cataract

摘要： Background: Hard brunescent nuclei are difficult to chop with traditional techniques, because leathery tough strands may connect the posterior surface and span across the fragments, which poses a challenge to completely divide the nuclei. The ultra-chopping technique was designed to mitigate this issue. Purpose: To compare the intraoperative parameters between Ultra-Chopper and Divide & Conquer Techniques. Setting: This study was performed at Hospital Oftalmológico de Brasília, Brasília, DF, Brazil. Patients and Methods: A prospective, randomized and comparative study. Patients with the diagnosis of dense cataract and surgical extraction programmed were divided into two groups: Ultra-Chopper and Divide & Conquer. Intraoperative data were collected and submitted for the statistical analysis. Results: 36 eyes were included, 19 eyes with Ultra-Chopper and 17 eyes with Divide & Conquer. Groups were statistically equivalent in age and nucleus density. There were no surgical complications. Torsional time and cumulative dissipated energy were significantly reduced in the ultra-chopper group. The ultra-chopper group had less total case time, fluid usage and aspiration (ASP) time. Conclusion: The ultra-chopper tech- nique can reduce ultrasound energy dissipation during cataract surgery, and decrease case time, fluid usage and ASP time.

摘要： Aim: To describe the socio-demographic profile of the participants and the ocular pathologies seen during a 3-day free eye screening and cataract surgical camp, to identify the groups we need to create awareness to, and to improve access in subsequent outreaches. Method: A retrospective cross-sectional descriptive study was carried out among 552 participants that attended a cataract surgical outreach camp in New Karu Local Government Area (L.G.A.), Nasarawa State from 10th to 14th September 2013. Data were analyzed using SPSS Version 20 using descriptive analysis such as frequencies and cross-tabulation. P Results: Six hundred and sixty-six people registered and 552 were examined comprising of 205 males and 347 females. The majority (81.7%) were younger than 60 years old, accounting for 4.5 times more than those older than 60. Females were in the majority (63%). Amongst those older than 60 years, males were slightly higher as compared to those younger than 60 years, where females were twice as much. Most of the participants (71.3%) reside within the L.G.A. Amongst those that reside within the L.G.A., females were twice the men and there was a fairly even distribution of both sexes amongst those that reside outside the L.G.A. The majority of the screened participants (41%) required presbyopic correction. Cataract was the second commonest ocular pathology (22.6%) and 53 (9.6%) participants with VA ≤ 6/60 were offered the free cataract surgery. Conclusion: There was an increase in female participation and those younger than 60 years. Amongst those younger than 60 years and those that reside within New Karu L.G.A., female participation was twice as much as males. When the barrier of distance is eliminated, it increases female participation.

摘要： Objectives: The study aimed to compare stereopsis, aniseikonia, and associated symptoms in bilateral pseudophakia with and without anisometropia. Methods: Patients with senile cataracts, previously scheduled for phacoemulsification with an IOL implant in both eyes were included in this cross-sectional study. Patients were divided into two groups: control group (n = 69) with an interocular post-surgical refraction difference in Spherical Equivalent (SE) TM 3 and stereopsis by Randot?; Stereotest. Ten symptoms related to aniseikonia were evaluated with a questionnaire. Statistical evaluation of data included models of univariate, multivariate, and regression analyses. Results: Cataract surgery-induced aniseikonia was 0.64% ± 1.41% in control group and 0.62% ± 1.76% in anisometropia group with an insignificant difference (p = 0.766). Measured stereoacuity was 1.95 ± 0.17 log10 seconds of arc in the control group and 2.12 ± 0.22 log10 seconds of arc in the anisometropia group with a significant difference (p Conclusions: The study showed that stereopsis, aniseikonia, and associated symptoms did not stand for a substantial problem for visual comfort of bilateral pseu- dophakia with anisometropia less than 3D.

