ABSTRACT
Purpose: To investigate refractive, visual, and safety outcomes of cataract surgery performed after scleral buckling (SB) for retinal detachment (RD). Patients and methods: A chart review at an academic medical center identified eyes with history of SB followed by subsequent cataract extraction between 2010 and 2022. Eyes with less than 3 weeks follow-up, silicone oil at time of biometry measurement, previous cornea surgery, or co-existing pathology impacting refractive outcomes were excluded. Predicted postoperative spherical equivalents (SE) were calculated with the Barrett Universal II (BU2), Kane, and SRK/T formulas for the implanted intraocular lens (IOL), and complications occurring within 1 year of surgery were abstracted. Results: Sixty eyes of 60 patients met criteria for inclusion, and 40 (66.7%) had postoperative refraction recorded. Absolute prediction errors were 0.49, 0.45, and 0.52D with BU2, Kane, and SRK/T, respectively. Actual postoperative refraction was within 0.5 and 1.0 D of predicted in 26 (65.0%) and 36 (90.0%) using BU2, 23 (58%) and 37 (93%) using Kane, and 21 (52.5%) and 36 (90.0%) using SRK/T. In eyes with macula-on RD, corrected distance visual acuity (CDVA) of logMAR 0.301 (≈20/40) and logMAR 0.544 (≈20/70) or better was achieved in 12 (75.0%) and 15 (93.8%) of eyes. For macula-off RD eyes, these proportions were 19 (63.3%) and 24 (80.0%), respectively. Posterior capsular opacification requiring Nd: YAG capsulotomy was the most frequent complication in 30 (56.7%) eyes. Conclusion: Refractive outcomes of cataract surgery following SB may be modestly reduced, even when using modern formulas. Nevertheless, cataract surgery in this population results in favorable visual outcomes.
The retina is the part of the eye that is responsible for converting incoming light into a signal that the brain can interpret. A retinal detachment is an emergent condition in which the retina is torn away from its normal position. Scleral buckling is one method of surgically reattaching the retina. Although quite successful, scleral buckling can cause changes to the shape of the eye, and also increases the risk of opacification of the natural lens of the eye, otherwise known as a cataract. The purpose of this study is to investigate the outcomes of cataract surgery in eyes with prior scleral buckle surgery. The results show that despite advancements in methods of measuring the shape of the eye, calculating the appropriately powered IOL to implant, and surgical technique, cataract surgery in eyes with prior scleral buckling may result in poorer outcomes compared to eyes with no history of scleral buckling.
ABSTRACT
Hypertriglyceridemia is one of the major causes of acute pancreatitis in addition to gallstones and alcohol use. These etiologies are often associated with underlying comorbidities. Acute pancreatitis secondary to hypertriglyceridemia is associated with an increase in clinical severity and further complications. We present a case of a 56-year-old man with a past medical history of hypertension, diabetes mellitus, and familial hypertriglyceridemia who was diagnosed with acute pancreatitis secondary to hypertriglyceridemia. The patient presented with 9/10 pressure across the abdomen radiating to the sternum. Labs revealed elevated triglyceride count > 8000 mg/dL and cholesterol > 705 mg/dL. Abdominal CT showed fat stranding along the anterior aspect of the pancreatic head. The patient was managed with IV fluids, nil per os (NPO), and statin management for hypertriglyceridemia. Seven days later, triglycerides decreased to 658 mg/dL, and abdominal pain resolved. This case highlights an unusual presentation of acute pancreatitis and demonstrates the importance of understanding the spectrum of etiologies for this condition.
ABSTRACT
PURPOSE: To assess pediatric ophthalmology-related information on TikTok (ByteDance). METHODS: The 12 most commonly searched terms from the American Association for Pediatric Ophthalmology and Strabismus website were queried as TikTok hashtags. The top 20 videos for each hashtag were analyzed for views, likes, comments, saves, shares, author status and gender, content, and engagement level ratio (ELR). Subanalysis of the educational videos for quality, understandability and actionability, and medical accuracy using the modified DISCERN (mDISCERN), Patient Education Materials Assessment Tool (PEMAT), and modified Medical Information and Content Index (mMICI) was performed. RESULTS: Analysis of 222 videos revealed a cumulative 191,337,973 views. Patients/families created the most videos (60.4%), followed by optometrists (14.4%), other (laypeople/unknown) (9.0%), ophthalmologists (7.7%), non-ophthalmology physicians (4.5%), and nurses (4.1%). Content was predominantly patient experience (56.8%), followed by educational (25.2%), humor (11.7%), self-promotional (3.6%), procedures (0.9%), other (0.9%), advertisements (0.5%), and career (0.5%). Educational videos had a lower ELR than humorous (3.3 vs 8.2, P < .001) and patient experience (3.3 vs 5.3, P < .001) videos, but more saves than patient experience videos (74 vs 25, P = .009). The mDISCERN scores were greater for videos authored by ophthalmologists (3, P < .001) and optometrists (2.5, P < .001) compared to lay-people (1.5). Ophthalmologist PEMAT understandability scores were greater than non-ophthalmology providers' (95.5% vs 67.4%, P = .002). There was no difference in PEMAT actionability (P = .743) or mMICI scores among the author subgroups (P = .206). CONCLUSIONS: Pediatric ophthalmology content on Tik-Tok ranges in quality and understandability. Additional research is needed to help promote posts created by eyecare providers to ensure evidence-based medical content reaches pediatric patients and their families. [J Pediatr Ophthalmol Strabismus. 2024;61(2):90-97.].
