Subject(s)
Cornea/pathology , Keratoconus/diagnosis , Practice Patterns, Physicians'/standards , Academies and Institutes/organization & administration , Corneal Diseases/diagnosis , Corneal Diseases/drug therapy , Corneal Diseases/surgery , Corneal Topography , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/drug therapy , Dilatation, Pathologic/surgery , Humans , Keratoconus/drug therapy , Keratoconus/surgery , Ophthalmology/organization & administration , Photochemotherapy , Physical Examination , Risk Factors , United StatesSubject(s)
Corneal Edema/diagnosis , Corneal Opacity/diagnosis , Practice Patterns, Physicians'/standards , Academies and Institutes/organization & administration , Corneal Edema/surgery , Corneal Opacity/surgery , Corneal Pachymetry , Descemet Stripping Endothelial Keratoplasty , Humans , Keratoplasty, Penetrating , Ophthalmology/organization & administration , Physical Examination , Slit Lamp Microscopy , United StatesSubject(s)
Conjunctivitis, Bacterial/diagnosis , Conjunctivitis, Viral/diagnosis , Eye Infections, Bacterial/diagnosis , Eye Infections, Viral/diagnosis , Practice Patterns, Physicians'/standards , Academies and Institutes/organization & administration , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Conjunctivitis, Bacterial/drug therapy , Conjunctivitis, Viral/drug therapy , Diagnosis, Differential , Diagnostic Techniques, Ophthalmological , Eye Infections, Bacterial/drug therapy , Eye Infections, Viral/drug therapy , Humans , Ophthalmology/organization & administration , Physical Examination , United StatesSubject(s)
Dry Eye Syndromes/diagnosis , Practice Patterns, Physicians'/standards , Academies and Institutes/organization & administration , Cyclosporine/therapeutic use , Diagnostic Techniques, Ophthalmological , Dry Eye Syndromes/drug therapy , Humans , Immunosuppressive Agents/therapeutic use , Ophthalmic Solutions , Ophthalmology/organization & administration , Phenylalanine/analogs & derivatives , Phenylalanine/therapeutic use , Physical Examination , Sulfones/therapeutic use , United StatesSubject(s)
Anti-Bacterial Agents/therapeutic use , Eye Infections, Bacterial/diagnosis , Keratitis/diagnosis , Practice Patterns, Physicians'/standards , Academies and Institutes/organization & administration , Administration, Ophthalmic , Bacteria/isolation & purification , Diagnosis, Differential , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/microbiology , Humans , Keratitis/drug therapy , Keratitis/microbiology , Ophthalmic Solutions , Ophthalmology/organization & administration , Physical Examination , United StatesSubject(s)
Anti-Bacterial Agents/therapeutic use , Blepharitis/diagnosis , Blepharitis/drug therapy , Glucocorticoids/therapeutic use , Practice Patterns, Physicians'/standards , Academies and Institutes/organization & administration , Diagnosis, Differential , Drug Therapy, Combination , Eyelid Diseases/diagnosis , Humans , Meibomian Glands/pathology , Ophthalmology/organization & administration , Physical Examination , Quality of Health Care/standards , United StatesABSTRACT
To document current cataract surgery practice patterns of ophthalmologists in the United States Veterans Health Administration, an anonymous online 27-question survey was emailed to the 132 members of the Association of Veterans Affairs Ophthalmologists. The results were tabulated in a computerized database and analyzed with descriptive statistics. The response rate was 53% (70/132); 89% (62/70) of the respondents performed cataract surgery. Sixty percent (36/60) of the responding cataract surgeons were full-time employees, and most (85%, 51/60) trained residents. Common practices among them included partial coherence interferometry for biometry (81%, 47/58), topical anesthesia (57%, 33/58), clear corneal incisions (91%, 53/58), and acrylic single-piece intraocular lens (IOL) implantation (97%, 56/58). Eighty-three percent (48/58) offered toric IOLs at their facilities. These results will help benchmark cataract surgery practice patterns in teaching hospitals and facilitate comparison with cataract surgery in other settings.
Subject(s)
Cataract Extraction/statistics & numerical data , Hospitals, Veterans/statistics & numerical data , Ophthalmology/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , United States Department of Veterans Affairs/statistics & numerical data , Education, Medical, Graduate/statistics & numerical data , Health Surveys , Humans , Internship and Residency , Intraoperative Care/statistics & numerical data , Lens Implantation, Intraocular/statistics & numerical data , Ophthalmology/education , Postoperative Care/statistics & numerical data , Preoperative Care/statistics & numerical data , Surveys and Questionnaires , United StatesABSTRACT
PURPOSE: To determine whether refractive complications can be prevented by applying the currently most accurate method of intraocular lens (IOL) power calculation in the post-radial keratotomy (RK) patient. SETTING: Department of Ophthalmology, University of California, Davis, Sacramento, and American Eye Institute, Cedars Sinai Medical Center, Los Angeles, California, USA. METHODS: Twenty-four eyes having cataract surgery after RK were studied retrospectively for the final postcataract refraction and for the target refraction used in selecting the IOL. Nine of the eyes were further studied for the keratometry (K) values obtained with different methods and for the theoretical postoperative refraction with an IOL aiming for plano or -1.50 diopters (D) based on the known flatter calculated K, axial length, power of the implanted IOL, and refraction after cataract surgery. RESULTS: Implantation of an IOL aiming for plano in the 24 post-RK eyes would have resulted in a hyperopic refraction in 83.4% cases. The choice of an IOL targeted at myopia reduced the frequency of hyperopia to 42.0% (24 cases). Selection of an IOL calculated with a flatter calculated K and aiming for plano decreased the frequency of hyperopia to 44.4%; however, aiming for -1.50 D still resulted in hyperopia in 44.4% of eyes (9 cases). CONCLUSIONS: Unintentional hyperopia can be significantly decreased but not eliminated as a complication of post-RK cataract surgery. The accuracy of the IOL power determination can be improved if myopia is targeted as the postcataract surgery refractive error and the flatter calculated K is used in the IOL determination.
