Cataract surgery for the developing world

Tabin, Geoffrey; Chen, Michael C.; Espandar, Ladan

doi:10.1097/icu.0b013e3282f154bd

Cited by 205 publications

(180 citation statements)

References 29 publications

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“…Among these disorders, cataract is the leading cause of blindness worldwide and accounts for estimated cases of 18 million, half of all these cases originating in developing countries (6,7). Several large-scale population-based epidemiological studies consistently revealed strong links between obesity and cataract (5,(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Increased risk of cataract development in WNIN‐obese rats due to accumulation of intralenticular sorbitol

et al. 2013

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Epidemiological studies have reported an association between obesity and increased incidence of ocular complications including cataract, yet the underlying biochemical and molecular mechanisms remained unclear. Previously we had demonstrated accumulation of sorbitol in the lens of obese rats (WNIN/Ob) and more so in a related strain with impaired glucose tolerance (WNIN/GR-Ob). However, only a few (15-20%) WNIN/Ob and WNIN/GR-Ob rats develop cataracts spontaneously with age. To gain further insights, we investigated the susceptibility of eye lens proteins of these obese rat strains to heat-and UV-induced aggregation in vitro, lens opacification upon glucose-mediated sorbitol accumulation ex vivo, and onset and progression of cataract was followed by galactose feeding and streptozotocin (STZ) injection. The results indicated increased susceptibility toward heat-or UV-induced aggregation of lens proteins in obese animals compared to their littermate lean controls. Further, in organ culture studies glucose-induced sorbitol accumulation was found to be higher and thus the lens opacification was faster in obese animals compared to their lean littermates. Also, the onset and progression of galactose-or STZ-induced cataractogenesis was faster in obese animals compared to lean control. These results together with our previous observations suggest that obesity status could lead to hyperaccumulation of sorbitol in eye lens, predisposing them to cataract, primarily by increasing their susceptibility to environmental and/or physiological factors. Further, intralenticular sorbitol accumulation beyond a threshold level could lead to cataract in WNIN/Ob and WNIN/ GR-Ob rats. V C 2013 IUBMB Life, 65(5): [472][473][474][475][476][477][478] 2013

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Section: Introductionmentioning

confidence: 99%

Increased risk of cataract development in WNIN‐obese rats due to accumulation of intralenticular sorbitol

et al. 2013

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“…A cirurgia de catarata é o procedimento cirúrgico oftalmológico mais comumente realizado no Brasil, sendo a facoemulsificação a técnica mais utilizada devido a diversos fatores como possibilidade de microincisão tunelizada com aplicação de lente intraocular (LIO) dobrável (diminuindo astigmatismo induzido), menor tempo cirúrgico e dano corneoendotelial, possibilitando uma recuperação pós-operatória mais rápida (1)(2)(3)(4) . Portanto, um treinamento qualificado da técnica deve ser um dos principais objetivos de qualquer programa de residência de oftalmologia.…”

Section: Discussionunclassified

“…É a principal causa tratável de cegueira em todo o mundo (1)(2)(3)(4) . Segundo a Organização Mundial de Saúde, há 45 milhões de cegos no mundo, dos quais 40% são devidos à catarata (5) .…”

Section: Introductionunclassified

Programa de ensino de facoemulsificação CBO/ALCON: resultados do Hospital de Olhos do Paraná

Fischer¹,

Pires²,

Klein³

et al. 2010

Arq. Bras. Oftalmol.

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“…1,2 Cataract surgery often achieves excellent visual outcomes with low rates of complication. 3,4 However, in LMICs, cataract surgical coverage is often low, and visual outcomes may be poor, 1,[5][6][7][8] especially owing to operative complications and uncorrected refractive errors, both of which require postoperative follow-up for diagnosis and treatment. 4,[8][9][10][11][12] Unfortunately, even shortterm (<6 weeks) follow-up rates after cataract surgery are less than 50% in many regions in LMICs and may fall below 30%.…”

mentioning

confidence: 99%

Cost and Expected Visual Effect of Interventions to Improve Follow-up After Cataract Surgery

Meltzer

Congdon

Kymes³

et al. 2017

JAMA Ophthalmol

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IMPORTANCE Some experts recommend increasing low rates of follow-up after cataract surgery in low-and middle-income countries using various interventions. However, little is known about the cost and effect of such interventions.OBJECTIVE To examine whether promoting follow-up after cataract surgery creates economic value. DESIGN, SETTING, AND PARTICIPANTSThe Prospective Review of Early Cataract Outcomes and Grading (PRECOG) is a cohort study with data from patients undergoing cataract surgery from January 19, 2010, to April 18, 2012. Final follow-up was completed on August 10, 2012. Data were collected before surgery, at discharge, and at follow-up at least 40 days after surgery from 27 centers in 8 countries in Asia, Africa, and Latin America. Each center enrolled 40 to 120 consecutive patients undergoing cataract surgery. If patients did not return to the hospital for the follow-up visit, hospitals could use telephone calls or transportation subsidies to increase follow-up rate. Data were analyzed from December 2013 to January 2016. MAIN OUTCOMES AND MEASURES Cost of interventions (telephone calls and transportationsubsidies) to increase follow-up at least 40 days after surgery, visual acuity (VA) in the eye undergoing cataract surgery, presence of complications, patient and facility costs per visit, and willingness to pay for treatment or glasses if needed. The maximum incremental cost of improving VA in 1 patient (incremental cost-effect ratio [ICER]) was calculated for spontaneous follow-up (compared with no follow-up) and follow-up with the telephone and transportation interventions. Expected ICERs were estimated including only those patients willing to pay. RESULTS Among 2487 patients (1068 men [42.9%]; 1405 women [56.5%]; 14 missing [0.6%]; mean [SD] age, 68.4 [11.3] years), 2316 (93.1%) received follow-up, of whom 369 (16.0%) were seen in an outside facility or home and were in the cost-effectiveness analysis as unable to follow up. A grand mean (a mean of means of the different countries) of 56.3% of patients needed glasses, of whom 56.9% were willing to pay, and 1.6% had treatable complications, of whom 39.4% were willing to pay. Maximum proportions with improved VA (and corresponding ICERs) were 0.08 for no follow-up, 0.45 ($151.56) for spontaneous follow-up, 0.53 ($164.46) for a telephone intervention, and 0.53 ($133.07) for a transportation intervention. These results were most sensitive to the cost of follow-up. Expected proportions (ICERs) were 0.08, 0.27

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Cataract surgery for the developing world

Cited by 205 publications

References 29 publications

Increased risk of cataract development in WNIN‐obese rats due to accumulation of intralenticular sorbitol

Increased risk of cataract development in WNIN‐obese rats due to accumulation of intralenticular sorbitol

Programa de ensino de facoemulsificação CBO/ALCON: resultados do Hospital de Olhos do Paraná

Cost and Expected Visual Effect of Interventions to Improve Follow-up After Cataract Surgery

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