic effects of statin treatment. We investigated whether common and rare genetic variants in HMGCR are associated with cataract risk, to gauge the likely long-term effects of statin treatment on lenticular opacities. Methods and Results We used genotyping data and exome sequencing data of unrelated European individuals in the UK Biobank to test the association between genetically proxied inhibition of HMGCR and cataract risk. First, we constructed an HMGCR genetic score consisting of 5 common variants weighted by their association with low-density lipoprotein cholesterol. Second, we analyzed exome sequencing data to identify carriers of predicted loss-of-function mutations in HMGCR. Common and rare variants in aggregate were then tested for association with cataract and cataract surgery. In an analysis of >402 000 individuals, a 38.7 mg/dL (1 mmol/L) reduction in low-density lipoprotein C by the HMGCR genetic score was associated with higher risk for cataract (odds ratio, 1.14 [95% CI, 1.00-1.39], P=0.045) and cataract surgery (odds ratio, 1.25 [95% CI, 1.06-1.48], P=0.009). Among 169 172 individuals with HMGCR sequencing data, we identified 32 participants (0.02%), who carried a rare HMGCR predicted loss-of-function variant. Compared with noncarriers, heterozygous carriers of HMGCR predicted loss-of-function had a higher risk of developing cataract (odds ratio, 4.54 [95% CI, 1.96-10.53], P=0.001) and cataract surgery (odds ratio, 5.27 [95% CI, 2.27-12.25], P=5.37×10-4). In exploratory analyses, we found no significant association between genetically proxied inhibition of PCSK9, NPC1L1, or circulating low-density lipoprotein cholesterol levels (P>0.05 for all) and cataract risk. Conclusions We found that genetically proxied inhibition of the HMGCR gene mimicking long-term statin treatment associated with higher risk of cataract. Clinical trials with longer follow-up are needed to confirm these findings.


Assuntos
Catarata , Inibidores de Hidroximetilglutaril-CoA Redutases , Catarata/diagnóstico , Catarata/epidemiologia , Catarata/genética , LDL-Colesterol , Coenzima A/genética , Variação Genética , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pró-Proteína Convertase 9/genética
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