Do variations in the theatre team have an impact on the incidence of complications?

BACKGROUND: To examine whether variations in non-medical personnel influence the incidence of complications in a cataract theatre. METHODS: A retrospective Case-Control study was undertaken in a single-site, designated cataract theatre. Staffing variations within theatre were examined and the incidence of cataract complications was assessed. RESULTS: 100 complicated lists and 200 uncomplicated control lists were chosen. At least 7 nurses were present for every list. Mean experience of the nurses was 6.4 years for case lists and 6.5 years for control lists. Average scrub nurse experience in years was 7.6 years for complicated lists and 8.0 years for controls. 26% of complicated case lists were affected by unplanned leave and 17% in control lists. Odds ratio 1.7 (1.0 to 3.1) 95% CI. CONCLUSION: Unplanned leave can have a detrimental effect on the operating list. The impact of this may be modifiable with careful planning

Incidence of submacular haemorrhage (SMH) in Scotland : a Scottish Ophthalmic Surveillance Unit (SOSU) study

PURPOSE: Submacular haemorrhage (SMH) is a cause of severe visual loss in neovascular age-related macular degeneration (nAMD). The incidence is uncertain and furthermore there is no widely used classification system nor agreed best practice. The aim of this national surveillance study was to identify the incidence, presenting features and clinical course of new fovea-involving submacular haemorrhage associated with nAMD. METHODS: A questionnaire was sent monthly to every ophthalmic specialist in Scotland over a 12-month period asking them to report all newly presenting patients with acute SMH secondary to nAMD of at least two disc diameters (DDs) in greatest linear diameter. A follow-up questionnaire was sent 6 months after initial presentation. Cases related to other causes were excluded. RESULTS: Twenty-nine cases were reported giving an incidence of 5.4 per million per annum (range 2-15). The mean age was 83 years (range 66-96) and females accounted for 17/29 (59%). Fifteen of the 29 cases (52%) had a past history of AMD, of which 7 had nAMD. Nineteen of the 29 cases (66%) presented within 7 days of onset and the majority had SMH of < 11 DD (20/29, 69%). Treatment options comprised the following: observation (n = 6, 21%), anti-VEGF alone (n = 6, 21%) or vitrectomy with co-application of tissue plasminogen activator (TPA), anti-VEGF and gas (n = 17, 58%). The vitrectomy group experienced the greatest change in vision from logMAR 1.89-1.50 (p = 0.374). Four of 20 (20%) cases with 6 months follow-up suffered a re-bleed at a mean time of 96 days. CONCLUSIONS: The incidence, clinical features and course of a consecutive national cohort of patients with SMH secondary to nAMD are presented

Epidemiology of presumed infectious endophthalmitis following cataract surgery in the UK and the characterisation of intraocular lens related bacterial biofilm

Available from British Library Document Supply Centre- DSC:DXN060053 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Deliverable D8.3 - GEOTeCH Project - Web-gis Interface

This document is the text part of the Deliverable D8.3 \u2018Web-gis interface\u2019, which describes which describes the main aspects of the web-gis linked to the GEOT\u20acCH website. It is a component of the Communication and Dissemination activities of work package 8 (WP8). Communicating and disseminating GEOT\u20acCH innovations in Europe also means to provide end-users and stakeholders preliminary information about the potential of the developed technologies in Europe. This is the main aim of the web-gis, focus of this Deliverable. Five maps have been chosen as available layers, results of multiple investigations carried out in Work Packages 5 and 7, and they give indications about the suitable installation and use of GEOT\u20acCH innovations in different European locations. The web-gis reports the exact location of the four demo-sites, too, in order to give end-users a mean of comparison between data from real installations and assumptions made for the rest of European territory. The present document describes the maps chosen for the insertion in the web-gis, the information selected to be published for the demo sites and the system architecture. The web-gis, together with the GEOT\u20acCH website, will be kept active and updated for 2 years after the end of the Project. The direct link is: www.geotech-project.eu/web-gi

Letter to the Editor: The use of control charts in monitoring endophthalmitis

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Suprachoroidal haemorrhage complicating cataract surgery in the UK: a case control study of risk factors

Aims: To study the risk factors for suprachoroidal haemorrhage (SCH) complicating cataract surgery in the United Kingdom. Methods: 109 cases of SCH complicating cataract surgery prospectively collected through the British Ophthalmological Surveillance Unit were compared with 449 controls that underwent cataract extraction from 13 “control centres” throughout UK in a case control study. 40 systemic, ophthalmic, and operative variables were examined. Results: Statistically significant risk factors for SCH in univariate analysis included: older age (p<0.001), taking at least one cardiovascular medication (p<0.001), peripheral vascular disease (p = 0.014), hyperlipidaemia (p = 0.005), glaucoma (p<0.001), elevated preoperative intraocular pressure (p<0.001), sub-Tenon’s local anaesthesia (LA) (p<0.001), topical LA (p<0.001), the lack of orbital compression following LA (p<0.001), posterior capsule (PC) rupture before SCH (p<0.001), elective extracapsular cataract extraction (ECCE) (p = 0.038), and phacoemulsification conversion (p<0.001). Logistic regression analysis identified the following significant independent risk factors: older age, taking at least one cardiovascular medication, glaucoma, elevated preoperative intraocular pressure, the lack of orbital compression, PC rupture before SCH, elective ECCE, and phacoemulsification conversion. Conclusion: The results allow identification of patients at risk of SCH. Attention to the various modifiable preoperative and intraoperative risk factors is recommended in order to minimise the risk of SCH