Clinical and Experimental Ophthalmology最新文献

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Intraocular lens power calculation accuracy in patients with keratoconus: Network meta-analysis and systematic review. 圆锥角膜患者人工晶状体度数计算的准确性:网络荟萃分析和系统评价。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-12-03 DOI: 10.1111/ceo.14470
Olga Reitblat, Ruti Sella, Rita Zlatkin, Irit Bahar, Tsahi T Lerman
{"title":"Intraocular lens power calculation accuracy in patients with keratoconus: Network meta-analysis and systematic review.","authors":"Olga Reitblat, Ruti Sella, Rita Zlatkin, Irit Bahar, Tsahi T Lerman","doi":"10.1111/ceo.14470","DOIUrl":"https://doi.org/10.1111/ceo.14470","url":null,"abstract":"<p><strong>Background: </strong>Accurate intraocular lens (IOL) calculation in eyes with keratoconus (KCN) poses significant challenges. While various formulas, including KCN-specific ones, have been investigated, the optimal calculation method remains inconclusive.</p><p><strong>Methods: </strong>The study was pre-registered in PROSPERO (CRD42023483119). PubMed, Embase and CENTRAL electronic databases were systematically searched for studies comparing IOL power calculation formulas in eyes with KCN. The percentage of eyes with a prediction error (PE) within ±0.50 D and ±1.00 D, the mean PE and the mean absolute error (MAE) were compared using a random effect model in Bayesian network meta-analysis.</p><p><strong>Results: </strong>Nine retrospective clinical studies were included, totalling 623 eyes and 25 calculation methods. The Barrett True-K formula for KCN with measured posterior cornea (BTK MPC) achieved the highest ranking for the percentage of PE within ±0.50 D and ±1.00 D, mean PE, and MAE, with surface under the cumulative ranking (SUCRA) of 95%, 95%, 97% and 95%, respectively. Subgroup analysis showed that for the predictability rates within ±0.50 D and ±1.00 D, the best ranking formulas were: Emmetropia Verifying Optical (EVO) (85%) and BTK MPC (78%), respectively, in mild KCN; BTK with predicted posterior cornea (PPC) (85%) and MPC (88%), respectively, in moderate KCN; and Kane KCN for both metrics in severe KCN (84% and 95%, respectively).</p><p><strong>Conclusion: </strong>The BTK MPC formula ranked highest across various metrics, suggesting its superior accuracy for IOL calculations in KCN. The optimal formulas may differ based on KCN severity, with current evidence suggesting potential advantage of Kane KCN for severe cases.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of anisometropic amblyopia on visual cognitive functions in children. 屈光参差性弱视对儿童视觉认知功能的影响。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-12-03 DOI: 10.1111/ceo.14472
Danyi Mao, Chenyao Liu, Ziang Yin, Zaifeng Cui, Jiali Zhang, Xue Li, Yingying Huang, Hao Chen, Jinhua Bao
{"title":"Effects of anisometropic amblyopia on visual cognitive functions in children.","authors":"Danyi Mao, Chenyao Liu, Ziang Yin, Zaifeng Cui, Jiali Zhang, Xue Li, Yingying Huang, Hao Chen, Jinhua Bao","doi":"10.1111/ceo.14472","DOIUrl":"https://doi.org/10.1111/ceo.14472","url":null,"abstract":"<p><strong>Background: </strong>To investigate visual cognitive functions, including visual attention, executive function, and visual working memory, in children with anisometropic amblyopia versus those with normal vision.</p><p><strong>Methods: </strong>Thirty-five children with anisometropic amblyopia and 34 with normal vision participated. Visual acuity, stereoacuity, and contrast sensitivity were measured, followed by the Cambridge Neuropsychological Test Automated Battery's six subtests for cognitive evaluation. Visual attention was assessed using reaction time (RTI) and rapid visual information processing (RVP). Executive function was evaluated through the multitasking test (MTT). Visual working memory was assessed with spatial working memory (SWM), delayed matching to sample (DMS), and paired association learning (PAL), all under binocular conditions.</p><p><strong>Results: </strong>The amblyopia group exhibited longer reaction and movement times in the RTI than the control group (p < 0.01). A trend towards lower RVP A' scores, reflecting reduced ability to detect target sequences, appeared in the amblyopia group (p = 0.056). Amblyopic children demonstrated a lower multitasking cost in the MTT compared with the control group (p = 0.04). As difficulty increased in the SWM (from four to six boxes), amblyopic children revisited more (p = 0.01). In the DMS task, while no differences were observed across all delay times (p = 0.55), amblyopic children performed significantly worse than the control group under the 12-second delay (p = 0.04). In the eight-pattern PAL condition, the amblyopia group made more errors (p = 0.01).</p><p><strong>Conclusions: </strong>Children with anisometropic amblyopia performed poorly on neuropsychological tests, particularly visual attention and working memory, but outperformed the control group in multitasking. These findings highlight the broader cognitive impacts of anisometropic amblyopia beyond vision.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mimickers of hydroxychloroquine retinal toxicity 羟氯喹视网膜毒性模拟物。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-12-03 DOI: 10.1111/ceo.14461
