The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Robert Ritch - One of the best experts on this subject based on the ideXlab platform.
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iridociliary apposition in plateau iris syndrome persists after Cataract Extraction
American Journal of Ophthalmology, 2003Co-Authors: Viet H Tran, Jeffrey M. Liebmann, Robert RitchAbstract:Abstract Purpose To evaluate the ultrasound biomicroscopic appearance of the anterior segment before and after Cataract Extraction in eyes with plateau iris syndrome and to determine the effect of postoperative zonular relaxation on ciliary body position. Design Interventional case series. Methods Eyes with plateau iris syndrome scanned before and after Cataract Extraction between January 1994 and September 2001 were enrolled. The iridociliary relationship and the anterior chamber depth at a distance of 3 mm from the scleral spur were assessed. Results We examined six eyes of six patients. Mean patient age was 74.2 ± 6.4 years (standard deviation [SD]) (range, 65–81 years). Mean refractive error was + 1.0 ± 3.9 diopters [D] (range, −5.75–+5.50), and mean axial length was 21.85 ± 0.77 mm (range, 20.90–22.95 mm). All eyes had undergone laser iridotomy and argon laser peripheral iridoplasty before Cataract Extraction. Ultrasound biomicroscopy examination revealed a narrow angle and absence of a ciliary body sulcus in all eyes with focal areas of iridotrabecular apposition in three eyes. Following Cataract Extraction, the anterior chamber depth increased ( P = .0006, paired t test), while the iridociliary contact remained unchanged. Conclusions Iridociliary apposition persists after Cataract Extraction in plateau iris syndrome. Whether the cause is congenital or acquired, or both, remains to be determined.
Therese Worstmann - One of the best experts on this subject based on the ideXlab platform.
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simultaneous bilateral Cataract Extraction
Journal of Cataract and Refractive Surgery, 2001Co-Authors: Tarun K Sharma, Therese WorstmannAbstract:Abstract Purpose To assess the visual outcome and safety of simultaneous bilateral Cataract Extraction. Setting Department of Ophthalmology, Queen’s Hospital, Burton on Trent, Staffordshire, United Kingdom. Methods Simultaneous bilateral Cataract Extraction was performed in 288 eyes of 144 patients over 10 years in a single department in selected cases. Case notes were retrospectively analyzed for final best corrected visual acuity (BCVA) and intraoperative and postoperative complication rates. Results The final BCVA was 6/9 or better in 87.0% of eyes. The incidence of intraoperative complications was 2.42%. These included posterior capsule rupture without vitreous loss (0.69%) and with vitreous loss (1.04%). Postoperative complications occurred in 10.05% of eyes and included raised intraocular pressure (IOP) (3.82%), iris prolapse (0.69%), uveitis (0.69%), and suture abscess (0.35%). There were no major bilateral complications such as endophthalmitis or corneal decompensation. Conclusion The outcome of simultaneous bilateral Cataract Extraction was comparable to that of single-eye Cataract surgery, indicating that the procedure is safe under strict surgical protocol and beneficial in selected cases.
Hussain H Fawzi - One of the best experts on this subject based on the ideXlab platform.
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simultaneous bilateral Cataract Extraction
Journal of Cataract and Refractive Surgery, 1999Co-Authors: Alan L Ramsay, Charles J M Diaper, Shanmugam N Saba, Zeidoon A Y Beirouty, Hussain H FawziAbstract:Abstract Purpose To evaluate the visual outcome and safety of simultaneous bilateral Cataract Extraction. Setting Stobhill Hospital NHS Trust, Glasgow, United Kingdom. Methods This retrospective case review comprised 259 consecutive patients (518 eyes) who had simultaneous bilateral Cataract surgery. Surgeries included bilateral extracapsular procedures, uniocular extracapsular procedures performed simultaneously with a different type of intraocular lens surgery in the other eye, and 1 bilateral intracapsular procedure. Outcome measures were postoperative best spectacle-corrected visual acuity (BSCVA), intraoperative and postoperative complication rates, and conjunctival swab culture results. Results Eighty-three percent of patients (75% of eyes) with measured preoperative and postoperative BSCVA achieved an acuity of 6/12 or better. Intraoperative and postoperative complication rates were similar to those in previous reports of unilateral extracapsular surgery and simultaneous bilateral Cataract surgery. Endophthalmitis occurred in 1 eye (0.19%). There were no bilateral complications that resulted in visual loss. Cultures were positive from 42% of conjunctival swabs; 81% of positive cultures were coagulase-negative Staphylococcus and 10% were Staphylococcus aureus . Conclusions Simultaneous bilateral Cataract surgery did not lead to an increased incidence of serious intraoperative or postoperative complications, and visual acuity results were good.
Jonathan C Javitt - One of the best experts on this subject based on the ideXlab platform.
