Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.274
Filtrar
1.
Int J Mol Sci ; 22(17)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34502323

RESUMO

The aim of the study was the multi-elemental analysis of aqueous humor (AH) collected from patients undergoing cataract surgery. The study included: 16 patients with age-related macular degeneration AMD (99 controls), 10 patients with retinopathy (105 controls), 61 patients with hypertension (54 controls), and 33 patients with coexisting diabetes (82 controls). The control groups were recruited from patients with a lack of co-existing disease characterizing the specified studied group. The measurements were performed by the use of inductively coupled plasma optical emission spectrometry (ICP-OES). The statistical analysis was carried out using non-parametric testing (Mann-Whitney U). The level of significance was set at p = 0.05. The data obtained revealed substantial variations in elemental composition between the test groups in comparison to the controls. However, the significant variations concerned only a few elements. The phosphorous (P) level and the ratio of P/Ca were significant in retinopathy and diabetes, whereas cobalt (0.091 ± 0.107 mg/L vs. 0.031 ± 0.075 mg/L; p = 0.004) was significant in AMD. In co-existing hypertension, the levels of tin (0.293 ± 0.409 mg/L vs. 0.152 ± 0.3 mg/L; p = 0.031), titanium (0.096 ± 0.059 mg/L vs. 0.152 ± 0.192 mg/L; p = 0.045), and ruthenium (0.035 ± 0.109 mg/L vs. 0.002 ± 0.007 mg/L; p = 0.006) varied in comparison to the controls. The study revealed inter-elemental interactions. The correlation matrices demonstrated the domination of the positive correlations, whereas negative correlations mainly concerned sodium.


Assuntos
Humor Aquoso/metabolismo , Catarata/metabolismo , Diabetes Mellitus/fisiopatologia , Retinopatia Diabética/fisiopatologia , Elementos Químicos , Hipertensão/fisiopatologia , Degeneração Macular/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Catarata/epidemiologia , Catarata/patologia , Catarata/terapia , Extração de Catarata , Feminino , Seguimentos , Humanos , Cristalino/cirurgia , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prognóstico
2.
Zhonghua Yan Ke Za Zhi ; 57(7): 481-486, 2021 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-34256466

RESUMO

Cataract is the main cause of treatable visual impairment in children. Children face more risks during the perioperative period of cataract surgery than adults because of their anatomical, physiological, behavioral, and developmental characteristics; therefore, special attention and management are required. This article comprehensively discusses the perioperative management of children's cataract surgery on the base of relevant literatures and the authors' clinical experience, including the indications and timing of surgery, preoperative examination, prevention and treatment of surgical complications, and postoperative visual function reconstruction. (Chin J Ophthalmol, 2021, 57: 481-486).


Assuntos
Extração de Catarata , Catarata , Oftalmologia , Baixa Visão , Catarata/terapia , Criança , Humanos , Complicações Pós-Operatórias , Período Pós-Operatório
3.
Zhonghua Yan Ke Za Zhi ; 57(7): 487-491, 2021 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-34256467

RESUMO

In recent years, intraocular lenses (IOLs) have been increasingly used in the correction of aphakia after congenital cataract extraction. But IOL implantation in infants and young children, especially under 1 year old, is still controversy. Large-scale, multi-center, randomly controlled clinical observations on this issue have been conducted. The mid-and long-term results have shown that infantile cataract extraction combined with primary IOL implantation can achieve the same or better visual outcome as aphakic contact lens correction. For infants over 7 months of age and young children, primary implantation of IOLs is relatively safe, with a low complication and secondary operation rate. Compared to the way of aphakic contact lens correction, which could be with more inconvenience, high demand of coordination, a higher infection risk, high cost and the need of a secondary IOL implantation surgery, primary implantation of IOLs at over 7 months of age is worth exploring, with appropriate understanding of the surgical indications and adequate surgical techniques. (Chin J Ophthalmol, 2021, 57: 487-491).


