Abstract:
PURPOSE:To devise a comprehensive cataract surgery complexity score system for the selection of appropriate cases for trainees using evidence-based, validated risk factors for posterior capsule rupture, patient-specific factors, and complexity stratification recommendations to minimize complications, optimize outcomes, and maximize patient safety. SETTING:Epsom and St. Helier University National Health Service Trust, London, United Kingdom. DESIGN:Retrospective cohort study. METHODS:Patients having primary phacoemulsification cataract surgery from January 1, 2011 until December 31, 2016 were included; combined corneal, glaucoma, or posterior segment procedures were excluded. Anonymized data on demographics, pupil size, pupil expander use, intraoperative and postoperative complications, and postoperative distance visual acuity were extracted. Patients were stratified by complexity score and surgeon grade (consultant, junior, intermediate, and senior trainee, and fellow). RESULTS:From 11 468 included cases, 8200 (71.5%) had a complexity score. Small pupil, pupil expander use, iris damage during phacoemulsification, zonular dialysis, postoperative raised intraocular pressure, and corneal edema (odds ratio, 3.17; 95% confidence interval, 2.05-4.92) were significantly associated with increasing complexity. Appropriate case allocation by complexity and surgeon grade resulted in no association between posterior capsule rupture and complexity score. Increasing complexity scores were associated with lower postoperative distance visual acuity. CONCLUSIONS:The updated evidence-based comprehensive cataract complexity score system is a useful tool for the stratification of case complexity and guides appropriate case selection to match trainee experience. Higher complexity scores were associated with greater intraoperative and postoperative complications and lower postoperative distance visual acuity. Patients with higher scores should be made aware of the guarded prognosis when obtaining consent.
journal_name
J Cataract Refract Surgjournal_title
Journal of cataract and refractive surgeryauthors
Nderitu P,Ursell Pdoi
10.1016/j.jcrs.2018.04.036subject
Has Abstractpub_date
2018-06-01 00:00:00pages
709-717issue
6eissn
0886-3350issn
1873-4502pii
S0886-3350(18)30354-7journal_volume
44pub_type
杂志文章abstract:PURPOSE:To compare 2-year neodymium:YAG (Nd:YAG) laser capsulotomy rates after bilateral implantation of hydrophobic or hydrophilic multifocal intraocular lenses (IOLs). SETTING:Private practice, southwest France. METHODS:This retrospective study included patients with cataract or clear lenses who had bilateral impla...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2010.01.027
更新日期:2010-07-01 00:00:00
abstract::The complement activation potential of surface modified (passivated) poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) with polypropylene loops was compared to that of standard PMMA IOLs with polypropylene loops. Both lens types were incubated in human sera for six hours and then the C3a and C5a levels were m...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(13)80243-x
更新日期:1991-03-01 00:00:00
abstract::A 60-year-old white man had cataract surgery with an AcrySof IQ intraocular lens (IOL) implanted in the right eye and a Tecnis IOL implanted in the left eye. The ocular spherical aberration (SA) target for a 6.0 mm pupil was +0.10 microm for the right eye and 0 microm for the left eye. After surgery, the ocular SA in ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2008.12.041
更新日期:2009-05-01 00:00:00
abstract:PURPOSE:To assess the effectiveness of using anterior chamber irrigation of unpreserved lidocaine 1% as anesthesia during cataract surgery. SETTING:Private group ophthalmology practice. METHODS:This study prospectively evaluated 1000 of 1012 consecutive eyes having temporal corneal incision cataract surgery to determ...
journal_title:Journal of cataract and refractive surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0886-3350(97)80212-x
更新日期:1997-05-01 00:00:00
abstract:PURPOSE:To evaluate the incidence of epithelial disruptions during primary laser in situ keratomileusis (LASIK) with the use of a preoperative hyperosmotic treatment comprising sodium chloride 5% ophthalmic ointment (Muro-128) and to identify the incidence of epithelial disruptions in various demographic populations. ...