Peter Jones MD, Gagan Kalra MD, Mayss Al-Sheikh MD, Jay Chhablani MD
{"title":"Mimickers of hydroxychloroquine retinal toxicity","authors":"Peter Jones MD,&nbsp;Gagan Kalra MD,&nbsp;Mayss Al-Sheikh MD,&nbsp;Jay Chhablani MD","doi":"10.1111/ceo.14461","DOIUrl":"10.1111/ceo.14461","url":null,"abstract":"<p>Hydroxychloroquine (HCQ) retinal toxicity is an important entity that can be challenging to differentiate from its mimickers. Bull's eye maculopathy is the classical presentation of HCQ retinopathy; however, its differential includes several drug-related retinal toxicities, inherited retinal disorders, and systemic conditions with associated retinopathies. Given the similarities in clinical presentation, imaging findings, and other diagnostic data, it can be quite challenging for all but the retina specialists to successfully identify retinal toxicity from HCQ. This review summarises HCQ retinopathy and its mimickers of with a special emphasis on key clinical and ancillary distinctions that can help comprehensive ophthalmologists and primary care offices in clenching this diagnosis.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 9","pages":"1003-1015"},"PeriodicalIF":4.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aqueous humour concentration of topically applied 2.0% ganciclovir eye drops in eyes with cytomegalovirus anterior uveitis and endotheliitis. 巨细胞病毒前葡萄膜炎和内皮细胞炎患者眼部局部使用 2.0% 更昔洛韦滴眼液的水液浓度。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-11-25 DOI: 10.1111/ceo.14469
Samanthila Waduthantri, Lei Zhou, Soon Phaik Chee
{"title":"Aqueous humour concentration of topically applied 2.0% ganciclovir eye drops in eyes with cytomegalovirus anterior uveitis and endotheliitis.","authors":"Samanthila Waduthantri, Lei Zhou, Soon Phaik Chee","doi":"10.1111/ceo.14469","DOIUrl":"https://doi.org/10.1111/ceo.14469","url":null,"abstract":"<p><strong>Background: </strong>To investigate the level of ganciclovir in the aqueous humour (AH) following topical application of 2.0% ganciclovir eye drop in eyes with cytomegalovirus (CMV) anterior segment infection.</p><p><strong>Methods: </strong>This is a prospective, non-randomised, interventional clinical study. We enrolled patients with active CMV anterior segment infection. Patients were treated with 2.0% ganciclovir eye drop, which was administered one drop every 3 h for 6 weeks. At the end of week 6, the CMV viral load in the AH was measured using real time polymerase chain reaction and the ganciclovir concentration in the AH was measured using high-performance liquid chromatography-mass spectrometry. The clinical activity and central corneal thickness (CCT) were recorded at baseline and post-treatment.</p><p><strong>Results: </strong>Of the 25 eyes of 25 patients studied, 21 had anterior uveitis and 4 had endotheliitis. After 6 weeks of treatment, 22 eyes did not have any inflammation in the anterior chamber (AC) and CMV was undetectable on real time PCR. Three eyes of non-compliant patients responded partially with reduced AC inflammation and decreased CMV viral load in the AH. The mean ganciclovir concentration in the AH was 1252.88 ± 2408.82 ng/mL. There was no significant correlation between the ganciclovir concentration in the AH and the CCT (Spearmen's r = +0.19, p = 0.36).</p><p><strong>Conclusions: </strong>Three-hourly application of 2.0% ganciclovir eye drops resulted in effective intra-cameral penetration with drug concentrations in the AH exceeding the 50% inhibitory dose for CMV replication. The ocular penetration of the ganciclovir eye drop was not dependent on corneal thickness.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MFRP, PRSS56, and MYRF account for 60.5% of a Chinese cohort with nanophthalmos. MFRP、PRSS56 和 MYRF 在中国纳米眼病患者中占 60.5%。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-11-21 DOI: 10.1111/ceo.14465
Jing Tao, Zi-Bing Jin, Ren-Juan Shen
