ABSTRACT
Purpose@#To evaluate risk factors predisposing to intraocular lens (IOL) dislocation after cataract surgery. @*Methods@#The medical and surgical records of patients diagnosed with IOL dislocation between January 2011 and December 2021 after undergoing extracapsular cataract extraction, phacoemulsification, and phacoemulsification with pars plana vitrectomy at Hallym University Sacred Heart Hospital were reviewed retrospectively. Preoperative factors (ocular parameters and demographics) and intra-operative factors (surgery time, surgeon, and intra-operative complications) were compared according to early, late, and bilateral dislocation. @*Results@#In 68 patents and 71 eyes, the average age at the diagnosis of dislocation was 63.3 years, and there were more males (77.5%) than females. Possible major factors predisposing to IOL dislocation were high myopia (9 eyes), retinal detachment (8 eyes), neodymium-doped yttrium aluminum garnet capsulotomy (6 eyes), and normal tension glaucoma (6 eyes). The rate of out-of-the bag dislocation was higher in early dislocation than in late. Early dislocation had a significantly older age, longer surgery time, and higher intraoperative complication rate during cataract surgery than did late dislocation. There was no difference in surgery time for late dislocated eyes compared to non-dislocated eyes. There was no difference in the incidence of dislocation between phacoemulsification and phacoemulsification with pars plana vitrectomy; there were seven eyes with prior vitrectomy only, with late dislocation. Of the seven patients with bilateral IOL dislocation, one had retinitis pigmentosa, two had retinal detachment, and one had high myopia. Bilateral dislocation patients were significantly younger at the time of cataract surgery, compared to unilateral dislocation patients. @*Conclusions@#Early dislocation was associated with long surgery time and intraoperative complications, while late dislocation had no significant correlation with surgery-related factors. A history of vitrectomy and combined vitrectomy with cataract surgery seemed to be associated with late dislocation, but this association was not significant.
ABSTRACT
OBJECTIVES: The purpose of this study was to explore insomniac demographic characteristics and the type of consultation provided to hospitalized patients asked to the Department of Psychiatry for insomnia and to compare patient insomnia characteristics by consultation type. METHODS: We performed a retrospective chart review of 4,966 patients who were hospitalized from August 1, 2005 to December 31, 2011 that received consultation in the Department of Psychiatry. Among them, 236 patients were referred for insomnia. We compared the differences in demographic characteristics and types of consultation between the insomnia patient group and other patient group. We also compared the difference between demographic characteristics and type of consultation by dividing total subjects into ‘with reconsultation’ and ‘without reconsultation’ groups. RESULTS: Our results came from the analysis of 9,689 consecutive consultation requests. There were 4,966 patients that participated in the study over 6 years and 6 months. The overall consultation rate was 3.3% of all admissions and insomnia patients comprised 4.8% of those. The ratio of re-consultation for insomnia was 27.5%. There was no significant difference in mean age between the insomnia ‘with reconsultation group’ and the insomnia ‘without reconsultation group’, but the ‘with reconsultation’ group had significantly more male patients and medical patients than the ‘without re-consultation’ group. For insomnia patients, consultation types were in the order of Mending request (51.3%), Paralle request (36.6%), Complementary request (9.0%) and this composition differed from that of total admission patients. CONCLUSION: Hospitalized patients referred for insomnia showed a higher proportion of male patients, lower rates of re-consultation compared with other patients, and most of these were for secondary insomnia. Each doctor should be aware of the possibility of inpatient insomnia, conduct positive assessments and referrals as necessary, and psychiatrists who might be asked for consultation need to prepare an active intervention with initial diagnosis and treatment, as well as recommendations for the timing of reconsultation.