Assuntos
Afacia Pós-Catarata , Extração de Catarata , Catarata , Lentes Intraoculares , Afacia Pós-Catarata/cirurgia , Catarata/terapia , Criança , Pré-Escolar , Seguimentos , Humanos , Lactente , Implante de Lente Intraocular , Complicações Pós-Operatórias , Acuidade Visual
4.
Clin Exp Ophthalmol ; 49(7): 672-685, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34291550

RESUMO

BACKGROUND: Cataract is a leading cause of blindness and vision impairment globally. Cataract surgery is one of the most frequently performed operations worldwide, but good quality services are not universally available. This scoping review aims to summarise the nature and extent of published literature on interventions to improve the quality of services for age-related cataract globally. METHODS: We used the dimensions of quality adopted by WHO-effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency-to which we added planetary health. On 17 November 2019, we searched MEDLINE, Embase and Global Health for manuscripts published since 1990, without language or geographic restrictions. We included studies that reported quality-relevant interventions and excluded studies focused on technical aspects of surgery or that only involved children (younger than 18 years). Screening of titles/abstracts, full-text review and data extraction were performed by two reviewers independently. Studies were grouped thematically and results synthesised narratively. RESULTS: Most of the 143 included studies were undertaken in high-income countries (n = 93, 65%); 29 intervention groups were identified, most commonly preoperative education (n = 17, 12%) and pain/anxiety management (n = 16, 11%). Efficiency was the quality element most often assessed (n = 58, 41%) followed by people-centredness (n = 40, 28%), while integration (n = 4) and timeliness (n = 3) were infrequently reported, and no study reported outcomes related to planetary health. CONCLUSION: Evidence on interventions to improve quality of cataract services shows unequal regional distribution. There is an urgent need for more evidence relevant to low- and middle-income countries as well as across all quality elements, including planetary health.


Assuntos
Extração de Catarata , Catarata , Catarata/epidemiologia , Catarata/terapia , Criança , Saúde Global , Humanos
5.
PLoS One ; 16(7): e0253434, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34197492

RESUMO

BACKGROUND: Descriptive analyses of 2009-2016 were performed using the data of the Universal Coverage Scheme (UCS) which covers nearly 70 percent of the Thai population. The analyses described the time and geographical trends of nationwide admission rates of type 2 diabetes mellitus (T2DM) and its complications, including chronic kidney disease (CKD), myocardial infarction, cerebrovascular diseases, retinopathy, cataract, and diabetic foot amputation. METHODS AND FINDINGS: The database of T2DM patients aged 15-100 years who were admitted between 2009 and 2016 under the UCS and that of the UCS population were retrieved for the analyses. The admitted cases of T2DM were extracted from the database using disease codes of principal and secondary diagnoses defined by the International Classification of Diseases 9th and 10th Revisions. The T2DM admission rates in 2009-2016 were the number of admissions divided by the number of the UCS population. The standardized admission rates (SARs)were further estimated in contrast to the expected number of admissions considering age and sex composition of the UCS population in each region. A linearly increased trend was found in T2DM admission rates from 2009 to 2016. Female admission rates were persistently higher than that of males. In 2016, an increase in the T2DM admission rates was observed among the older ages relative to that in 2009. Although the SARs of T2DM were generally higher in Bangkok and central regions in 2009, except that with CKD and foot amputation which had higher trends in northeastern regions, the geographical inequalities were fairly reduced by 2016. CONCLUSION: Admission rates of T2DM and its major complications increased in Thailand from 2009 to 2016. Although the overall geographical inequalities in the SARs of T2DM were reduced in the country, further efforts are required to improve the health system and policies focusing on risk factors and regions to manage the increasing T2DM.


Assuntos
Complicações do Diabetes/terapia , Diabetes Mellitus Tipo 2/terapia , Admissão do Paciente/tendências , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Catarata/complicações , Catarata/terapia , Diabetes Mellitus Tipo 2/etiologia , Pé Diabético/complicações , Pé Diabético/cirurgia , Retinopatia Diabética/complicações , Retinopatia Diabética/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/terapia , Admissão do Paciente/estatística & dados numéricos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Tailândia , Adulto Jovem
6.
N Z Med J ; 134(1536): 105-112, 2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-34140717