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.2014.07.042
更新日期:2015-05-01 00:00:00
abstract:PURPOSE:To compare the in vitro optical quality of multifocal apodized intraocular lenses (IOLs) at different focal points. SETTING:University of Valencia, Valencia, Spain. DESIGN:Experimental study. METHODS:The Acrysof Restor +3.0 diopter (D) multifocal IOL with 2 main foci (bifocal IOL) and the Finevision multifoc...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2012.12.038
更新日期:2013-06-01 00:00:00
abstract::Interlenticular opacification (ILO) developed 7 months after secondary acrylic piggyback lens implantation in which the anterior lens was placed in the bag. This resulted in glare and a hyperopic shift. Treating the ILO with the neodymium:YAG laser successfully reduced the glare and corrected the hyperopic shift. ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(01)00865-3
更新日期:2001-09-01 00:00:00
abstract::Laser refractive surgery has increased markedly in recent years, making the detection of corneal abnormalities extremely relevant. For this reason, an accurate diagnosis of clinical or subclinical keratoconus is critical. Corneal topography is the primary diagnostic tool for keratoconus detection, and pachymetry data ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jcrs.2017.07.021
更新日期:2017-09-01 00:00:00
abstract:PURPOSE:To compare results of intraocular lens (IOL) power calculation methods using different keratometry (K) values after myopic refractive surgery. SETTING:Seoul St. Mary's Hospital, Seoul, South Korea. DESIGN:Evaluation of diagnostic test or technology. METHODS:The IOL power of patients who had cataract surgery ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2013.04.045
更新日期:2013-11-01 00:00:00
abstract:UNLABELLED:We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly during surgery. Skin pr...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2013.02.034
更新日期:2013-06-01 00:00:00
abstract::We describe a variation of stop and chop phacoemulsification. During chopping the chopper's vertical element is depressed posteriorly toward the optic nerve and is placed well within the capsulorhexis margin, leading to in situ chopping. Each fragment is continuously chopped, and the small pieces are stuffed inside th...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章,评审
doi:10.1016/s0886-3350(96)80003-4
更新日期:1996-06-01 00:00:00
abstract:PURPOSE:To compare the efficacy of 30 minute preoperative versus 1 day postoperative administration of ketorolac tromethamine 0.5% ophthalmic solution (Acular) in reducing anterior chamber inflammation after cataract surgery. SETTING:The Hermann Eye Center, The University of Texas Health Science Center-Houston, Texas,...
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(00)00519-8
更新日期:2000-11-01 00:00:00
abstract:PURPOSE:To compare ocular surface fluid ingress into the anterior chamber at the end of microcoaxial, standard coaxial, and bimanual phacoemulsification using trypan blue as the quantifying tracer. SETTING:Iladevi Cataract and IOL Research Centre, Ahmedabad, India. METHODS:This prospective randomized observational st...
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.2008.03.015
更新日期:2008-06-01 00:00:00
abstract:PURPOSE:To evaluate safety, efficacy, predictability, and stability in the treatment of myopic astigmatism with laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) using the 200 Hz flying-spot technology of the LaserSight LSX excimer laser. SETTING:SynsLaser Clinic, Tromsø, Norway. METHODS:This...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(01)00996-8
更新日期:2001-08-01 00:00:00
abstract::Corneal scrapings were collected from a case of keratitis and microbiological investigations done. Coagulase-negative Staphylococcus (Staphylococcus epidermidis) was identified on culture, and antibiotic susceptibility tests were performed. Treatment was started with topical cefazolin sulfate 5% and gatifloxacin 0.3%;...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2007.04.015
更新日期:2007-08-01 00:00:00
abstract:PURPOSE:To investigate the efficacy of tissue plasminogen activator (tPA) in the treatment of severe fibrinous anterior chamber reactions after intraocular surgery. SETTING:Ophthalmology Department, AHEPA University Hospital, Thessaloniki, Greece. METHODS:The study comprised routine surgical and postoperative cases s...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(02)01813-8
更新日期:2003-04-01 00:00:00
abstract::The elimination of hydroxypropyl methylcellulose (HPMC) of molecular weight 86,000 daltons (2%, viscosity 4,000 centipoises; 2.5%, 15,000 centipoises) and 120,000 daltons (2%, 15,000 centipoises) from the anterior chamber of rabbit eyes was determined colorimetrically and was nearly complete by 24 hours. The eliminati...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(89)80009-4
更新日期:1989-03-01 00:00:00
