Abstract:
PURPOSE:To assess the accuracy of surrogate decision making for elective cataract surgery. SETTING:Comprehensive Ophthalmology Department of Tertiary Care Hospital. METHODS:Decisions regarding elective cataract surgery of currently competent, elderly patients were compared with the predictions of patient-identified surrogate decision makers in scenarios of current state of mental health and progressive dementia. Patients were identified (age >50 years, Mini-Mental Status Score >20, absence of significant noncataract pathology) consecutively at a scheduled clinic visit to a single provider. Preferences for cataract surgery in the current state of health and hypothetical progressive dementia were assessed on a Likert scale. The same interviewer contacted patient-identified surrogate decision makers within 48 hours. Independently, a survey of community ophthalmologists was performed. The concordance of surrogate predictions with patient preferences (32 pairs) was assessed using percentage agreement, the kappa coefficient with dichotomous Likert scale data, and chi-square analyses (concordance beyond chance). RESULTS:In their current state of health, most patients said they would prefer to have surgery if they were deemed to have a visually significant cataract, which was accurately predicted by surrogates (72% agreement, kappa = 0.65, chi square = 16.5). In a hypothetical dementia scenario, contrary to perceptions of patients and their surrogates, proxies were unable to accurately represent a patient's wishes for elective cataract surgery (34% agreement, kappa = 0.23, chi square = 14.4). Physicians tended to withhold intervention in the dementia scenario. CONCLUSIONS:The findings suggest that current methods of decision making in elective surgery for patients unable to make autonomous decisions may be seriously flawed. This extends previous findings of inaccuracy with the substituted judgment approach to end-of-life issues to reflect elective surgical scenarios.
journal_name
J Cataract Refract Surgjournal_title
Journal of cataract and refractive surgeryauthors
Mantravadi AV,Sheth BP,Gonnering RS,Covert DJdoi
10.1016/j.jcrs.2007.07.036subject
Has Abstractpub_date
2007-12-01 00:00:00pages
2091-7issue
12eissn
0886-3350issn
1873-4502pii
S0886-3350(07)01602-1journal_volume
33pub_type
杂志文章abstract::A 25-year-old woman with myopia who had an AC pIOL implantation in the left eye and posterior chamber pIOL implantation in the right eye developed bilateral granulomatous panuveitis 2 months after the second surgery. Physical examination showed bilateral Koeppe and Busacca nodules. Fluorescein angiography showed diffu...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2012.02.026
更新日期:2012-06-01 00:00:00
abstract:PURPOSE:To develop and test the validity of a surgical competency assessment tool for simulated small-incision cataract surgery (SICS). SETTING:Participating ophthalmologists contributed from 8 countries. DESIGN:Qualitative and quantitative development and evaluation of face and content validity of an assessment rubr...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrs.2019.04.010
更新日期:2019-09-01 00:00:00
abstract::We describe a small-incision technique that reduces the phacoemulsification time. It reduces the risk for strong intraocular inflammation after surgery and posterior capsule rupture during surgery in young patients with uveitis. ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2008.03.047
更新日期:2008-08-01 00:00:00
abstract::We report six-month results of the Summit Technology Myopic Keratomileusis Phase I multicenter study. Fifty-seven eyes of 57 patients had keratomileusis to correct high myopia. A microkeratome was used for the primary keratectomy and the excimer laser was used to ablate the stroma of the resected lenticle (cap) or the...
journal_title:Journal of cataract and refractive surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0886-3350(13)80648-7
更新日期:1994-11-01 00:00:00
abstract::A prospective randomized study was performed involving 200 patients divided into four groups: (1) Healon aspirated, (2) Amvisc aspirated, (3) Viscoat aspirated, and (4) Viscoat not aspirated. Postoperative intraocular pressures were measured at 4, 8, and 24 hours, two to three days, and one month. Significant differen...