RESUMO

AIM: This cross-sectional study aimed to investigate whether presenting visual acuity or patient demographic variables were associated with geographic proximity to primary and secondary ophthalmic services. METHODS: Demographics for all patients referred within the Waikato District between October 2017 and March 2019 that met the threshold for publicly funded cataract surgery were analysed. GPS coordinates for all patient and optometrist addresses were obtained. The driving distance and driving time for each patient to travel to their referring optometrist were calculated. Quality-of-life data were obtained. Analysis of visual acuity, driving distance, age, ethnicity and gender was completed using. Furthermore, a comparative analysis of Maori and New Zealand European defined as having remote access was completed. RESULTS: A total of 1,260 patients were included. Multivariate analysis showed no significant association between driving distance and visual acuity. Comparative analysis of Maori and New Zealand European defined as having remote access showed Maori had significantly worse visual acuity than New Zealand Europeans at the time of referral. No significant difference was found in quality of life. Maori were on average younger than New Zealand European. Driving time and distance were on average 27% longer for Maori compared with New Zealand Europeans defined as having remote access. CONCLUSIONS: Maori presenting with cataract typically are younger and have lower visual acuity than New Zealand European. Longer driving distances represent a potential geographic barrier for Maori to access ophthalmic care and referral to tertiary services. No significant association was found between driving distance and visual acuity.


Assuntos
Condução de Veículo/estatística & dados numéricos , Catarata/terapia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Acuidade Visual/fisiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Nova Zelândia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos
7.
Sci Rep ; 11(1): 12203, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34108591

RESUMO

The purpose of this study was to evaluate intraocular pressure (IOP) pre- and postoperatively, together with anterior chamber angle (ACA) parameters and biometrical results in cataract patients with or without open angle glaucoma (OAG). The prospective observational case-control study included 15 eyes with cataract and OAG in the glaucoma group and 25 eyes with only cataract in control group. Examination included full ophthalmic evaluation, IOP, ocular biometry and anterior segment optical coherence tomography measuring ACA pre- and 6 months postoperatively. OAG patients had a larger absolute IOP reduction compared to control group. Anterior chamber depth (ACD) and ACA width significantly increased in both groups. The OAG group had a tendency of narrower ACA preoperatively, but overall ACA parameters did not differ in either group pre- and postoperatively. The ACD change after surgery correlated with ACA parameters in the control group, but not in OAG group. Axial length was shorter postoperatively in the control group, but remained similar in the OAG group. Absolute IOP reduction was more pronounced in cataract patients with OAG than in cataract patients without glaucoma. ACD and ACA postoperatively increased in both groups and AL shortening was observed in non-OAG in cataract group.


Assuntos
Catarata/fisiopatologia , Glaucoma de Ângulo Aberto/fisiopatologia , Pressão Intraocular/fisiologia , Tonometria Ocular/métodos , Idoso , Biometria , Estudos de Casos e Controles , Catarata/complicações , Catarata/terapia , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/complicações , Glaucoma de Ângulo Aberto/cirurgia , Humanos , Masculino , Facoemulsificação , Prognóstico , Estudos Prospectivos , Tomografia de Coerência Óptica
8.
Sci Rep ; 11(1): 12869, 2021 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-34145357

RESUMO

This study evaluated the accuracy of total keratometry (TK) and standard keratometry (K) for intraocular lens (IOL) power calculation in eyes treated with femtosecond laser-assisted cataract surgery. The retrospective study included a retrospective analysis of data from 62 patients (91 eyes) who underwent uneventful femtosecond laser-assisted cataract surgery with Artis PL E (Cristalens Industrie, Lannion, France) IOL implantation by a single surgeon between May 2020 and December 2020 in Severance Hospital, Seoul, South Korea. The new IOLMaster 700 biometry device (Carl Zeiss Meditec, Jena, Germany) was used to calculate TK and K. The mean absolute error (MAE), median absolute error (MedAE), and the percentages of eyes within prediction errors of ± 0.25 D, ± 0.50 D, and ± 1.00 D were calculated for all IOL formulas (SRK/T, Hoffer-Q, Haigis, Holladay 1, Holladay 2, and Barrett Universal II). There was strong agreement between K and TK (intraclass correlation coefficient = 0.99), with a mean difference of 0.04 D. For all formulas, MAE tended to be lower for TK than for K, and relatively lower MAE and MedAE values were observed for SRK/T and Holladay 1. Furthermore, for all formulas, a greater proportion of eyes fell within ± 0.25 D of the predicted postoperative spherical equivalent range in the TK group than in the K group. However, differences in MAEs, MedAEs, and percentages of eyes within the above prediction errors were not statistically significant. In conclusion, TK and K exhibit comparable performance for refractive prediction in eyes undergoing femtosecond laser-assisted cataract surgery.


