Cataract Surgery in Very Old Patients: A Case-Control Study

Nussinovitch, Hanan; Tsumi, Erez; Tuuminen, Raimo; Malyugin, Boris; Lior, Yotam; Rosenblatt, Hadar Naidorf; Boyko, Matthew; Achiron, Asaf; Knyazer, Boris

doi:10.3390/jcm10204658

Cited by 4 publications

(3 citation statements)

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“…Previous reports have demonstrated the safety and possible visual recovery after cataract surgery in people aged ≥90 years. [ 13 , 14 ] However, cataract surgery could be performed in patients aged ≥100 years by adequately controlling comorbidities through consulting medical doctors, providing medical care, and postoperative management. All patients underwent surgery under topical anesthesia, as general anesthesia for nonagenarians and centenarians would have adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of cataract surgeries performed in 8 eyes of centenarians

Ono,

Fukuda,

Iwasaki

et al. 2024

Medicine

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Cataract surgery outcomes in centenarian patients have not previously been explored. This study aimed to examine characteristics and report clinical results of people aged ≥100 years undergoing cataract surgery. This was a retrospective observational study, including patients aged ≥100 years who underwent cataract surgery between 2003 and 2021 at Miyata Eye Hospital in Japan. Medical charts were reviewed for information on cataract severity, surgery type, anesthesia, as well as ocular and medical comorbidities. Using Mann–Whitney test, visual acuity, intraocular pressure, and corneal endothelial cell density were compared before and after surgery. Eight eyes of 5 patients were included in the study (mean age, 101.5 ± 1.2 years). Seven of these eyes (87.5%) belonged to women. All surgeries were performed under topical anesthesia using phacoemulsification and insertion of the intraocular lens fixed in the bag. All patients had multiple preoperative medical comorbidities; however, there were no intraoperative, postoperative ocular, or general complications. The postoperative best-corrected visual acuity was significantly improved compared to that before surgery (1.18 ± 0.74 and 0.29 ± 0.52, respectively, P = .004). Neither intraocular pressure nor corneal endothelial cell density demonstrated a significant difference postoperatively. Cataract surgery can be safely performed under topical anesthesia in centenarians without complications using proper perioperative medical control and preparation.

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Section: Discussionmentioning

confidence: 99%

Outcomes of cataract surgeries performed in 8 eyes of centenarians

Ono,

Fukuda,

Iwasaki

et al. 2024

Medicine

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“…The Chinese population is currently undergoing societal aging, and the prevalence of cataracts increases markedly with increasing age [1]. In addition, increased age is associated with an increased risk of complications and bad surgical outcomes [2].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Toric Intraocular Lens Implantation in Patients Older Than 80 Years with Cataracts and Corneal Astigmatism

et al. 2023

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Introduction: This study analyzed the visual outcome following cataract surgery with toric intraocular lenses (IOLs) in patients older than 80 years with corneal astigmatism. Methods: A total of 159 patients (159 eyes) older than 80 years with corneal astigmatism (C 0.75 D) were included. Fifty-three eyes received Acrysof IQÒ toric IOLs (SN6AT2-5), while the others received non-toric IOLs: 51 eyes received Acrysof IQÒ IOLs (SN60WF) and 55 eyes received A1-UV IOLs. The uncorrected distance visual acuity, corrected distance visual acuity, and refraction (spherical equivalent, refractive cylinder) were assessed at 3 months postoperatively. The prediction error of refractive outcome and percentages of eyes within ± 0.50 D and ± 1.00 D in the toric IOL group obtained using five toric IOL formulas (Barrett predicted posterior corneal astigmatism (PCA), Barrett measured PCA, Kane, EVO 2.0 and Naeser-Savini) were compared. Results: At 3 months postoperatively, the average uncorrected distance visual acuity was better in the toric IOL group than the non-toric IOL group (p \ 0.001). The mean residual refractive cylinder was lower in the toric IOL group than the non-toric IOL group (p \ 0.001). The Naeser-Savini formula achieved the lowest mean absolute error (0.39 D) and had the highest percentages of eyes within an absolute error of 0.50 D and 1.00 D (72% and 98%) compared to the other formulas. Conclusion:The results demonstrate the efficacy of toric IOL implantation in patients older than 80 years with corneal astigmatism and provide strong evidence for cataract surgeons to encourage such patients to choose toric IOLs.

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“…With increased life expectancy, cataract surgery is becoming more common, even among very old patients. As shown in the article by Nussinovitch et al, cataract surgery in very old patients may demand more experienced surgeons due to higher nuclear density and the rates of intraoperative floppy iris syndrome [ 1 ]. This is of utmost importance, as one of our earlier studies has shown that, at one of the timepoints, the prevalence of capsular bag complications in a general population undergoing cataract surgery is 7.03% for resident surgeons and only 0.36% for senior surgeons [ 2 ].…”

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confidence: 99%