Cataract in the Adult Eye Preferred Practice Pattern®

Olson, Randall J.; Braga-Mele, Rosa; Chen, Sherleen; Miller, Kevin M.; Pineda, Roberto; Tweeten, James P.; Musch, David C.

doi:10.1016/j.ophtha.2016.09.027

Cited by 213 publications

(165 citation statements)

References 1,124 publications

(1,160 reference statements)

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“…As an outcome in the observational studies, cataract was defined as an administrative code indicating surgery and/or a clinical diagnosis by a physician. Among other principles, referral for cataract surgery is based on a significant decrease in visual acuity which can impair daily tasks . The sensitivity analysis demonstrated that, among the studies exclusively using cataract surgery as the outcome, the initially identified overall increased risk remains statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivity analysis demonstrated that, among the studies exclusively using cataract surgery as the outcome, the initially identified overall increased risk remains statistically significant. However, neither surgery nor clinical diagnosis used as outcomes ensures a comparable decision‐making process allowing ascertaining the severity of the condition . Moreover, clinical practice may differ among countries and regions, bringing additional difficulties when comparing the studies.…”

Section: Discussionmentioning

confidence: 99%

“…Cataracts are responsible for one‐third of all blindness cases and represent one‐fifth of visual impairment worldwide . A cataract is defined as a degradation of the optical quality of the crystalline lens, which affects visual acuity, and can occur in both eyes . Aging, cardiovascular and metabolic diseases, ophthalmic comorbidities, trauma, smoking, ultraviolet‐B light, corticosteroids, and antidepressants are known risk factors …”

Section: Introductionmentioning

confidence: 99%

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Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Alves

Mendes

Marques

2018

Cardiovascular Therapeutics

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Summary Introduction Two previous meta‐analyses evaluated the risk of cataracts associated with statins, but did not include relevant studies suggesting a cataractogenic effect. Aims The aim of this systematic review and meta‐analysis of observational studies is to evaluate such association considering the latest published evidence. Methods A literature search was conducted to identify observational, comparative studies evaluating the risk of developing cataracts in patients treated with statins. A meta‐analysis was performed to estimate odds ratios (ORs). Results were stratified according to the following studies’ subgroups: design, methodological quality, method of diagnosis of cataract, patients’ age, and median follow‐up. Meta‐regressions evaluated the influence of the following risk factors: smoking, hypertension, corticosteroids, selective serotonin reuptake inhibitors (SSRI), diabetes mellitus, and cardiovascular disease. Results Twenty‐one studies were included. Treatment with statins was associated with an increased risk of cataracts [OR: 1.11 (95% CI: 1.02‐1.21); P = 0.017; I2 = 97.5%]. This risk remained statistically significant among case‐controls, good methodological quality studies, studies with length of follow‐up ≥5 years and those which outcome was cataract surgery. Between‐studies heterogeneity was high among all risk estimates. Meta‐regressions identified an inverse relationship between the risk of cataracts and the proportion of diabetic patients in the studies. Conclusions The results point out an increased risk of cataract development with statins. However, since the magnitude of the effect is low and between‐studies heterogeneity is high, the extent in which these results have impact on the benefit/risk ratio of statins is difficult to ascertain due to the uncertainty of the findings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Alves

Mendes

Marques

2018

Cardiovascular Therapeutics

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“…The American College of Chest Physicians and American Academy of Neurology advised continuous use of antiplatelets before cataract surgery [18, 19]. The cataract in the Adult Eye Preferred Practice Pattern of the American Academy of Ophthalmology gave a 1- grade recommendation that aspirin should be discontinued perioperatively only if the risk of bleeding outweighed its potential benefit [20]. Same as these clinical researches, in our experience, there was no statistic difference in postoperative BCVA among the three groups.…”

Section: Discussionmentioning

confidence: 87%

Continuation of Aspirin Therapy before Cataract Surgery with Different Incisions: Safe or Not?

Qian

Zhang

et al. 2018

Journal of Ophthalmology

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Purpose To assess whether to continue aspirin therapy while having uncomplicated phacoemulsification cataract surgery with different incisions. Methods Consecutive patients having cataract surgery under topical anesthesia with different incisions between May 2016 and August 2017 were followed. 236 eyes of 166 patients on routine aspirin therapy were randomized into 2 groups: continuation group, 112 eyes; discontinuation group, 124 eyes. 121 eyes of 94 patients on no routine anticoagulant therapy were used as the control group. Patients were examined 1 day preoperatively and 1 day and 7 days postoperatively. Intraoperative and postoperative complications were recorded. Results Statistically, there was no significant difference about postoperative BCVA among three groups. A higher incidence of subconjunctival hemorrhage was shown in the continuation group than in the discontinuation group and the control group (17.0% versus 8.1%, p=0.038; 17.0% versus 7.4%, p=0.025, resp.). Although corneal edema was greater in clear corneal incision cases than that of scleral tunnel incision cases (22.5% versus 12.0%, p=0.009), subconjunctival hemorrhage was greater in scleral tunnel incision cases (14.9% versus 6.6%, p=0.011). Subgroup analyses revealed that patients of scleral tunnel incision who continued taking aspirin had a higher incidence of subconjunctival hemorrhage compared with those who discontinued (25.5% versus 10.9%, p=0.038), but no same conclusion in clear corneal incision cases (8.8% versus 5.0%, p=0.483). Conclusions The outcomes indicated that phacoemulsification cataract surgery under topical anesthesia could be safely performed without ceasing systemic aspirin therapy. Clear corneal incision could be a better choice in patients treated with aspirin.

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“…Cataracts—an opaque clouding of the lens in the eye—are the leading cause of blindness in the world . Cataract‐induced blindness is remedied by cataract surgery, which is the most frequently performed surgical procedure in the United States . With a success rate over 90%, cataract surgery represents one of the most successful intraocular procedures .…”

Section: Background and Motivationmentioning

confidence: 99%

Intraocular robotic interventional surgical system (IRISS): Semi‐automated OCT‐guided cataract removal

Chen

Lee

Gerber

et al. 2018

Int J Med Robotics Comput Assist Surg

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Background With the development of laser‐assisted platforms, the outcomes of cataract surgery have been improved by automating several procedures. The cataract‐extraction step continues to be manually performed, but due to deficiencies in sensing capabilities, surgical complications such as posterior capsule rupture and incomplete cataract removal remain. Methods An optical coherence tomography (OCT) system is integrated into our intraocular robotic interventional surgical system (IRISS) robot. The OCT images are used for preoperative planning and intraoperative intervention in a series of automated procedures. Real‐time intervention allows surgeons to evaluate the progress and override the operation. Results The developed system was validated by performing lens extraction on 30 postmortem pig eyes. Complete lens extraction was achieved on 25 eyes, and “almost complete” extraction was achieved on the remainder due to an inability to image small lens particles behind the iris. No capsule rupture was found. Conclusion The IRISS successfully demonstrated semiautomated OCT‐guided lens removal with real‐time supervision and intervention.

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Cataract in the Adult Eye Preferred Practice Pattern®

Cited by 213 publications

References 1,124 publications

Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Continuation of Aspirin Therapy before Cataract Surgery with Different Incisions: Safe or Not?

Intraocular robotic interventional surgical system (IRISS): Semi‐automated OCT‐guided cataract removal

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