Assuntos
Biometria , Extração de Catarata/métodos , Extração de Catarata/normas , Catarata/terapia , Cristalino/cirurgia , Lentes Intraoculares , Refração Ocular , Idoso , Idoso de 80 Anos ou mais , Catarata/fisiopatologia , Feminino , Humanos , Cristalino/fisiopatologia , Lentes Intraoculares/normas , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
9.
PLoS One ; 16(6): e0252640, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086796

RESUMO

BACKGROUND: Transparent and complete publications of randomised controlled trials (RCT) ought to comply with the guidelines of the CONSORT Statement, which stipulates sample size calculation as an important aspect of trial planning. The objective of this study was to analyse and compare the reporting of statistical sample size calculations in RCT papers on the treatment of age-related macular degeneration (AMD), glaucoma and cataract published in 2018. MATERIAL AND METHODS: This study comprises a total of 113 RCT papers (RCT-P) published in 2018 (AMD: 14, glaucoma: 28, cataract: 71), in English or German, and identified through an internet-based literature search in PubMed and EMBASE. The primary outcome measure of the study was the number of trials providing a complete description of the underlying sample case calculation on the basis of the variables required (significance level, expected outcomes, power, and resulting sample size). RESULTS: Of the RCTs reviewed, 64% (AMD), 61% (glaucoma) and 31% (cataract) provided a justification of the number of patients included. A complete description of the described studies' sample size calculation including all the necessary values (primary outcome measure of this study) was described by 21% of the AMD, 29% of the cataract and 18% of the glaucoma RCT publications (in total: 24 of 113 (21%) at a confidence interval of 95%: [13%; 29%]). CONCLUSION: All three treatment areas analysed lacked reporting quality regarding the justification of the number of patients included in a clinical trial based on a sample size calculation required for ethical reasons. More than half of all RCT publications reviewed did not provide all of the required information on statistical sample size calculation, and thus lacked transparency and completeness. It is therefore urgently required to involve methodologists in a study's planning and publishing processes to ensure that methodology descriptions are transparent and of high quality.


Assuntos
Catarata/terapia , Glaucoma/terapia , Degeneração Macular/terapia , Editoração/estatística & dados numéricos , Tamanho da Amostra , Catarata/patologia , Bases de Dados Factuais , Glaucoma/patologia , Humanos , Modelos Logísticos , Degeneração Macular/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Rev. cuba. oftalmol ; 34(2): e1006, 2021. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1341460

RESUMO

La disfotopsia negativa representa un motivo importante de insatisfacción del paciente tras una cirugía de catarata no complicada. Se manifiesta como una sombra oscura en el campo visual temporal, habitualmente en forma de medialuna, que cuando es persistente transforma en frustrante un resultado posquirúrgico que de otra manera sería considerado exitoso. Dada la amplia literatura publicada al respecto, esta revisión pretende resumir lo más actualizado sobre este fenómeno óptico en cuanto a sus causas, factores asociados, diagnóstico y tratamiento. Se realizó una búsqueda en Scholar Google con las palabras clave "Negative dysphotopsia", la cual se confinó a artículos de la Journal of Cataract Refractive Surgery, y se encontró un total de 822 resultados; de ellos, 54 desde el año 2019 hasta el momento de la revisión(AU)


Negative disfotopsia is an important cause of patient´s dissatisfaction after an uncomplicated cataract surgery. The affected individuals perceive a dark shadow on the temporal visual field, in the form of a crescent or arc, that transforms in frustrating a postsurgical result otherwise considered as successful. Given the several articles published on this topic, this review hopes to summarize the most up-to-date literature about this optic phenomenon considering its causes, associated factors, diagnosis and current treatment(AU)


Assuntos
Humanos , Catarata/diagnóstico , Campos Visuais , Causalidade , Catarata/terapia , Literatura de Revisão como Assunto
11.
J Glaucoma ; 30(7): 552-558, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34008525