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risk of retinal detachment following Cataract Extraction results from the international Cataract surgery outcomes study
British Journal of Ophthalmology, 1996Co-Authors: Jens Christian Norregaard, Jonathan C Javitt, Henrik Thoning, Tavs Folmer Andersen, Peter Bernthpetersen, Gerald F AndersonAbstract:AIMS: To estimate the risk of retinal detachment (RD) following Cataract Extraction in Denmark, and to compare the risk with that following Cataract Extraction in the USA, and with that in a sample of Danish patients who did not have ocular surgery. METHODS: A sample was created from the administrative Danish Hospital Register and included 19,252 patients who underwent first eye Cataract surgery between 1985 and 1987, and who were 50 years of age or older. The patients were then followed for 4-6 years using the register data. The design and definition of events were identical to the US National Study of Cataract Outcomes. RESULTS: In Denmark a 4 year cumulative risk of hospitalisation for RD of 0.93% (95% confidence interval (CI) 0.71-1.16) was observed following an extracapsular Cataract Extraction with a lens implant. A similar cumulative risk of RD was reported from the US study. Thus, no difference in outcomes concerning risk of RD was shown between Denmark and the USA. In a multivariate analysis younger age, male sex, and intracapsular Cataract Extraction were all associated with higher risk of postoperative RD. A reference group of 7636 people not undergoing any ocular surgery was created and the incidence of RD in this group was calculated. During the sixth year following Cataract surgery, the incidence of RD in the Cataract group was still 7.5 (95% CI 1.6-22.0) times higher than that observed in the reference group.
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national outcomes of Cataract Extraction increased risk of retinal complications associated with nd yag laser capsulotomy
Ophthalmology, 1992Co-Authors: Jonathan C Javitt, James M Tielsch, Joseph K Canner, Margaret M Kolb, Alfred Sommer, Earl P SteinbergAbstract:Purpose: The authors studied 57,103 randomly selected Medicare beneficiaries who underwent extracapsular Cataract Extraction in 1986 or 1987 to determine the possible association between performance of neodymium (Nd):YAG laser capsulotomy and the risk of subsequent retinal break or detachment. Methods: Cases of Cataract surgery were identified from Medicare claims submitted in 1986 and 1987 and were followed through the end of 1988. Episodes of Cataract surgery, posterior capsulotomy, and retinal complications were ascertained based on procedure and diagnosis codes listed in physician bills and hospital discharge records. Lifetable and Cox's proportional hazards models were used to analyze the risk of retinal detachment or break in patients undergoing and not undergoing capsulotomy during the period of observation. Results: Of the 57,103 persons identified as having undergone extracapsular Cataract Extraction in 1986 or 1987, 13,709 subsequently underwent Nd:YAG laser cap=sulotomy between 1986 and 1988. A total of 337 persons had aphakic or pseudophakic retinal detachments between 1986 and 1988 and an additional 194 underwent repair of a retinal break. Proportional hazards modeling shows a 3.9-fold increase in the risk of retinal break or detachment among those who underwent capsulotomy (95% confidence interval: 2.89 to 5.25). Younger patient age, male sex, and white race also were associated with increased risk of retinal complications after extracapsular Cataract Extraction. Conclusion: The authors conclude that there is a statistically significant increase in the risk of retinal detachment or break in those patients who undergo capsulotomy after Cataract Extraction. Therefore, capsulotomy should be deferred until the patient's impairment caused by capsular opacification warrants the increased risk of retinal complications associated with performance of capsulotomy.
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National outcomes of Cataract Extraction. Endophthalmitis following inpatient surgery.
