ABSTRACT
BACKGROUND AND OBJECTIVE: Determine the ability of Lambda retinometry to predict post-cataract surgery visual acuity in vitrectomized eyes. PATIENTS AND METHODS: Prospective study including 47 cataract surgery candidates with a history of pars plana vitrectomy (PPV). Lambda retinometry using a hand-held Lambda retinometer and best-corrected visual acuity (BCVA) were measured preoperatively, and BCVA was reassessed postoperatively. RESULTS: Lambda predictions strongly correlated with postoperative BCVA (logarithm of the minimum angle of resolution [logMAR]) (P < .001, r2 = 0.57), especially combined with preoperative BCVA (logMAR) (P < .001, r2 = 0.65). In 89% of cases, postoperative BCVA was equal to or higher than the prediction. Neither cataract grades nor indications for PPV were associated with the accuracy of Lambda predictions (P = .882 and P = .790, respectively). Underestimation of visual outcome was more common than overestimation. A Lambda prediction of ≥ 20/40 (Snellen) had a positive predictive value of 85.7% and a negative predictive value of 73.6% for the postoperative outcome. CONCLUSIONS: Lambda retinometry can reliably predict the postoperative BCVA in cataract patients who previously underwent PPV, with a tendency towards underestimation. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:535-542.].
Subject(s)
Cataract Extraction , Cataract , Cataract/complications , Cataract/diagnosis , Humans , Prospective Studies , Visual Acuity , VitrectomyABSTRACT
Purpose: To evaluate the correlation between pain during cataract surgery and preoperative anxiety.Methods: This prospective observational masked study included 103 eyes of 103 consecutive patients who underwent routine clear corneal incision phacoemulsification surgery at the Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel. Patients were interviewed prior to surgery and 5 min following surgery by two separate independent interviewers. Anxiety level was measured by the Visual Analog Scale for Anxiety (VASA) and pain by the Visual Analog Scale (VAS). The main outcome measure was the maximum amount of pain endured during the procedure using VAS.Results: The mean participant age was 68.9 ± 8.9 years, and 46.6% were male. Severe anxiety (VASA ≥ 7) and pain (VAS ≥ 7) were documented in 18.5 and 17.5% of patients, respectively. There was a statistically significant positive correlation between VAS and VASA (r = 0.62, p < .001) as well as between VAS and duration of surgery (r = 0.20, p = .04). There was no association between VAS and all other investigated parameters in the univariate analysis. In backward regression analysis, VASA was the only parameter that was significantly associated with VAS (R2 = 36.61%, p < .001). Patients with severe anxiety were >10 times more likely to experience severe pain, and a VASA > 4 predicted severe pain with a sensitivity of 88.9% and a specificity of 69.4%.Conclusions: One-fifth of patients experienced severe anxiety and pain. Preoperative anxiety levels were the only significant predictor of pain. Reducing preoperative anxiety in cataract patients is warranted.
Subject(s)
Anxiety/etiology , Cataract Extraction/adverse effects , Intraoperative Complications/diagnosis , Pain Measurement/methods , Pain/diagnosis , Aged , Anxiety/epidemiology , Female , Follow-Up Studies , Humans , Incidence , Intraoperative Complications/etiology , Israel/epidemiology , Male , Pain/etiology , Preoperative Period , Prognosis , Prospective StudiesABSTRACT
A well-focused operating microscope addresses several needs that are all secondary to the surgeon's need to see clearly at all times. These needs include: the assistant; the sharpness of the video and monitor; as well as field of view, asthenopia, and focusing issues related to zoom, accommodation, and presbyopia. We provide a practical approach to achieve optimal focus that we call the sloping paper calibration method.