RESUMO

PRCIS: Combined phacoemulsification-goniosynechialysis (phaco-GSL) and unaugmented phacotrabeculectomy were both found to be effective in treating eyes with significant cataract and medically unresponsive acute primary angle closure glaucoma (PACG). Phaco-GSL seemed to be safer, with fewer surgical complications, and achieved better visual acuity than phacotrabeculectomy. OBJECTIVES: To compare the results of combined phaco-GSL with unaugmented phacotrabeculectomy in the management of eyes with medically unresponsive acute PACG and cataract. PARTICIPANTS AND RESEARCH METHODS: This was a prospective randomized controlled trial involving patients with significant cataract and acute PACG who were not responsive to maximal medical therapy. Three ophthalmic centers in Hanoi, Vietnam, participated in this trial. Study subjects were randomized into 2 groups: phaco-GSL or phacotrabeculectomy. Of note, mitomycin-C or 5-fluorouracil were not used during trabeculectomy, but postoperative bleb needling with 5-fluorouracil injection(s) was allowed. The primary outcome of the study was the rate of postoperative surgical complications in the first 3 months after surgery. The secondary outcome, determined at 1 year, assessed whether treatment was completely successful [defined as intraocular pressure (IOP)<21 mm Hg without IOP-lowering drops], or partially successful (IOP<21 mm Hg with IOP-lowering drops). Treatment failure was defined as IOP≥21 mm Hg with maximal IOP-lowering drops. RESULTS: In total, 79 eyes from 79 patients (62 females, 17 males) were recruited (42 and 37 eyes in the phaco-GSL and phacotrabeculectomy groups, respectively). There were no statistically significant differences between the 2 groups at baseline in terms of age, visual acuity, IOP, anterior angle width, or preoperative ultrasound biomicroscopy index. Postoperative complications in the first 3 months were seen more frequently in the phacotrabeculectomy group (62.2%) than in the phaco-GSL group (14.3%, P<0.01). At 1 year postsurgery, treatment was 100% successful in both groups, with no difference in the mean IOP (15.38±3.42 vs. 15.72±4.47 mm Hg). The visual field index improved significantly following surgery in both groups, but there was also no significant difference between the 2 groups. However, there was a significant difference in the best corrected visual acuity at 1 year, with patients in the phaco-GSL group achieving better vision (0.45±0.21 logMAR in the phaco-GSL group vs. 0.64±0.27 logMAR in the phacotrabeculectomy group, P=0.04). The mean angle width was also significantly larger in the phaco-GSL group than the phacotrabeculectomy group (2.34±0.33 vs. 1.25±0.41 Shaffer degrees). Similarly, on ultrasound biomicroscopy, the anterior chamber was deeper after 12 months (2.87±0.28 to 2.48±0.33 mm), and the mean trabecular-iris angle area was wider at 12 months (21.88±7.07 vs. 14.95±4.39 degrees) in the phaco-GSL than the phacotrabeculectomy group. CONCLUSIONS: Phaco-GSL and phacotrabeculectomy were both effective in treating medically unresponsive cases of acute PACG with cataracts. However, phaco-GSL showed better visual outcomes, wider drainage angles postsurgery, and fewer complications than phacotrabeculectomy.


Assuntos
Catarata , Glaucoma de Ângulo Fechado , Facoemulsificação , Trabeculectomia , Catarata/complicações , Catarata/terapia , Feminino , Glaucoma de Ângulo Fechado/complicações , Glaucoma de Ângulo Fechado/cirurgia , Humanos , Pressão Intraocular , Masculino , Estudos Prospectivos , Resultado do Tratamento
12.
Sci Rep ; 11(1): 9525, 2021 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-33947910

RESUMO

Currently, there is no clear consensus in cataract surgery if low compared to high energy femto-lasers may enable better capsulotomy quality and induce lower inflammatory response. Therefore, the aim of this study was to compare the intra-operative outcomes achieved with high and low pulse energy femtosecond laser systems for cataract surgery. The charts of 200 eyes of 200 patients aged 68.3 ± 10.3 years who had undergone femtosecond laser-assisted cataract surgery using either group 1 high pulse energy: LenSx (Alcon Laboratories) (N = 100) or group 2 low pulse energy: FEMTO LDV Z8 (Ziemer) (N = 100) laser were reviewed retrospectively. Integrity of anterior capsulotomy, classified as (1) complete (free-floating or with minor microadhesions), (2) incomplete and (3) with capsular tears, intraoperative completeness of the clear corneal incisions (CCI, main incision and side port), incidences of intraoperative miosis and incidence of subconjunctival hemorrhage were evaluated and compared between the two groups. The proportion of complete capsulotomies was significantly higher in the group 2 than the group 1 (100% vs 94%; p = 0.03). The incidences of intraoperative miosis (0% vs 19%) and subconjunctival hemorrhage (1% vs 63%) were significantly lower in the group 2 than the group 1 (p < 0.001). Completeness of the main incision was comparable (97% vs 95%; p = 0.721) between the two groups. Although not statistically significant, the completeness of side-port incision was slightly better in the group 2 than the group 1 (91% vs 86%). Low energy laser system performed significantly better in terms of completeness of capsulotomy, intraoperative miosis and sub-conjunctival hemorrhage, compared with high energy laser; the CCI outcomes were comparable.


