38 research outputs found
DETECT: DEveloping and testing a model to identify preventive vision loss among older paTients in gEneral praCTice:Protocol for a complex intervention in Denmark
The number of people living with visual impairment is increasing. Visual impairment causes loss in quality of life and reduce self-care abilities. The burden of disease is heavy for people experiencing visual impairment and their relatives. The severity and progression of age-related eye diseases are dependent on the time of detection and treatment options, making timely access to healthcare critical in reducing visual impairment. General practice plays a key role in public health by managing preventive healthcare, diagnostics and treatment of chronic conditions. General practitioners (GPs) coordinate services from other healthcare professionals. More involvement of the primary sector could potentially be valuable in detecting visual impairment. METHODS: We apply the Medical Research Council framework for complex interventions to develop a primary care intervention with the GP as a key actor, aimed at identifying and coordinating care for patients with low vision. The development process will engage patients, relatives and relevant health professional stakeholders. We will pilot test the feasibility of the intervention in a real-world general practice setting. The intervention model will be developed through a participatory approach using qualitative and creative methods such as graphical facilitation. We aim to explore the potentials and limitations of general practice in relation to detection of preventable vision loss. ETHICS AND DISSEMINATION: Ethics approval is obtained from local authority and the study meets the requirements from the Declaration of Helsinki. Dissemination is undertaken through research papers and to the broader public through podcasts and patient organisations.</p
Steroids and nonsteroidal anti-inflammatory drugs in the postoperative regime after trabeculectomy â which provides the better outcome?:A systematic review and meta-analysis
Prophylactic treatment of intraocular pressure elevation after uncomplicated cataract surgery in nonglaucomatous eyes
Biometry and corneal aberrations after cataract surgery in childhood
BACKGROUND: To report longâterm biometric and refractive outcomes in a group of Danish children after surgery for childhood cataract. METHODS: Children between 7 and 18âyears who had undergone uniâ or bilateral cataract surgery at the Department of Ophthalmology, Rigshospitalet, Denmark, were examined in this crossâsectional study. Swept source optical coherence tomography (OCT) based optical biometry (IOLmaster 700) and anterior tomography (Pentacam) was performed. Healthy fellow eyes from those with unilateral cataract were used as controls. RESULTS: We included 56 children in the study with a median age at surgery of 43.8 months (1.6â137.6). The amount of higher order aberrations was significantly increased in operated eyes (median root mean square 0.461âÎźm [range 0.264â1.484]) compared with nonâoperated eyes (median root mean square 0.337âÎźm [range 0.162â0.498], pâ<â0.001). Younger age at surgery was positively associated with more higher order aberrations at followâup (pâ<â0.001), but we found no significant associations between the amount of higher order aberrations and visual acuity or contrast vision. Longer axial length was associated to glaucoma while shorter axial length was associated to strabismus (pâ<â0.001). CONCLUSIONS: Eyes operated for childhood cataract have higher order aberrations compared with nonâoperated eyes. Higher order aberrations are complex refractive errors that cannot be corrected by normal lenses and may contribute to poor visual outcomes for the children. We found an association between young age at surgery and higher order aberrations
Comparative Efficacy of Phacotrabeculectomy versus Trabeculectomy with or without Later Phacoemulsification: A Systematic Review with Meta-Analyses
There is no consensus on the surgical management of coexisting cataract in patients who undergo glaucoma surgery. In this study, we systematically reviewed the literature to compare the efficacy and safety of phacotrabeculectomy and trabeculectomy either alone or followed by later phacoemulsification. We systematically searched the literature databases PubMed/MEDLINE, EMBASE, and the Cochrane Central. Eligible studies were comparative trials of eyes with glaucoma that underwent either phacotrabeculectomy or trabeculectomy with or without later phacoemulsification. Our primary outcome measure was intraocular pressure (IOP) control closest to 12 months. Secondary outcome measures were efficacy closest to 12 months in terms of visual acuity, visual field, prevalence of complications, needling or revision, number of antiglaucomatous medications, and surgical success. We identified 25 studies with a total of 4,749 eyes. The IOP did not differ significantly between those who underwent phacotrabeculectomy versus trabeculectomy with (MD: 0.63, CI95%: â0.32, 1.59, p=0.19) or without later phacoemulsification (MD: â0.52, CI95%: â1.45, 0.40, p=0.27). However, phacotrabeculectomy was associated with lower risk of complications (RR: 0.80, CI95%: 0.67, 0.95, p=0.01) and better visual acuity corresponding to a 1.4-line difference (MD: â0.14, CI95%: â0.27, â0.95, p=0.03) compared to trabeculectomy. Other secondary outcome measures did not differ significantly (visual field, needling or revision, number of antiglaucomatous medications, and surgical success). In conclusion, postoperative IOP is comparable, and the number of complications is lower when phacotrabeculectomy is compared to trabeculectomy with or without later phacoemulsification in patients with coexisting glaucoma and cataract. However, our study also reveals that the level of evidence is low, and randomized clinical trials are warranted