Surgical interventions for age-related cataract

Riaz, Yasmin; Mehta, J. S.; Wormald, Richard; Evans, Jennifer R; Foster, Andrew L.; Ravilla, Thulasiraj; Snellingen, Torkel

doi:10.1016/j.ajo.2007.02.015

Cited by 17 publications

(19 citation statements)

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“…For example, in most parts of the world aphakia has been superseded by pseudophakia due to better visual outcomes,[17] and tends to be prevalent among those undergoing surgery longer ago. However, aphakia remains an important contributor to poor outcomes in some settings.…”

Section: Discussionmentioning

confidence: 99%

“…[17] Also, data collection can readily occur through rapid, low-cost population-based surveys[29] and the UEH Action Plan has called for Member States to undertake more RAAB surveys to plan and monitor eye care services. [14] Through the RAAB Repository an increasing amount of comparable data are available from different settings,[30] including examples of national follow-up surveys that monitor change over time.…”

Section: Discussionmentioning

confidence: 99%

“…Cataract surgery is a cost-effective intervention[16] that usually restores sight. [17] It can also improve quality-of-life,[18–20] time-use,[20] and social status[19] and positively impacts on poverty alleviation. [18–20] These strengths and benefits have contributed to the inclusion of cataract surgery in recent essential surgery lists,[21, 22] as well as in the proposed initial surgical package for UHC.…”

Section: Introductionmentioning

confidence: 99%

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Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage

et al. 2017

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Objective To define and demonstrate effective cataract surgical coverage (eCSC), a candidate UHC indicator that combines a coverage measure (cataract surgical coverage, CSC) with quality (post-operative visual outcome). Methods All Rapid Assessment of Avoidable Blindness (RAAB) surveys with datasets on the online RAAB Repository on April 1 2016 were downloaded. The most recent study from each country was included. By country, cataract surgical outcome (CSOGood, 6/18 or better; CSOPoor, worse than 6/60), CSC (operated cataract as a proportion of operable plus operated cataract) and eCSC (operated cataract and a good outcome as a proportion of operable plus operated cataract) were calculated. The association between CSC and CSO was assessed by linear regression. Gender inequality in CSC and eCSC was calculated. Findings Datasets from 20 countries were included (2005–2013; 67,337 participants; 5,474 cataract surgeries). Median CSC was 53.7% (inter-quartile range[IQR] 46.1–66.6%), CSOGood was 58.9% (IQR 53.7–67.6%) and CSOPoor was 17.7% (IQR 11.3–21.1%). Coverage and quality of cataract surgery were moderately associated—every 1% CSC increase was associated with a 0.46% CSOGood increase and 0.28% CSOPoor decrease. Median eCSC was 36.7% (IQR 30.2–50.6%), approximately one-third lower than the median CSC. Women tended to fare worse than men, and gender inequality was slightly higher for eCSC (4.6% IQR 0.5–7.1%) than for CSC (median 2.3% IQR -1.5–11.6%). Conclusion eCSC allows monitoring of quality in conjunction with coverage of cataract surgery. In the surveys analysed, on average 36.7% of people who could benefit from cataract surgery had undergone surgery and obtained a good visual outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage

et al. 2017

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“…SICS in combination with biometry has been shown to yield better visual outcomes than ECCE with biometry16 including in rural settings 17. The low level of refractive error in Bangladesh could be due to greater surgical skill, but the proportion of adverse outcome due to surgical complications was no better in Bangladesh than in the other countries (22% of poor outcome (excluding refractive error) in Bangladesh, 24% in Kenya and 13% in Philippines) suggesting that SICS with biometry was more important than surgical skill in minimising refractive error.…”

Section: Discussionmentioning

confidence: 99%

Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh

Lindfield

Kuper

Polack

et al. 2009

British Journal of Ophthalmology

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Adverse outcomes following cataract surgery were frequent in the three countries. Main causes were refractive error and preoperative comorbidities. Many patients are not attaining the outcomes available with modern surgery. Focus should be on correcting refractive error, through operative techniques or postoperative refraction, and on a system for assessing comorbidities and communicating risk to patients. These are only achievable with a commitment to ongoing surgical audit.

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“…Notable advances in the materials used for intraocular lenses (IOLs) and in surgical techniques, have taken place in the last decades [8,9]. These improvements make the extraction of the natural opaque crystalline and the replacement by an IOL one of the most cost-effective interventions in current healthcare [10]. The field of IOLs now extends to refractive surgery procedures useful for permanent and accurate correction of common vision errors such as presbyopia, myopia or hyperopia [9], which may involve clear lens extraction (CLE), namely the removal of the noncataractous natural lens and replacement with an IOL of adequate corrective power; or just the insertion of a corrective lens (phakic implantable lens) in front of the eye’s natural lens [11].…”

Section: Intraocular Lenses (Iols)mentioning

confidence: 99%

Drug-Eluting Intraocular Lenses

González-Chomón

Concheiro

2011

Materials

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Notable advances in materials science and in surgical techniques make the management of cataract by replacement of the opaque crystalline with an intraocular lens (IOL), one of the most cost-effective interventions in current healthcare. The usefulness and safety of IOLs can be enhanced if they are endowed with the ability to load and to sustain drug release in the implantation site. Drug-eluting IOLs can prevent infections and untoward reactions of eye tissues (which lead to opacification) and also can act as drug depots for treatment of several other ocular pathologies. Such a myriad of therapeutic possibilities has prompted the design of drug-IOL combination products. Several approaches are under study, namely combination of the IOL with an insert in a single device, soaking in drug solutions, impregnation using supercritical fluids, coating with drug/polymer layers, and covalent grafting of the drug. The advantages/limitations of each technique are discussed in the present review on selected examples. Although more in vivo data are required, the information already available proves the interest of some approaches in ocular therapeutics.

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Surgical interventions for age-related cataract

Cited by 17 publications

References 0 publications

Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage

Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage

Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh

Drug-Eluting Intraocular Lenses

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