journal_title:Journal of cataract and refractive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0886-3350(89)80060-4
更新日期:1989-07-01 00:00:00
abstract:PURPOSE:To evaluate the efficacy and safety of phenylephrine 1.0%-ketorolac 0.3% (Omidria) for maintenance of mydriasis during, and reduction of ocular pain after, cataract surgery. SETTING:Twenty centers in the United States and the Netherlands. DESIGN:Prospective randomized clinical trials. METHODS:Patients having...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jcrs.2015.10.053
更新日期:2015-10-01 00:00:00
abstract:UNLABELLED:We report a case in which toric intraocular Collamer lenses (ICLs) effectively corrected the refractive errors of pellucid marginal degeneration (PMD). Preoperatively, in the patient's right eye, the manifest refraction was -10.5 -3.5 x 55, the uncorrected distance visual acuity (UDVA) was 20/1000, and the c...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2009.08.021
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:To evaluate the visual, refractive, contrast sensitivity, and aberrometric outcomes as well as the patient quality of life and photic phenomena disturbances after cataract surgery with implantation of a new trifocal toric intraocular lens (IOL). SETTINGS:Premium Clinic, Regional Hospital in Havlickuv Brod, Cze...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2015.07.033
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:To determine whether the keratometric and refractive surgical effects of paired intrastromal corneal ring segments (ICRS) depend on their alignment relative to steep and flat topographic meridians. SETTING:St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom. DESIGN:Comparative ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2012.04.024
更新日期:2012-08-01 00:00:00
abstract:PURPOSE:To explore the use of the Pulsar Z1 solid-state 213 nm photorefractive laser platform in topography-guided transepithelial photorefractive keratectomy (PRK) for irregular astigmatism. SETTING:Moorfields Eye Hospital, London, United Kingdom. DESIGN:Prospective clinical case series. METHODS:Patients with irreg...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2012.08.056
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:To evaluate the changes occurring in the cornea, anterior segment anatomy, and intraocular pressure (IOP) in pregnant women. SETTING:Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel. DESIGN:Prospective single-center comparative study. METHODS:The Ocular Response Analyzer dynamic bid...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2014.02.042
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:To determine whether frozen cultured sheets of human allogeneic epidermal keratinocytes (CEAK) improved wound repair after experimental corneal ablation by photorefractive keratectomy (PRK). SETTING:Hospital "Luis Sanchez Bulnes" de la Asociación para Evitar la Ceguera en Mexico, I.A.P, and Department of Cell ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(01)01349-9
更新日期:2002-09-01 00:00:00
abstract:PURPOSE:To determine the prevalence of laser corneal refractive surgery (laser vision correction [LVC]) among ophthalmologists who perform these procedures and to assess the willingness of these ophthalmologists to recommend LVC to immediate family members. SETTING:Online survey with results analyzed at Surgivision Co...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrs.2015.10.027
更新日期:2015-09-01 00:00:00
abstract::Posterior-assisted levitation is used to retrieve and levitate a sinking nucleus in cataract surgery associated with posterior capsule rupture. After the nucleus is levitated in the anterior chamber, the intraocular lens (IOL) scaffold procedure helps emulsify the nuclear remnants with the phacoemulsification probe an...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2017.06.004
更新日期:2017-07-01 00:00:00
abstract::The oil-drop cataract is a common yet often overlooked cause of progressive vision loss. Although the nuclear change can be subtle on slitlamp biomicroscopic examination, retinoscopy reveals the classic oil droplet silhouetted against the red reflex. We present seven patients with oil-drop cataracts referred for neuro...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(13)80962-5
更新日期:1993-03-01 00:00:00
abstract:PURPOSE:To evaluate long-term intraocular pressure (IOP) control after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (IOL) implantation in patients with primary angle-closure glaucoma. SETTING:Ophthalmology Department, Groote Schuur Hospital, Cape Town, South Africa. METHODS:This re...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(97)80255-6
更新日期:1997-07-01 00:00:00
abstract:PURPOSE:To assess the capability of new software to decrease the proportion of eyes that have insufficient signal-to-noise ratio (SNR) in optical biometry. SETTING:Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. DESIGN:Evaluation of diagnostic test or technology. METHODS:In a prospective study,...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2010.07.023
更新日期:2011-01-01 00:00:00
abstract:PURPOSE:To determine depth of focus and visual quality after implantation of a diffractive intraocular lens (IOL) and a refractive IOL. SETTING:University Eye Clinic, Vienna, Austria. METHOD:This study comprised 10 eyes of 9 patients with a diffractive IOL (3M 825x + 4) and 13 eyes of 9 patients with a refractive len...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(98)80262-9
更新日期:1998-05-01 00:00:00
abstract:PURPOSE:To analyze uveal and capsular biocompatibility 1 year following implantation of a sharp-edged, hydrophilic, collagen-containing posterior chamber intraocular lens (IOL). SETTING:Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria. METHOD:In a prospective study, a Collamer CC4204B...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2003.11.041
更新日期:2004-06-01 00:00:00
abstract::Capsular bag distension syndrome (CBDS) is a rare complication of cataract surgery due to collection of fluid behind the intraocular lens (IOL). Nd:Yag laser capsulotomy is commonly performed to release the fluid collection; however, the potential risk of infection and inflammation has led to adaptation of numerous su...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1097/j.jcrs.0000000000000362
更新日期:2020-12-01 00:00:00
abstract::We present a case of endocapsular hematoma, a rare form of intraocular hemorrhage that developed in a patient with pseudophakia receiving oral anticoagulants for previous mitral valve replacement and cerebrovascular disease. ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2005.07.011
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:To compare the effect of four commercially available viscoelastic agents on postoperative intraocular pressure (IOP). SETTING:Four outpatient sites. METHODS:Sixty-nine patients having routine extracapsular cataract extraction were enrolled in the study; 54 were available for a 3 month follow-up examination. T...
