Cataract surgery under patient choice on supervised training lists is associated with a visual outcome and an incidence of complications at least as good as the published national average. User satisfaction is high. Cataract surgery under patient choice is compatible with training activity in receiving hospitals. The improvement in outcomes since the 1997-98 NCSS suggest that the accepted standards for complication rates should be updated to reflect the fact that phacoemulsification has become an established procedure.

No abstract

No abstract

Cataract surgery is performed more easily if

No abstract

Contrary to our expectation, the longer acting anaesthetic, bupivacaine, was inferior to tetracaine. Limited and supervised use of topical anaesthetics is recommended in controlling pain following photorefractive keratectomy.

Ninety years ago, the first issue of the Postgraduate Medical Journal published a review of an article written by Mr Robert Lindsay-Rea, a consultant ophthalmic surgeon in the Western Ophthalmic Hospital and an oculist in the West End Hospital for Nervous Diseases, entitled "A preliminary report on the treatment of keratitis". Today, microbial keratitis remains an important cause of avoidable visual impairment in the world. The aetiology of microbial keratitis has changed greatly over the past century due to the discovery of antibiotics, improvement in sanitation and education, the rising trend of contact lens wear and increased air travel. Significant advances have also been made in our understanding and management of this important disorder. This article highlights some of these changes and discusses the current management and research.

Eighty-four patients with up to -6.00 dioptres of myopia underwent photorefractive keratectomy (PRK), using 5.00 mm ablation zones. Three months post-operatively 38 (45%) complained of disturbances in night vision, compared with 21 (25%) pre-operatively. In the majority, these disturbances were regarded as negligible. However, 9 (11%) reported significant problems, defined as an inability to drive safely at night with the treated eye. At 12 months, 32 patients (38%) complained of impaired night vision, 4 (5%) of whom had significant problems. A series of measurements were performed to investigate the origins of these disturbances, especially in patients reporting significant problems. Visual impairment from forward scattered light was investigated using a computerised technique. Back scattered light was measured with a charge coupled device-camera system and a computer program was used to assess the degree of halation around a bright light source on a high-resolution monitor. Pupillary diameters were measured by infrared television pupillometry. At 6 months, those reporting a starburst effect around lights at night had small hyperopic shifts, minimal halos and high forward and back light scatter measurements. Patients who reported halo phenomena had large hyperopic shifts, little light scatter and large pupillary diameters. Of the 4 patients who reported significant disturbances at 12 months, all had persistent halo problems. Those with starburst effects in the early post-operative period noticed an improvement with time as their corneal haze gradually improved. Perturbations of night vision after PRK manifest as starbursts and halos around lights.(ABSTRACT TRUNCATED AT 250 WORDS)