摘要： Introduction: Cataract surgery has undergone many changes with the size of incision progressively decreasing over time with an incision of 12.0 mm for intracapsular cataract extraction to 2.2 - 2.8 mm in phacoemulsification. However, phacoemulsification due to high cost and equipment maintenance cannot be employed widely in developing countries. The phacoalternative or Manual small-incision cataract surgery (MSICS) offers similar advantages with the merits of wider applicability, less time consuming, a shorter learning curve, and lower cost. Haven’t not being without complications like any other surgery We have identified the factors influencing the outcome of phacoalternative cataract surgery in order to improve our quality of care for our patients suffering from blindness induced by the world’s first leading cause of legal blindness. We have identified the factors influencing the outcome of cataract surgery. Patients and Methods: This was a prospective observational study of the descriptive type lasting six (6) months from March 1 to August 30, 2020 including all patients operated on for cataracts and having lower visual acuity at 3/10. The operating form included demographic data, the patient’s personal ophthalmological history, postoperative visual acuity, per and postoperative complications and the type of pathology involved. The analysis was carried out using epi-info 7.2.0.1 software. Results: During this study period, we collected 61 cases of failure of cataract surgery out of a total of 1182 operated eyes, i.e. a frequency of 5.16%. Women represented more than half of the sample with 74%. Almost all of our patients, i.e. 96.72%, were over the age of 60. Loss of visual acuity was the main complaint in all our patients, i.e. 100% followed by photophobia with 24.4% of cases. Arterial hypertension present in 8.20% of patients was the most common comorbidity in our series followed by diabetes with 4.92%. 18 patients (29.5%) presented early postoperative complications such as corneal edema in 15 patients (24.6%) and hyphema in 3 patients (4.9%). Late postoperative complications were dominated by capsular fibrosis encountered in 42.89% of our patients. The causes of failure after cataract surgery were dominated by selection errors which accounted for 36.06% followed by late postoperative complications 34.43%. Conclusion: Like any surgery, cataract surgery can often be marred by various complications often occurring during the intraoperative or postoperative period. These complications in addition to negligence and/or non-deep analysis of certain cases (selection) are often associated with poor functional recovery.

摘要： Background: Cataract is the leading cause of blindness in the world and its treatment is exclusively surgical. However, the results of cataract surgery are not always as good as is assumed and this aspect of surgical services needs a lot of attention. The purpose of this study is to evaluate the functional results of the free cataract surgery campaign carried out at the Siguiri Prefectural Hospital in Guinea. Patients and Method: This was a descriptive and retrospective cross-sectional study over a period of three months (1 October-31 December 2017). Records of cataract-operated patients during the study period were reviewed. The complete files for the main variables sought were retained. Sociodemographic data and visual acuity without pre- and post-operative correction were assessed. Functional outcomes were analysed according to WHO guidelines and recommendations for post-operative functional outcomes of cataract surgery. The data was collected and processed using Excel version 2010 software. Results: A total of 108 eyes from 102 patients were the subject of this present study on 314 eyes from 289 operated patients. 64 (%) men and 38 women (%) had a follow-up of 6 weeks after cataract surgery, a sex ratio of 1.68 in favor of women. The average age was 62.45 ± 15.20 years with extremes of 25 and 90 years. The age group from 60 to 69 years is the most represented with 46 cases or 45.45%. Housewives and farmers are the most represented strata with 42 cases (41.18%) and 31 cases (30.39%) respectively. The operative technique was Phaco A in 4/5 of the cases. No implant calculations were performed. Functional results indicate that 66% of patients had good visual acuity (≥3/10);29% of patients had borderline visual acuity (between 1/10 and 2/10) and 13.30% had poor visual acuity (Conclusion: The importance of the rate of poor results in our study should draw our attention to the conduct of free cataract surgery campaigns. The problem of cataract blindness is often compounded by poor outcomes of surgical procedures, especially in low-income settings. The use of biometrics, implants of appropriate power as well as compliance with operative indications, surgical protocols and postoperative follow-up by surgeons will improve the visual result without correction.

摘要： Background:This study aims to investigate the application and effect of a new daytime surgery and same-day discharge mode in cataract clinic.Methods:Two hundred patients with cataract intended to undertake daytime surgery from August 2019 to January 2020 in the Cataract department were enrolled for the study.Among them,100 patients from January 2020 with the new daytime surgery and same-day discharge were the experimental group.While the other 100 patients without the designated set-up from August 2019 worked as a control group.The length and cost of hospitalization,the length of waiting for the elevator,the patient satisfaction,and the awareness rate of health education were evaluated.Results:After application of the new daytime surgery and same-day discharge set-up,the patients’satisfaction rate increased from 91%to 95%,and the rate of awareness of health education increased from 87%to 90%,the difference was statistically significant(χ^(2)=0.61,P=0.04 andχ^(2)=0.22,P=0.01).The length of hospitalization,hospitalization costs and waiting time for elevators were much reduced than those without this set-up.Conclusions:The application of the cataract daytime surgery and same-day discharge set-up can effectively alleviate the overcrowding of the ward environment,reduce the workload of medical staff,and improve patient satisfaction.Therefore,the daytime surgery and same-day discharge set-up has wide clinical applications.