abstract:PURPOSE:To describe the postoperative evolution of visual acuity, flap morphology, and stromal optical density femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). SETTING:Clínica Rementería, Madrid, Spain. DESIGN:Prospective case series. METHODS:The study comprised 44 consecutive eyes that had FS-LAS...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1097/j.jcrs.0000000000000008
更新日期:2020-02-01 00:00:00
abstract:UNLABELLED:Presbyopia is the most common refractive disorder for people older than 40 years. It is characterized by a gradual and progressive decrease in accommodative amplitude. Many surgical procedures for the correction of presbyopia exist, with additional procedures on the horizon. This review describes the prevale...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jcrs.2016.05.003
更新日期:2016-06-01 00:00:00
abstract:PURPOSE:To study the repeatability and reproducibility of corneal power measurements obtained with a new corneal topographer (Keratograph 4) and assess their agreement with those obtained by a rotating Scheimpflug camera (Pentacam HR) and an automated keratometer (IOLMaster). SETTING:Eye Hospital, Wenzhou Medical Univ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2013.04.029
更新日期:2013-10-01 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 prospectively compare the postoperative blood-aqueous barrier breakdown induced by phacoemulsification and implantation of a heparin-surface-modified poly(methyl methacrylate) intraocular lens in the capsular bag in eyes with different stages of diabetic retinopathy (DR) and a control group. SETTING:St. Eri...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(98)80104-1
更新日期:1998-08-01 00:00:00
abstract:PURPOSE:To evaluate and compare the predictability and safety of immediate small-incision lenticule extraction, also known as SMILE, after suction loss during the procedure with those of uneventful small-incision lenticule extraction. SETTING:Nunemiso Eye Center, Seoul, South Korea. DESIGN:Retrospective case series. ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2016.12.034
更新日期:2017-04-01 00:00:00
abstract::A 58-year-old woman had successful phacoemulsification with intraocular lens (IOL) implantation in January 2001. Two years later, nonpenetrating glaucoma surgery with mitomycin-C (MMC) 0.02% was performed for uncontrolled glaucoma. Two months later, opacification of the anterior IOL surface was observed. The IOL was r...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2006.07.038
更新日期:2007-01-01 00:00:00
abstract::A transition from trabeculectomy to nonpenetrating trabecular surgery (NPTS) is proposed under the name of sclerotrabeculectomy. The technique, which is aimed at facilitating the transition to NPTS, is a modification of both penetrating and nonpenetrating techniques. Sclerotrabeculectomy uses a more superficial sclero...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(02)01363-9
更新日期:2002-12-01 00:00:00
abstract::Twenty-eight epikeratophakia procedures have been performed at the University of Minnesota since December 1985. This report describes several technique modifications and compares the refractive and visual outcome of these cases with the national results. There have been 17 aphakic cases (13 adult and four pediatric), ...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(89)80091-4
更新日期:1989-05-01 00:00:00
abstract:PURPOSE:To compare the outcomes of combined cataract surgery with trabecular microbypass stents and ab interno trabeculotomy in patients with open-angle glaucoma. SETTING:University of Toronto, Toronto, Ontario, and University of Montreal, Montreal, Quebec, Canada, and Glaucoma Associates of Texas, Dallas, Texas, USA....
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2014.12.061
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:To determine whether riboflavin and ultraviolet-A (UVA) corneal crosslinking can be used as an alternative therapy to prevent the progression of keratectasia. SETTING:Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland, and a private clinic, Athens, Greece. METHODS:Corneal crosslinking was pe...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/j.jcrs.2007.07.028
更新日期:2007-12-01 00:00:00
abstract:PURPOSE:To study the intensity of trypan blue and fluorescein staining over time in anterior lens capsules and various intraocular lens (IOL) materials. SETTING:Fritz Eye Associates, Geislingen, Germany. METHODS:Excised anterior lens capsules and IOLs were exposed to trypan blue 0.1% and fluorescein 2% solution to as...
journal_title:Journal of cataract and refractive surgery
pub_type: 杂志文章
doi:10.1016/s0886-3350(02)01238-5
更新日期:2002-06-01 00:00:00
abstract:PURPOSE:To determine the safety and efficacy of viscocanalostomy and cataract extraction by phacoemulsification combined with viscocanalostomy (phacoviscocanalostomy) in the management of medically uncontrolled glaucoma. SETTING:Department of Ophthalmic Surgery, Warrington Hospital, Warrington, England. METHODS:This ...
journal_title:Journal of cataract and refractive surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0886-3350(01)01285-8
更新日期:2002-05-01 00:00:00