Intraoperative complications of 1000 phacoemulsification procedures: A prospective study

Ng, David; Rowe, Neil; Francis, Ian C.; Kappagoda, Medduma B.; Haylen, Margaret J.; Schumacher, Ralf; Alexander, Stella L; Boytell, Kerry A.; Lee, Bin Bin

doi:10.1016/s0886-3350(98)80235-6

Cited by 105 publications

(59 citation statements)

References 12 publications

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“…70 This anterior capsular tear rate of 4% compares with other studies of conventional cataract surgery, which have demonstrated rates of 3.8% and 4.7-5.3%. 72,73 This study of FLACS also gave an overall incidence of 3.5% for PCR and 2% for posterior lens dislocation, although there was a trend towards fewer complications with time, and fewer complications among surgeons with previous experience with femtosecond lasers. 70 These figures may seem high when compared with those commonly quoted for conventional phacoemulsification.…”

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confidence: 76%

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

Trikha

Turnbull

Morris

et al. 2013

Eye

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Femtosecond laser-assisted cataract surgery (FLACS) represents a potential paradigm shift in cataract surgery, but it is not without controversy. Advocates of the technology herald FLACS as a revolution that promises superior outcomes and an improved safety profile for patients. Conversely, detractors point to the large financial costs involved and claim that similar results are achievable with conventional small-incision phacoemulsification. This review provides a balanced and comprehensive account of the development of FLACS since its inception. It explains the physiology and mechanics underlying the technology, and critically reviews the outcomes and implications of initial studies. The benefits and limitations of using femtosecond laser accuracy to create corneal incisions, anterior capsulotomy, and lens fragmentation are explored, with reference to the main platforms, which currently offer FLACS. Economic considerations are discussed, in addition to the practicalities associated with the implementation of FLACS in a healthcare setting. The influence on surgical training and skills is considered and possible future applications of the technology introduced. While in its infancy, FLACS sets out the exciting possibility of a new level of precision in cataract surgery. However, further work in the form of large scale, phase 3 randomised controlled trials are required to demonstrate whether its theoretical benefits are significant in practice and worthy of the necessary huge financial investment and system overhaul. Whether it gains widespread acceptance is likely to be influenced by a complex interplay of scientific and socio-economic factors in years to come.

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mentioning

confidence: 76%

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

Trikha

Turnbull

Morris

et al. 2013

Eye

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“…[20][21][22][23][24][25][26][27][28][29][30][31] A variety of other curves were used to describe the learning relationship: logarithmic, [32][33][34][35] 43 In addition to the 24 papers using least squares regression, Monte Carlo simulation was used in another paper to estimate the shape of the learning curve. 44 The correlation between experience and outcome was tested by Spearman's correlation coefficient, 45,46 chi-squared test for trend, 47,48 or a Komolgorov-Smirnoff test. 49 In three studies an attempt was made to model the relationship between experience and outcome using repeated measures ANOVA.…”

Section: Univariate Trendmentioning

confidence: 99%

Statistical assessment of the learning curves of health technologies

Ramsay

Grant

Wallace

et al. 2001

Health Technol Assess

314

269

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK.We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. The study described in this report has also been published as: HTARamsay CR, Grant AM, Wallace SA, Garthwaite PH, Monk AF, Russell IT. Assessment of the learning curves in health technologies: a systematic review. Int J Technol Assess Healthcare 2000;16:1095-108. NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.Although the National Coordinating Centre for Health Technology Assessment (NCCHTA) commissions r...

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“…Up until the past few years, surgery was performed using either retrobulbar or peribulbar blocks. 8 In this study, all patients were operated using ATA, with the option of changing to assisted local anaesthesia (ALA) if necessary, utilising a retrobulbar or peribulbar block. 9 We also sought to assess patient recall of intraoperative anxiety, fear, and sensory perceptions, both visual and auditory, during second eye cataract surgery using ATA in comparison with their first eye surgery.…”

Section: Introductionmentioning

confidence: 99%

Patient perceptions of second eye clear corneal cataract surgery using assisted topical anaesthesia

Sharma

Ooi

et al. 2007

Eye

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Aim To assess patient recall of intraoperative pain, anxiety, fear, and sensory (visual and auditory) perceptions during second eye clear corneal cataract surgery using assisted topical anaesthesia (ATA), in comparison with first eye cataract surgery using the same technique. Methods This prospective, consecutive, observational study was conducted in a free-standing dedicated ophthalmic day surgery centre. A voluntary questionnaire was distributed to 129 consecutive patients who underwent clear corneal cataract surgery using ATA. Two patients had to be converted to block anaesthesia, and were excluded. Patients were asked to rate intraoperative pain, anxiety, and fear using a visual analogue scale (VAS), and recollection of intraoperative visual and auditory perceptions. Results were analysed using the Mann-Whitney U and Spearman correlation tests. Results There were 70/127 (55%) patients undergoing first eye cataract surgery and 57/127 (45%) undergoing second eye surgery. There was no significant difference in mean pain, anxiety, and fear scores between those undergoing the second eye operation compared with those undergoing their first eye operation. Similarly, there was no significant difference in sensory perceptions between the two cohorts. Overall, there was a small but significant positive correlation between recall of visual and auditory perceptions and combined pain, fear, and anxiety scores (r ¼ 0.33, P ¼ 0.0002). Conclusion There was no significant difference in levels of intraoperative pain, anxiety, fear, and sensory perceptions experienced by patients between the first eye and second eye surgeries. We recommend that preoperative counselling for a patient's second eye be as comprehensive as for the first eye surgery.

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Intraoperative complications of 1000 phacoemulsification procedures: A prospective study

Abstract: The frequency of major and minor complications fell sharply after the first 150 operations and was maintained. This study may provide a guide for beginning phacoemulsification surgeons and a basis for experienced surgeons to compare their performance outcomes.

Cited by 105 publications

References 12 publications

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

Statistical assessment of the learning curves of health technologies

Patient perceptions of second eye clear corneal cataract surgery using assisted topical anaesthesia

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