{"title":"MFRP, PRSS56, and MYRF account for 60.5% of a Chinese cohort with nanophthalmos.","authors":"Jing Tao, Zi-Bing Jin, Ren-Juan Shen","doi":"10.1111/ceo.14465","DOIUrl":"https://doi.org/10.1111/ceo.14465","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to present the genetic profile of a rare ocular disease nanophthalmos (NO) in a large Chinese cohort, to explore its genetic characteristics and genotype-phenotype correlations.</p><p><strong>Methods: </strong>A total of 43 unrelated pedigrees diagnosed with NO were recruited. Whole exome sequencing and copy number variation analysis were performed, followed by validation and pathogenicity classification of the detected variants.</p><p><strong>Results: </strong>The overall genetic diagnostic rate was 60.5%. Twenty-eight unique genetic variants of MFRP, PRSS56, and MYRF have been identified, of which 19 were reported for the first time. The c.1486G>A variant in MFRP and the c.1066dupC variant in PRSS56 were the two most frequent variants. Patients with variants in MFRP or PRSS56 tended to possess shorter axial lengths than those with MYRF variants. Among patients with MFRP null variants, a higher proportion developed uveal effusion syndrome (UES) than did those without null variants, whereas among patients with PRSS56 null variants, a greater number of patients developed angle-closure glaucoma (ACG). A higher proportion of MFRP-related NO patients developed both UES and ACG.</p><p><strong>Conclusions: </strong>MFRP, PRSS56, and MYRF account for the majority of genetic causes of NO. MFRP-related NO patients tend to exhibit a strong predisposition to complications. Null variants in MFRP and PRSS56 may increase susceptibility to clinical complications. This study provides insights into the genetic landscape and clinical characteristics of NO. These findings will lead to a better understanding of the mechanisms underlying nanophthalmos and other diseases associated with eye development.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utilisation of patient-centred outcome measures in age-related macular degeneration research and clinical practice: A systematic review. 在老年性黄斑变性研究和临床实践中采用以患者为中心的结果测量法:系统综述。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-11-21 DOI: 10.1111/ceo.14466
Cheng Yi Loo, Eva K Fenwick, Ryan E K Man, Ecosse L Lamoureux, Anna C S Tan
{"title":"Utilisation of patient-centred outcome measures in age-related macular degeneration research and clinical practice: A systematic review.","authors":"Cheng Yi Loo, Eva K Fenwick, Ryan E K Man, Ecosse L Lamoureux, Anna C S Tan","doi":"10.1111/ceo.14466","DOIUrl":"https://doi.org/10.1111/ceo.14466","url":null,"abstract":"<p><strong>Background: </strong>To identify the utilisation, type, and psychometric properties of patient-centered outcome measures (PCOMs) associated with the performance-based assessment of visual function (VF) in age-related macular degeneration (AMD) in clinical care and research.</p><p><strong>Methods: </strong>A systematic literature search identified studies, available in English, that used PCOMs to assess VF in patients with any AMD severity, published from January 2015 to November 2023. Two researchers screened studies for quality using the Mixed Methods Appraisal Tool (MMAT) 2018 and assessed the psychometric properties of the PCOMs with the guidance of Consensus-based Standards for the selection of health Measurement Instruments (COSMIN).</p><p><strong>Results: </strong>Of 514 studies shortlisted in the literature, 31 were eligible with the majority (77.4%) fulfilling all the MMAT criteria, indicating good quality. The most used PCOM was reading (14/31 = 45.1%), with 5 of the 14 studies (35.7%) showing that the increasing severity and/or progression of AMD were associated with a worsening reading ability. AMD also negatively affected mobility and physical activity levels (7/31 = 22.6%), and visual search and exploration (4/31 = 12.9%). Based on the COSMIN checklist, apart from reading and physical activity measured with the accelerometer, the other PCOMs had 'inadequate' psychometric properties.</p><p><strong>Conclusions: </strong>Limited published studies include PCOMs as an assessment of VF in AMD patients. Apart from reading, there is a lack of robust validation data to support the widespread use of other PCOMs. Hence, well-designed, robustly validated, and simple to use PCOMs are required for more widespread implementation in AMD clinical care and research.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of obesity and metabolic syndrome with incident primary open angle glaucoma in the UK Biobank. 英国生物库中肥胖和代谢综合征与原发性开角型青光眼发病率的关系。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-11-18 DOI: 10.1111/ceo.14467
Carmelo Z Macri, Christopher X Wong, Samuel J Tu, David F Sun, Robert Casson, Kuldev Singh, Sophia Wang, Michelle T Sun