journal_title:Journal of cataract and refractive surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0886-3350(96)80199-4
更新日期:1996-09-01 00:00:00
abstract::The desire for rapid visual rehabilitation following phacoemulsification for cataract and intraocular lens implantation has stimulated a quest for an "astigmatically neutral" incision. We have evaluated an underemphasized aspect of wound closure technique for a small incision wound (5.1 mm). The essential element of t...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(13)80688-8
更新日期:1991-01-01 00:00:00
abstract:PURPOSE:To correlate cycloplegic subjective refraction with cycloplegic autorefractometry in eyes that have had laser in situ keratomileusis (LASIK). SETTING:Vlemma Eye Institute, Athens, Greece. METHODS:Subjective refraction and autorefractometry under cycloplegia were performed in 73 eyes of 46 patients 1, 6, and 1...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(02)01743-1
更新日期:2003-01-01 00:00:00
abstract:PURPOSE:To evaluate noncorneal astigmatism after implantation of a one-piece, plate-haptic silicone or one-piece poly(methyl methacrylate) PMMA intraocular lens (IOL). SETTING:Klinik und Poliklinik für Augenheilkunde der Universität Regensburg, Germany. METHODS:After a follow-up of at least 3 months, the degree of po...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(97)80117-4
更新日期:1997-11-01 00:00:00
abstract::Two hundred consecutive patients were enrolled in a randomized, prospective clinical trial evaluating the efficacy of diclofenac sodium (Voltaren Ophthalmic) in reducing patient discomfort after cataract surgery. Other factors evaluated were the effect of preoperative flurbiprofen (Ocufen) in preventing intraoperative...
journal_title:Journal of cataract and refractive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0886-3350(13)80508-1
更新日期:1995-03-01 00:00:00
abstract:PURPOSE:To describe and evaluate the Catquest self-assessment questionnaire for cataract patients. SETTING:Thirty-five Swedish departments of ophthalmology. METHODS:The Catquest is designed to be used by cataract surgeons for continuous quality control regarding appropriateness and outcome of surgery. It is administe...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(97)80321-5
更新日期:1997-10-01 00:00:00
abstract:PURPOSE:To evaluate the results of ab externo 4-point scleral fixation of posterior chamber intraocular lenses (PC IOLs) as a primary or secondary procedure. SETTING:Aravind Eye Hospital, Madurai, India. METHODS:This retrospective study comprised 25 patients: 17 aphakic and 8 with traumatic subluxated lenses. The sub...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(99)80093-5
更新日期:1999-03-01 00:00:00
abstract:UNLABELLED:We present a new option for visual rehabilitation of patients with advanced macular degeneration and evaluate the outcomes in the first 8 patients who had implantation of the ciliary sulcus-fixated macular add-on intraocular lens (IOL) (Scharioth Macula Lens) at our institute. The surgical technique for impl...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2015.07.018
更新日期:2015-08-01 00:00:00
abstract:UNLABELLED:We report a 66-year-old patient who presented with increasing hyperopia, astigmatism, and presbyopia in both eyes 8 years after bilateral laser in situ keratomileusis (LASIK) and LASIK enhancement in the left eye aiming for spectacle independence. Bilateral multifocal toric Lentis Mplus intraocular lenses (I...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2012.08.042
更新日期:2012-11-01 00:00:00