Archives of ophthalmology (Chicago Ill. : 1960), 1991Co-Authors: Jonathan C Javitt, Joseph K Canner, Susan Vitale, Debra A. Street, Henry Krakauer, A. Marshall Mcbean, Alfred SommerAbstract:• We analyzed the likelihood of rehospitalization for endophthalmitis in 338 141 Medicare beneficiaries over age 65 years who were admitted to US hospitals for Cataract Extraction in 1984. This cohort represents approximately one half of all persons who underwent Cataract Extraction under the Medicare program in 1984. Extracapsular Extraction was performed in 195 587 (58%) of cases, intracapsular Cataract Extraction in 99 971 (30%), and phacoemulsification in 28 474 (8%). The risk of rehospitalization for endophthalmitis in the year following surgery was 0.17% for intracapsular Cataract Extraction compared with 0.12% for extracapsular Extraction or phacoemulsification (P
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national outcomes of Cataract Extraction retinal detachment and endophthalmids after outpatient Cataract surgery
Ophthalmology, 1991Co-Authors: Jonathan C Javitt, James M Tielsch, Margaret M Kolb, Alfred Sommer, Debra A. Street, Qin Wang, Oliver D Schein, Marilyn Bergner, Earl P SteinbergAbstract:Background: A near-total shift to Cataract Extraction on an outpatient basis occurred as a result of an administrative ruling by the Health Care Financing Administration. No national study has been conducted to assess the possible effects of that decision on clinical outcomes of surgery. The authors compared the rates of retinal detachment (RD) repair and hospitalization for endophthalmitis after extracapsular Cataract Extraction (ECCE) (including phacoemulsification) in 1986 and 1987 with those following inpatient Cataract Extraction in 1984. Methods: Using the 5% random sample of Medicare beneficiaries, we analyzed the claims of all individuals 66 years of age or older who underwent ECCE by nuclear expression or phacoemulsification in 1986 and 1987. A total of 57,103 patients were identified and followed to the end of 1988. Cumulative probability of RD repair and hospitalization for endophthalmitis was calculated by standard lifetable methods. These findings were compared with the cumulative probability of the same complications in a cohort of 330,000 patients who underwent Cataract Extraction on an inpatient basis in 1984. Results: In the 1986-to-1987 cohort, the cumulative probability of RD within 3 years after Cataract surgery was 0.81% and the cumulative probability of endophthalmitis within 1 year was 0.08%. The rate of RD is similar to that which we previously reported for 330,000 patients who underwent inpatient surgery in 1984, but the rate of endophthalmitis is significantly lower in the 1986-to-1987 outpatient cohort (0.08% versus 0.12%; z = 2.42; P = 0.01). Conclusions: The shift to outpatient Cataract surgery was accompanied by no significant increase in the probability of RD repair and possibly a significant decrease in the rate of hospitalization for endophthalmitis.
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national outcomes of Cataract Extraction i retinal detachment after inpatient surgery
Ophthalmology, 1991Co-Authors: Jonathan C Javitt, Joseph K Canner, Susan Vitale, Henry Krakauer, Marshall A Mcbean, Alfred SommerAbstract:Abstract Rehospitalization for retinal detachment (RD) was studied in 338,141 Medicare beneficiaries older than 65 years of age who were undergoing inpatient Cataract Extraction in 1984. Extracapsular Cataract Extraction (ECCE) was performed in 60% of patients, intracapsular Cataract Extraction (ICCE) in 31 %, and phacoemulsification in 9%. The risk of rehospitalization for RD within 4 years of ICCE was 1.55%, over 1.5 times the risk associated with ECCE (0.9%). The risk of RD after phacoemulsification was 1.17%. Cataract surgery accompanied by anterior vitrectomy was associated with a 5.0%, likelihood of RD at 4 years, which is 4.5 times greater than that for Cataract surgery alone (1.12%). White patients were 1.7 times more likely to be rehospitalized for RD than were black patients (1.15% versus 0.67%; P P P
Ranjana Chauhan - One of the best experts on this subject based on the ideXlab platform.
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Phacoemulsification Cataract Extraction and posterior chamber lens implantation in patients with uveitis.
American Journal of Ophthalmology, 2001Co-Authors: Marc F.g Estafanous, Careen Y. Lowder, David M. Meisler, Ranjana ChauhanAbstract:Abstract PURPOSE: This study reports outcomes of phacoemulsification Cataract Extraction and posterior chamber intraocular lens implantation within the capsular bag in patients with uveitis. METHODS: We retrospectively reviewed the charts of 32 patients (39 eyes) with uveitis who underwent phacoemulsification Cataract Extraction and posterior chamber intraocular lens implantation by two surgeons at The Cleveland Clinic Foundation from January 1990 to June 1998. Patients with less than 3 months of follow-up were excluded. RESULTS: Diagnoses of uveitis included idiopathic (15 eyes), sarcoidosis (10 eyes), pars planitis (four eyes), CMV retinitis (two eyes), Fuchs heterochromic iridocyclitis (two eyes), syphilis (two eyes), and one eye each of tuberculosis, Crohn's disease, HLA-B27 associated, and acute retinal necrosis. Average follow-up was 20 months (range, 3 to 63 months). Best-corrected visual acuity improved in 37 eyes (95%). Average improvement was 4 ± 3 Snellen acuity lines (range, 1 to 10 lines). Thirty-four eyes (87%) attained final visual acuity better than or equal to 20/40. Visual loss occurred in one eye (3%) with CMV retinitis. No improvement in visual acuity was seen in one eye (3%) that developed a retinal pigment epithelial detachment. Posterior capsule opacification occurred in 24 eyes (62%), 12 of which required Nd:YAG capsulotomy (31%). Other postoperative complications included recurrence of uveitis (41%), cystoid macular edema (33%), epiretinal membrane formation (15%), and posterior synechiae (8%). CONCLUSIONS: Phacoemulsification Cataract Extraction with posterior chamber intraocular lens implantation is safe in patients with uveitis. The incidences of recurrence of uveitis, cystoid macular edema, epiretinal membrane, and posterior synechiae were lower than those reported previously for extracapsular Cataract Extraction.