Office-Based Cataract Surgery

Ianchulev, Tsontcho; Litoff, David; Ellinger, Donna; Stiverson, Kent; Packer, Mark

doi:10.1016/j.ophtha.2015.12.020

Cited by 84 publications

(61 citation statements)

References 16 publications

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“…Patients included in our study were slightly younger, mean of 70.42 years, than those included in the 2013 (mean 73.9 years) and 2018 (mean 73.5 years) EUREQUO reports [6,7], with a majority of women. e percentage of eyes with prior pathologies and preoperative conditions increasing the surgical complexity (28.55% and 11.1% respectively) was similar in our study to those in the previous reports [6,9,10].…”

Section: Discussionsupporting

confidence: 91%

“…Intrasurgical complications in our study were rare. e rate of capsular tears was 0.33%, compared with reported rates as low as 0.55% [9], to more commonly reported rates of between 1.14% and 1.78% [10][11][12][13] or occasionally as high as 3.1% [14]. Vitreous loss in our study appeared in 0.33% of cases, compared with reported rates ranging from 0.34% [9] to 2.2% [14]; the incidence of zonular dehiscence (0.40%) and dropped nucleus (0.11%) is also similar or lower compared with that of other reports [10,14].…”

Section: Discussionmentioning

confidence: 77%

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Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Rementería-Capelo

García-Pérez

Gros-Otero

et al. 2020

Journal of Ophthalmology

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Introduction. Currently available outcome data for cataract surgery include mostly patients from public health systems. The purpose of this study was to report the visual and refractive outcomes of cataract procedures performed during one year in a private practice center, which may include a different spectrum of patients. Methods. Our center’s database was used to identify all isolated cataract procedures performed during 2017. The electronic records were reviewed to collect the preoperative information, presence of intra- or postsurgical complications, and visual and refractive outcomes one month after surgery. Results. In 2017, 2714 eyes of 1543 patients underwent cataract surgery in our center. Mean patient age was 70.42 years. 775 eyes (28.55%) had prior ophthalmic pathologies, and 113 eyes (4.16%) had undergone previous surgical procedures. Surgical complications developed in 35 eyes (1.29%), including 9 posterior capsule tears (0.33%) and 3 cases of dropped lens fragments (0.11%). A toric or multifocal intraocular lens was implanted in 45.6% of eyes. As regards postoperative complications, 59 eyes (2.17%) required a return to the operating theater, including 29 eyes (1.07%) requiring reinterventions due to an unexpected refractive result. There were no cases of endophthalmitis. Mean LogMAR-corrected distance visual acuity (CDVA) improved from 0.25 (SD 0.34) preoperatively to 0.04 (SD 0.17) postoperatively; 86.5% of eyes achieved a CDVA ≤0.0, with 97.5% achieving ≤0.3. In 86.4% of eyes, the difference between target and residual spherical equivalent difference was of 0.50 D or lower; 88% of eyes had a spherical equivalent ±0.50 D. Conclusions. The visual and refractive outcomes of cataract surgery in a private practice setting were excellent, well over the benchmarks set by the ESCRS. The safety profile was also within expected standards. This study provides information for ophthalmologists in private practice on expected outcomes.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 77%

Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Rementería-Capelo

García-Pérez

Gros-Otero

et al. 2020

Journal of Ophthalmology

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“…Ianchulev et al . [3] and Tsontcho et al . reported office-based cataract surgery in 21,501 eyes and more and more topical or intracameral lidocaine (51.2%) replaced retrobulbar lidocaine (<0.03%) as the local anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…[2] also reported the initial 2 years of experience with the AAO National Eyecare Outcomes Network cataract surgery database, which collected data of 249 ophthalmologists from 1996 to 1997, and 41.4% of cataract surgeries were done under retrobulbar injection local anesthesia. Although there is a trend of less using retrobulbar injection for cataract surgeries,[3] it remains as a crucial technique in ophthalmic practices.…”

Section: Introductionmentioning

confidence: 99%

Vertical diplopia after cataract surgery, overacting, and/or underacting extraocular muscle