Assuntos
Catarata/terapia , Idoso , Extração de Catarata/métodos , Feminino , Humanos , Terapia a Laser/métodos , Lasers , Implante de Lente Intraocular/métodos , Cristalino , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia
13.
BMJ Open ; 11(4): e046226, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827846

RESUMO

OBJECTIVE: This study aims to advance understanding of globally valid versus country-specific quality dimensions and indicators, as perceived by relevant stakeholders. It specifically addresses patient-level indicators for cataract surgery. DESIGN: A mixed-methods case study comparing Singapore and The Netherlands SETTING: Singapore (2017-2019) and The Netherlands (2014-2015). PARTICIPANTS: Stakeholder representatives of cataract care in Singapore and The Netherlands. INTERVENTION: Based on the previously identified complete set of stakeholders in The Netherlands, we identified stakeholders of cataract care in Singapore. Stakeholder representatives then established a multi-stakeholder perspective on the quality of cataract care using a concept mapping approach. This yielded a multidimensional cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined during a plenary session. Thereafter, Singaporean dimensions were matched with dimensions obtained in The Netherlands to identify commonalities and differences. MAIN OUTCOME MEASURE: Health-services quality dimensions of cataract care. RESULTS: 19 Singaporean stakeholders representing patients, general practitioners, ophthalmologists, nurses, care providers, researchers and clinical auditors defined health-services quality of cataract care using the following eight dimensions: clinical outcome, patient outcomes, surgical process, surgical safety, patient experience, access, cost and standards of care. Compared with the Dutch results, 61% of the indicators were allocated to dimensions of comparable names and compositions. Considerable differences also existed in the composition of some dimensions and the importance attached to indicators. CONCLUSIONS AND RELEVANCE: This study on cataract care in Singapore and The Netherlands shows that cataract care quality measurement instruments can share a common international core. At the same time, it emphasises the importance of taking a country-specific multi-stakeholder approach to quality definition and measurement. Complementing an international core set with country-specific measures is required to ensure that the included dimensions and indicators adequately capture the country-specific quality views.


Assuntos
Catarata , Indicadores de Qualidade em Assistência à Saúde , Catarata/terapia , Serviços de Saúde , Humanos , Países Baixos , Singapura
14.
PLoS One ; 16(3): e0248618, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33760830

RESUMO

INTRODUCTION: In Ethiopia, cataract surgery is mainly provided by donors free of charge through outreach programs. Assessing willingness to pay for patients for cataract surgery will help explain how the service is valued by the beneficiaries and design a domestic source of finance to sustain a program. Although knowledge concerning willingness to pay for cataract surgery is substantive for developing a cost-recovery model, the existed knowledge is limited and not well-addressed. Therefore, the study aimed to assess willingness to pay for cataract surgery and associated factors among cataract patients in Outreach Site, North West Ethiopia. METHODS: A cross-sectional outreach-based study was conducted on 827 cataract patients selected through a simple random sampling method in Tebebe Gion Specialized Hospital, North West Ethiopia, from 10/11/2018 to 14/11/2018. The data were collected using a contingent valuation elicitation approach to elicit the participants' maximum willingness to pay through face to face questionnaire interviews. The descriptive data were organized and presented using summary statistics, frequency distribution tables, and figures accordingly. Factors assumed to be associate with a willingness to pay were identified using a Tobit regression model with a p-value of <0.05 and confidence interval (CI ≠ 0). RESULTS: The study involved 827 cataract patients, and their median age was 65years. About 55% of the participants were willing to pay for the surgery. The average amount of money willing to pay was 17.5USD (95% CI; 10.5, 35.00) and It was significantly associated with being still worker (ß = 26.66, 95% CI: 13.03, 40.29), being educated (ß = 29.16, 95% CI: 2.35, 55.97), free from ocular morbidity (ß = 28.48, 95% CI: 1.08, 55.90), duration with the condition, (ß = -1.69, 95% CI: -3.32, -0.07), admission laterality (ß = 21.21, 95% CI: 3.65, 38.77) and remained visual ability (ß = -0.29, 95% CI (-0.55, -0.04). CONCLUSIONS: Participants' willingness to pay for cataract surgery in outreach Sites is much lower than the surgery's actual cost. Early intervention and developing a cost-recovery model with multi-tiered packages attributed to the neediest people as in retired, less educated, severely disabled is strategic to increase the demand for service uptake and service accessibility.