{"title":"Association of obesity and metabolic syndrome with incident primary open angle glaucoma in the UK Biobank.","authors":"Carmelo Z Macri, Christopher X Wong, Samuel J Tu, David F Sun, Robert Casson, Kuldev Singh, Sophia Wang, Michelle T Sun","doi":"10.1111/ceo.14467","DOIUrl":"10.1111/ceo.14467","url":null,"abstract":"<p><strong>Background: </strong>We sought to investigate the association between obesity, metabolic syndrome, and metabolic health with incident primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>We included 103 249 UK Biobank participants without previously diagnosed glaucoma or glaucoma-related procedures at enrolment. The primary outcome was POAG identified from diagnostic coding via linked hospital inpatient and primary care data. We used multivariable Cox regression to evaluate the association of body mass index (BMI), and the interaction with metabolic syndrome (MetS) and a novel definition of metabolic health status with incident POAG. BMI was modelled as a time-varying coefficient. Multivariable analysis was adjusted for age, sex, ethnicity, intraocular pressure, spherical equivalent, polygenic risk score and stratified by the presence of primary care data.</p><p><strong>Results: </strong>There were 647 events of incident POAG over 464 117 580 person-years and a mean follow-up of 12.6 years. At baseline (time = 0), each one unit increase in BMI was associated with a 9% lower hazard of incident glaucoma (HR 0.91, CI 0.86-0.97, p = 0.0066). Further, compared to a normal BMI range of 18.5-24 kg/m<sup>2</sup>, a BMI ≥30 kg/m<sup>2</sup> was associated with a 65% relative hazard reduction (HR 0.35, CI 0.16-0.80, p = 0.012). There was no significant interaction between BMI and metabolic syndrome or metabolic health (all p > 0.05).</p><p><strong>Conclusion: </strong>The effect of BMI on the risk of incident POAG varied with time. Higher BMI was associated with a decreased risk of incident POAG in this large prospective cohort. There was no significant association with systemic metabolic health.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eye diseases in chronic kidney disease: A nationwide longitudinal case-control study in Sweden. 慢性肾脏病患者的眼部疾病:瑞典全国性纵向病例对照研究。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-11-17 DOI: 10.1111/ceo.14464
Pablo Ballester Dolz, Karin Ålander, Petra Smedberg, Per Vihlborg, Ing-Liss Bryngelsson, Jessica Westerlund, Karim Makdoumi
{"title":"Eye diseases in chronic kidney disease: A nationwide longitudinal case-control study in Sweden.","authors":"Pablo Ballester Dolz, Karin Ålander, Petra Smedberg, Per Vihlborg, Ing-Liss Bryngelsson, Jessica Westerlund, Karim Makdoumi","doi":"10.1111/ceo.14464","DOIUrl":"https://doi.org/10.1111/ceo.14464","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a growing health issue that is becoming more prevalent globally, increasing financial cost on healthcare systems. The purpose of this study is to investigate the incidence of eye diseases in patients diagnosed with CKD in Sweden and to evaluate which eye diseases are most likely to develop.</p><p><strong>Methods: </strong>A longitudinal population-based retrospective case-control study was conducted including all individuals diagnosed with chronic kidney disease during the time period 2001-2019. A total of 19 455 cases and 38 890 controls were included. For each case, two controls were matched with the same sex, age, and county of residence.</p><p><strong>Results: </strong>CKD patients had a significantly higher risk of contracting any eye disease compared to individuals without kidney disease HR 1.73 (CI 1.67-1.79), with an elevated risk for all blocks of diagnoses except for glaucoma HR 0.95 (CI 0.85-1.06). However, this condition developed earlier in cases than in controls. Subanalyses showed an increased risk for chronic eye disease patients to develop cataract HR 1.70 (CI 1.63-1.78), other retinal disorders HR 1.86 (CI 1.72-2.02), and retinal vascular occlusions HR 2.08 (CI 1.73-2.51). In general, diagnosis of an eye disease occurred earlier in cases than controls.</p><p><strong>Conclusions: </strong>The results from this study suggest that CKD patients have an increased risk to develop eye disease. Ocular disease seems to develop considerably earlier in CKD, even without staging the severity of the disease, with particularly high risk of developing retinal diseases and cataracts. Screening for eye disease in CKD should be considered.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is it time to consider how we approach bilateral same-day cataract surgery? 现在是考虑如何进行双侧当天白内障手术的时候了吗?