Shen

2017

Taiwan J Ophthalmol

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The purpose of this study was to demonstrate two cases of vertical diplopia after cataract surgery and to discuss the mechanism and types of strabismus caused by the local anesthesia with retrobulbar injection. Two cases of vertical diplopia after cataract surgeries were reported. They were operated by the same surgeon and both happened to the left eye and both presented with marked left hypotropia. The clinical findings consisted of overacting left inferior rectus (LIR) in case 1 and mixed overacting and restrictive LIR in case 2. The diplopia and left hypotropia were eliminated after muscle operation. Retrobulbar injection is a basic technique in ophthalmic practice. Although it is generally safe, complications do happen in certain cases including diplopia and strabismus. Ophthalmologists should know about the orbital anatomy and learn to prevent any accidental insult to extraocular muscles.

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“…More recently, the Intelligent Research in Sight Registry found that the rate of endophthalmitis after cataract surgery was 0.08% (0.8 per 1000 surgeries) for 2013 and 2014 combined (Coleman 2015). Also, there were no cases of endophthalmitis following 21,501 office-based cataract surgeries performed at Kaiser Permanente Colorado from 2011 to 2014 (Ianchulev 2016). Reported incidences for other types of exogenous endophthalmitis are between 0.006% and 0.16% for intravitreous injection, between 0.3% and 0.7% for trabeculectomy, 2.0% for glaucoma drainage surgery, and between 0.9% and 17% for traumatic injury to the globe (Sadaka 2012; Stein 2008).…”

Section: Introductionmentioning

confidence: 99%

Adjunctive steroid therapy versus antibiotics alone for acute endophthalmitis after intraocular procedure

Kim¹,

Chen²,

Coleman³

2017

Cochrane Database of Systematic Reviews

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Background Endophthalmitis refers to severe infection within the eye that involves the aqueous humor or vitreous humor, or both, and threatens vision. Most cases of endophthalmitis are exogenous (i.e. due to inoculation of organisms from an outside source), and most exogenous endophthalmitis is acute and occurs after an intraocular procedure. The mainstay of treatment is emergent administration of broad-spectrum intravitreous antibiotics. Due to their anti-inflammatory effects, steroids in conjunction with antibiotics have been proposed to be beneficial in endophthalmitis management. Objectives To assess the effects of antibiotics combined with steroids versus antibiotics alone for the treatment of acute endophthalmitis following intraocular surgery or intravitreous injection. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 11), MEDLINE Ovid (1946 to 8 December 2016), Embase Ovid (1980 to 8 December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 8 December 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 8 December 2016, ClinicalTrials.gov (www.clinicaltrials.gov); searched 8 December 2016, and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 8 December 2016. We did not use any date or language restrictions in the electronic searches for trials. Selection criteria We included randomized controlled trials comparing the effectiveness of adjunctive steroids with antibiotics alone in the management of acute, clinically diagnosed endophthalmitis following intraocular surgery or intravitreous injection. We excluded trials with participants with endogenous endophthalmitis unless outcomes were reported by source of infection. We imposed no restrictions on the method or order of administration, dose, frequency, or duration of antibiotics and steroids. Data collection and analysis Two review authors independently screened the search results, assessed risk of bias, and extracted data using methods expected by Cochrane. We contacted study authors to try to obtain missing information or information to clarify risk of bias. We conducted a meta-analysis for any outcomes that were reported by at least two studies. Outcomes reported from single studies were summarized in the text. We assessed the certainty of the evidence using GRADE. Main results We included three trials with a total of 95 randomized participants in this review and identified one ongoing trial. The studies were conducted in South Africa, India, and the Netherlands. Out of the 92 analyzed participants, 91 participants were diagnosed with endophthalmitis following cataract surgery. In the remaining participant, endophthalmitis was attributable to penetrating keratoplasty. All studies used intravitreous dexamethasone for adjunctive steroid therapy and a combination of two intravitreous antibiotics that provided gram-posi...

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Office-Based Cataract Surgery

Cited by 84 publications

References 16 publications

Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

Vertical diplopia after cataract surgery, overacting, and/or underacting extraocular muscle

Adjunctive steroid therapy versus antibiotics alone for acute endophthalmitis after intraocular procedure

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