摘要： Background: The implantation of the intraocular lens (IOL) is still subject to error and complication, as it can result in traumatic opening of the IOL leading to rupture of the posterior capsule and zonular dialysis, it takes time to train paramedic teams to assemble such IOLs with the manual injectors. Moreover, there is a potential risk of comtamination and endophthalmitis as there is manipulation of the IOL and cartridge. The preloaded IOLs tend to reduce those unwanted results and may optimize the surgical time. Purpose: The aim of this study is to compare the effectiveness and implantation time between three injectors and three intraocular lenses, two pre-loaded and one conventional. Methodology: Videos of thirty patients undergoing cataract surgery from December 2019 to December 2020 at the Hospital Oftalmológico de Brasília (HOB), Brasília, Brazil were included in this observational, analytical retrospective study, non randomized. All patients had their surgeries recorded, from which the time of injection and opening of the intraocular lens (IOL) was extracted, 20 eyes were implanted with preloaded intraocular lens, and 10 eyes with conventional IOL implant. The patients were divided into three groups with similar eye characteristics. The first received the AutonoMeTM (CE) injector with the Clareon® IOL, the second the IsertTM injector (I) with the Hoya® IOL, and the third was injected with Johnson & Johnson Platinum 1 Series injector used to deliver Sensar® One AAB00 lens. The Welch test and Tukey’s Post Hoc test were used in the statistical analysis. Results: It was observed that there was a statistical significance regarding the presence of a haptic stuck (5 Clareon vs 0 Sensar and Hoya), between the mean opening time of the IOL optics Sensar One, Hoya and Clareon (25.00 vs 31.40 vs 11.70 s, p < 0.001) and between the total time (the injection time more the opening time of the IOL) in relation to Hoya and Clareon lenses (39.50 s vs 19.60 s, p < 0.001);the total time of the Sensar IOL was 31.30 s. The opening time of the IOL optics was significantly longer for the Sensar One and Hoya groups compared to Clareon group, and the total time of Hoya group was significantly longer compared to the total time of the Clareon group. Conclusion: The study demonstrated that the choice of injector and IOL set can significantly affect the total time of IOL implantation. However, there was no difference regarding complications and collateral damage depending on the set chosen for the implant.

摘要： Background:To explore the action mechanism of the classic ancient prescription Si-Jun-Zi decoction in slowing down cataract process by network pharmacology.Methods:In Traditional Chinese Medicines for Systems Pharmacology Database and Analysis Platform Database,screening the chemical components and functional targets of the classic ancient prescription Si-Jun-Zi decoction,and the targets of cataract disease were obtainded through GeneCards and the Online Mendelian Inheritance in Man Database.In the STRING database,the protein-protein interaction network was built.And network visualization were created in Cytoscape.The genetic ontology and Kyoto Gene and Genome Encyclopedia pathways of key proteins were enriched via the DAVID data platform.Results:Ninety-six active components and 33 key targets were obtained in this work.The protein-protein interaction network consisted of 33 proteins.There were 33 genetic ontology entries and 72 Kyoto Gene and Genome Encyclopedia pathway enrichment analysis.Conclusion:This work provided a new means to understand the pathogenesis of cataract and revealed the action mechanisms of the classic ancient prescription Si-Jun-Zi decoction.

摘要： Background:To explore the application effect of Acknowledge-Introduce-Duration-Explanation-Thank you(AIDET)communication mode in reducing anxiety and improving the care services satisfaction of the patients.Methods:The 100 cases undergoing cataract daytime operation from February to July 2019 were divided into test group and control group.The test group conducted health education and nursing care for patients during admission,pre-operation,post-operation,and discharge according to the AIDET communication mode.And the control group was given health education and nursing care to the patients according to the traditional way of communication.Results:The difference of the socioeconomic information between these two groups showed no statistical significance.The care services satisfaction score in the test group was statistically higher than that in the control group(P<0.05).The Self-Rating Anxiety Scale(SAS)score in the test group was significantly lower than that in the control group(P<0.01).This result indicated that the patients suffered less anxiety with the AIDET mode of communication.Conclusions:The application of AIDET communication mode to the nursing service of cataract daytime operation can reduce the tension and anxiety of the patients from the treatment and improve their satisfaction to care services.