Assuntos
Extração de Catarata/economia , Catarata/terapia , Financiamento Pessoal/economia , Custos de Cuidados de Saúde , Necessidades e Demandas de Serviços de Saúde , Idoso , Estudos Transversais , Etiópia , Honorários Médicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
15.
Sci Rep ; 11(1): 6699, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33758333

RESUMO

This meta-analysis aimed to evaluate the clinical outcomes following implantation of trifocal intraocular lenses (IOLs) or a hybrid multifocal-extended depth of focus (EDOF) IOL in cataract or refractive lens exchange surgeries. We examined 13 comparative studies with bilateral implantation of trifocal (898 eyes) or hybrid multifocal-EDOF (624 eyes) IOLs published through 1 March 2020. Better uncorrected and corrected near visual acuity (VA) were observed in the trifocal group (MD: - 0.143, 95% CI: - 0.192 to - 0.010, P < 0.001 and MD: - 0.149, 95% CI: - 0.217 to - 0.082, P < 0.001, respectively), while the hybrid multifocal-EDOF group presented better uncorrected intermediate VA (MD: 0.055, 95% CI: 0.016 to 0.093, P = 0.005). Trifocal IOLs were more likely to achieve spectacle independence at near distance (RR: 1.103, 95% CI: 1.036 to 1.152, P = 0.002). The halo photic effect was generated more frequently by the trifocal IOLs (RR: 1.318, 95% CI: 1.025 to 1.696, P = 0.031). Contrast sensitivity and subjective visual quality yielded comparable results between groups. Trifocal IOLs demonstrated better performance at near distance but apparently led to more photic disturbances. Our findings provided the most up-to-date and comprehensive evidence by comparing the benefits of advanced IOLs in clinical practice.


Assuntos
Implante de Lente Intraocular , Lentes Intraoculares , Lentes Intraoculares Multifocais , Catarata/terapia , Oftalmopatias/cirurgia , Humanos , Razão de Chances , Satisfação do Paciente , Refração Ocular , Resultado do Tratamento , Acuidade Visual
16.
Zhonghua Yan Ke Za Zhi ; 57(3): 166-170, 2021 Mar 11.
Artigo em Chinês | MEDLINE | ID: mdl-33721956

RESUMO

Primary glaucoma with cataract is a common eye disease in China, and surgery is the main treatment. With the continuous advance of medical technology, the choice of surgical methods is controversial, and there is still a lack of consensus with general guiding significance in China. In order to standardize the clinical treatment, Chinese Glaucoma Society has formulated this consensus after a serious discussion. This consensus is aiming at guiding clinical practice and putting forward instructive opinions on the operation methods, perioperative and follow-up management of different types and stages of primary glaucoma with cataract surgery indications. (Chin J Ophthalmol, 2021, 57:166-170).


Assuntos
Extração de Catarata , Catarata , Glaucoma , Catarata/terapia , China , Consenso , Glaucoma/cirurgia , Humanos
17.
Sci Rep ; 11(1): 747, 2021 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-33436915

