Clinical Outcomes of Cataract Surgery in Very Elderly Adults

Lai, Frank Hiu Ping; Lok, Julie Y. C.; Chow, Prudence P. C.; Young, Alvin L.

doi:10.1111/jgs.12590

Cited by 30 publications

(31 citation statements)

References 26 publications

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“…Previous studies have reported different rates ranging from 0.45 to 7.2%. 34,35 The relatively low rate of PCR -VL PCR in this study could be caused by the learning curve of the ophthalmologists because most studies with high PCR -VL rates date back to two decades ago. In other words, phacoemulsification was a new method then, and surgeons were not experienced.…”

Section: Discussionmentioning

confidence: 90%

Intraoperative Complications of Cataract Surgery in Tehran Province, Iran

Hashemi

Rezvan

Etemad

et al. 2016

Optometry and Vision Science

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This study evaluated the prevalence of intraoperative complications of cataract surgery for the first time in Tehran Province. The prevalence of complications was high in this study. To achieve the goals of the Vision 2020 Initiative and improve surgical quality, it is necessary to minimize complication rates. Factors to note for decreasing complication rates include type of surgery, surgeon experience, and patient age.

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Section: Discussionmentioning

confidence: 90%

Intraoperative Complications of Cataract Surgery in Tehran Province, Iran

Hashemi

Rezvan

Etemad

et al. 2016

Optometry and Vision Science

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“…[12–15] Risk factors commonly associated with worse visual outcomes include: age-related macular degeneration (ARMD), diabetic retinopathy, corneal opacity/pathology, older age, female sex, previous vitrectomy, previous retinal detachment surgery, alpha-blockers, complex surgery, and intraoperative complications. [12–15] We found similar trends in our LASSO models, including ARMD, corneal pathology, alpha-blocker medications, and complex surgery each as recurring risk factors for a number of complications. For example, we find an increased risk of intraoperative complications associated with preoperative use of alpha-blockers such as tamsulosin—a relationship which has reported extensively in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…[8–11] However, much of the existing literature focuses on the relationship between risk factors and post-operative visual acuity. [12–15] Studies examining the effect of risk factors on complications have tended to look at aggregated outcomes (e.g. any intraoperative complication).…”

Section: Introductionmentioning

confidence: 99%

“…any intraoperative complication). [12, 16, 17] Studies exploring specific outcomes have tended to focus either on the relationship between preoperative risk factors and intraoperative complications,[10, 18–25] or on the relationship between intraoperative and postoperative complications. [26–28] Few studies have examined relationships between preoperative risk factors and postoperative complications, or explored the combined effects of a large number of risk factors and complications simultaneously.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Modeling of Risk Factors and Complications of Cataract Surgery

Gaskin

Pershing

Cole

et al. 2015

European Journal of Ophthalmology

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Purpose To quantify the relationship between aggregated preoperative risk factors and cataract surgery complications, as well as to build a model predicting outcomes on an individual-level—given a constellation of demographic, baseline, preoperative, and intraoperative patient characteristics. Setting Stanford Hospital and Clinics between 1994 and 2013. Design Retrospective cohort study Methods Patients age 40 or older who received cataract surgery between 1994 and 2013. Risk factors, complications, and demographic information were extracted from the Electronic Health Record (EHR), based on International Classification of Diseases, 9th edition (ICD-9) codes, Current Procedural Terminology (CPT) codes, drug prescription information, and text data mining using natural language processing. We used a bootstrapped least absolute shrinkage and selection operator (LASSO) model to identify highly-predictive variables. We built random forest classifiers for each complication to create predictive models. Results Our data corroborated existing literature on postoperative complications—including the association of intraoperative complications, complex cataract surgery, black race, and/or prior eye surgery with an increased risk of any postoperative complications. We also found a number of other, less well-described risk factors, including systemic diabetes mellitus, young age (<60 years old), and hyperopia as risk factors for complex cataract surgery and intra- and post-operative complications. Our predictive models based on aggregated outperformed existing published models. Conclusions The constellations of risk factors and complications described here can guide new avenues of research and provide specific, personalized risk assessment for a patient considering cataract surgery. The predictive capacity of our models can enable risk stratification of patients, which has utility as a teaching tool as well as informing quality/value-based reimbursements.

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“…According to previous studies, the prevalence of posterior capsular rupture and vitreous loss varies from 1.92 -7% [29,30]. Interestingly, the rate of 4.4% has been reported in a study from the United Kingdom [31].…”

Section: Discussionmentioning

confidence: 94%

Outcome of cataract surgery in diabetic patients

et al. 2018

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Introduction. The association between diabetes and cataract formation has been shown in many clinical studies. Development of cataract occurs more frequently and at an earlier age in diabetic patients. Due to the increasing prevalence of diabetes worldwide, the incidence of diabetic cataracts steadily rises. While the overall outcomes of cataract surgery are excellent, patients with diabetes may have poorer vision outcomes than those without diabetes. The objective of this study was to evaluate the visual outcomes (visual acuity and visual function), intraoperative and postoperative complications of cataract surgery, and to assess the final surgical outcomes. Material and Methods. The prospective study included 128 patients (133 eyes) with cataract and diagnosis of diabetes mellitus type 2 at least 5 years prior to cataract surgery, operated at the Eye Clinic, Clinical Center of Vojvodina, Novi Sad. A full medical history included patients' age, the time since the diagnosis of diabetes, current management of diabetes, blood pressure and assessment of glycemic control using glycosylated hemoglobin. All patients underwent complete ophthalmological examination before cataract surgery, and were re-examined 7 days, one and six months after the surgery. Results. The mean age of patients at the time of surgery was 63.5 years (SD ± 6.5, range 57 -70 years) with mean duration of diabetes 8.5 years. The glycosylated haemoglobin level in the group treated with insulin was 6.8 vs. 8.2 in patients on oral medications (p < 0.05). Diabetes mellitus was accompanied by other systemic diseases in 81 patients (63.28%), whereas 45 of 133 operated eyes (33.83%) had other ocular diseases. Intraoperative complications occurred in 20 of 133 operated eyes (15%): posterior capsular rupture with vitreous loss, intraoperative miosis, iris hemorrhage and suprachoroidal hemorrhage. Conclusion. Cataract surgery with intraocular lens implantation is an effective and safe surgical procedure in diabetic patients, and sight threatening complications are rare. Our study confirmed that visual acuity after surgery in diabetic patients depends on the severity of diabetic retinopathy at the time of surgery.

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Clinical Outcomes of Cataract Surgery in Very Elderly Adults

Abstract: Despite a high prevalence of systemic and ocular comorbidities in very elderly adults, good clinical outcomes of cataract surgery were attainable. ARMD and vitreous loss were associated with a lower chance of postoperative visual improvement.

Cited by 30 publications

References 26 publications

Intraoperative Complications of Cataract Surgery in Tehran Province, Iran

Intraoperative Complications of Cataract Surgery in Tehran Province, Iran

Predictive Modeling of Risk Factors and Complications of Cataract Surgery

Outcome of cataract surgery in diabetic patients

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