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-11-11 DOI: 10.1111/ceo.14436
Michael Lawless FRANZCO
{"title":"Is it time to consider how we approach bilateral same-day cataract surgery?","authors":"Michael Lawless FRANZCO","doi":"10.1111/ceo.14436","DOIUrl":"10.1111/ceo.14436","url":null,"abstract":"&lt;p&gt;In this issue of CEO, Ng et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; explore ophthalmologists' attitudes to performing immediate sequential bilateral cataract surgery (ISBCS) with a survey of ophthalmologists in Singapore. The study also looks at ophthalmologist's appetite for ISBCS around the world, from a low of 13.9% performing this type of surgery in the United Kingdom to a high of 86% among Kaiser Permanente ophthalmologists in an HMO model in the United States. In Singapore, 27.6% practise ISBCS, and the most commonly cited reason being convenience for patients and faster rehabilitation.&lt;/p&gt;&lt;p&gt;Well, why not?&lt;/p&gt;&lt;p&gt;Dr Michael Goggin&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; in an editorial on the same subject in 2015 concluded ‘when we are at a point where complication rates are as low as can be achieved, when we have access, for instance to a routinely commercially available prophylactic intracameral antibiotic, when surgeons learn that they can trust their biometers and IOL power formulas, then perhaps we may be persuaded to move to ISBCS’.&lt;/p&gt;&lt;p&gt;Is it reasonable for us, nearly a decade later, to consider whether that time has arrived?&lt;/p&gt;&lt;p&gt;The most recent data from Australia is a snapshot of current practice from a survey by Sutton and Hodge.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The feedback on this survey was provided by 194 RANZCO Fellows. Only 4.1% of ophthalmologists offered ISBCS, and of those who did perform it, 69% offered it in 5%–10% of their patients. It would appear to be the lowest rate of ISBCS in the world!&lt;/p&gt;&lt;p&gt;The current RANCZO guidelines&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; question the quality of evidence regarding ISBCS and leaves the decision with the surgeon and the patient without giving specific advice.&lt;/p&gt;&lt;p&gt;There are essentially three arguments against ISBCS. The first is the risk of bilateral simultaneous postoperative endophthalmitis, and the second is the risk of bilateral simultaneous toxic anterior segment syndrome. The third is possible inaccurate intraocular lens selection in the first eye, implying that lens selection in the second eye can be improved with knowledge of the result from the first eye. This could involve the power of the IOL (spherical and/or toric error) or the type of IOL, for example, is the patient going to tolerate a presbyopia correcting IOL with complex optics such as a trifocal or EDOF in the first eye before deciding whether to implant a similar or different IOL in the second eye. I argued that the IOL power issue could no longer be taken seriously in a chapter written in a textbook on ISBCS.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; If this was a serious argument, the time between surgeries would be a minimum of 6 weeks to be truly certain of the refractive result in the first eye. Even surgeons who are opposed to ISBCS do not argue for this time interval between surgeries. With modern formulae, tear film optimisation, and better surgical techniques for toric intraocular lens orientation, the delay on accuracy grounds, for the majority of routin","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 8","pages":"795-796"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.14436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuing Professional Development 继续职业发展。
IF 4.9 2区 医学
Clinical and Experimental Ophthalmology Pub Date : 2024-11-11 DOI: 10.1111/ceo.14458
{"title":"Continuing Professional Development","authors":"","doi":"10.1111/ceo.14458","DOIUrl":"10.1111/ceo.14458","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"52 8","pages":"897-899"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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