RESUMO

To evaluate the effect of postoperative corticosteroids on surgical outcome and autotaxin (ATX) levels after microhook ab interno trabeculotomy combined with cataract surgery (µLOT-CS), prospective, consecutive non-randomized case series comparing outcomes of 30 eyes with primary open angle glaucoma was performed. The aqueous ATX, intraocular pressure (IOP) and glaucoma medications were monitored for 3 months postoperatively. An in-vivo mouse µLOT model was generated. In vitro, ATX and fibrotic changes induced by dexamethasone (Dex) treatment following scratch (S) in cultured human trabecular meshwork (hTM) cells were assessed by immunofluorescence, immunoenzymatic assay, and RT-qPCR. Postoperative ATX at 1 week and the number of antiglaucoma medications at 3 months were significantly lower in non-steroid group, and steroid use was the only variable significantly associated with postoperative medications at 3 months in multiregression analyses. In vitro, ATX activity was significantly upregulated in the Dex + S group, and αSMA was significantly upregulated in the Dex and Dex + S groups. Fibronectin and COL1A1 were significantly upregulated in the S group. µLOT-CS decreased IOP and medications in the overall cohort, and non-use of postoperative steroids resulted in a smaller number of postoperative medications. Limiting postoperative steroids in µLOT may minimize IOP elevation and postoperative fibrosis.


Assuntos
Corticosteroides/farmacologia , Catarata/terapia , Glaucoma de Ângulo Aberto/cirurgia , Diester Fosfórico Hidrolases/metabolismo , Malha Trabecular/efeitos dos fármacos , Trabeculectomia/métodos , Idoso , Idoso de 80 Anos ou mais , Animais , Feminino , Humanos , Masculino , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Estresse Mecânico , Resultado do Tratamento
18.
Int Ophthalmol ; 41(4): 1403-1413, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33507461

RESUMO

PURPOSE: We aimed to evaluate the efficacy of bandage contact lens (BCL) for the management of dry eye disease (DED) after cataract surgery. METHODS: A total of 120 patients (140 eyes) with age-related cataract and DED were enrolled in this study. Patients underwent standard micro-incision phacoemulsification surgeries and were divided into control or BCL groups. Slit-lamp biomicroscopic examination, Ocular Surface Disease Index, keratograph analysis and Schirmer I test were executed, and the levels of tear inflammatory molecules were detected. RESULTS: In the control group, the NIAvg-BUT and Schirmer I test scores were significantly decreased at 1 week post-operation compared with baseline levels (P = 0.035 and P = 0.009, respectively). In the BCL group, the NIF-BUT and Schemer I test scores were significantly improved at 1 month after operation compared with the control group (P = 0.012 and P < 0.001, respectively). Levels of IL-6, IL-8 and ICAM-1 were significantly increased in the control group at 1 month after the operation (P = 0.005, P = 0.038 and P = 0.022, respectively), while there was no difference in the BCL group. The increase in the IL-6 level in the control group was significantly higher compared with that in the BCL group (P = 0.047). In DED patients, there were significant correlations between ocular surface parameters and inflammatory molecules. CONCLUSIONS: Cataract surgery could lead to the development or worsening of DED. The application of BCLs after cataract surgery could stabilize the ocular surface and tear film, improve the corneal healing and reduce the inflammation. Collectively, our findings suggested that proper use of BCLs after cataract surgery played an effective role in the management of DED. TRIAL REGISTRATION: ClinicalTrials, NCT04100031. Registered 18 September 2019-retrospectively registered.


Assuntos
Catarata , Lentes de Contato Hidrofílicas , Síndromes do Olho Seco , Bandagens , Catarata/terapia , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/terapia , Humanos , Estudos Prospectivos
20.
BMJ Case Rep ; 14(1)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472806

RESUMO

This 75-year-old woman had phacomorphic angle closure, dense nuclear sclerosis, deep set eye, miotic pupil and tight corneal wound during phacoemulsification. Phacoemulsification wound burn was noted at the end of surgery. Tenon was harvested from the inferior conjunctiva, placed over the gape and anchored by two radial corneoscleral 10-0 nylon. Ten days later, anterior optical coherence tomography showed good wound apposition and sutures were removed with visual recovery to 20/25 (6/7.5) without astigmatism.


Assuntos
Catarata/terapia , Lesões da Córnea/cirurgia , Queimaduras Oculares/cirurgia , Complicações Intraoperatórias/cirurgia , Facoemulsificação/efeitos adversos , Cápsula de Tenon/transplante , Idoso , Capsulorrexe , Catarata/complicações , Lesões da Córnea/etiologia , Queimaduras Oculares/etiologia , Feminino , Glaucoma de Ângulo Fechado/complicações , Humanos , Complicações Intraoperatórias/etiologia , Tomografia de Coerência Óptica , Transplante Autólogo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...