Search Results - International Ophthalmology

International Journal of Basic & Clinical Pharmacology, Medip Academy, Vol. 7, No. 2 ( 2018-01-23), p. 315-

Background: Drug therapy is a major component of patient care management in health care settings. Irrational and inappropriate use of drugs in health care system observed globally is being a major concern. In the field of ophthalmology, there have been many drug developments and different classes of drugs with combinational products are available in ophthalmology for the treatment of ophthalmic diseases. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objectives were to study the prescribing pattern and drug utilization trends in Ophthalmology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of six months in Ophthalmology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 103 adult patients visiting Ophthalmology OPD for curative symptoms were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 1.9. Percentage of drugs prescribed by brand was 100 % versus generic 0 %. Percentage of drugs prescribed from National Essential drug list (NEDL) was 53%. The percentage of encounters with antibiotics was 30.6%. The commonest prescribed drugs were ocular lubricants followed by antibiotics. Eye drops were the commonest prescribed dosage form.Conclusions: Ocular lubricants and antibiotics dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologist to prescribe generic and selection of essential drugs.

Online Resource

2279-0780, 2319-2003

Undetermined

Medip Academy

2018

2681376-2

15,3

International Journal of Ophthalmology, Press of International Journal of Ophthalmology (IJO Press), ( 2018-9-18)

Online Resource

2222-3959, 2227-4898

Undetermined

Press of International Journal of Ophthalmology (IJO Press)

2018

2663246-9

International Journal of Ophthalmology, Press of International Journal of Ophthalmology (IJO Press), Vol. 16, No. 9 ( 2023-9-18), p. 1357-1360

Online Resource

2222-3959, 2227-4898

Undetermined

Press of International Journal of Ophthalmology (IJO Press)

2023

2663246-9

International Practice Development Journal, Foundation of Nursing Studies, Vol. 13, No. 1 ( 2023-05-24), p. 1-18

Background: Ophthalmology in the Republic of Ireland has one of the longest waiting lists in healthcare, with around 44,000 people awaiting a first outpatient appointment. In the north-east region, 12,500 people are waiting. The North-Eastern Region Integrated Eye Care Service (NERIECS) was established in 2021 to improve patient care and access to services. A key driver for the team was to understand ‘how we work together’ to enable a shared vision of change within regional services. Aim: To support hospital and community ophthalmology services, which comprise eight organisations in the region, to prepare for the development of system-level integration of eyecare services. Methods: We integrated a popular process-improvement methodology, Lean Six Sigma, with a person-centred approach to support staff to develop a shared vision of change and to deliver improvements for ophthalmology services. Findings: The integrated approach enabled staff to work in ways that supported the development of good quality, person-centred care that takes account of the outcomes for and experiences of ophthalmology patients and their families, and of staff. Conclusions: Our work builds on a recent study that identified coherence in the underlying philosophy, intention, method and outcomes of Lean Six Sigma and person-centred approaches to healthcare improvement, highlighting the added value of an integrated approach in enabling improvement that positively impacts patient outcomes and healthcare culture. Implications for practice: The application of an integrated approach to process improvement in healthcare is shown to be effective beyond a single study site, having a positive impact across geographic and organisational boundaries, and across levels of care (primary, secondary, tertiary and post-acute) The integrated approach puts the focus on synergies between both methodological approaches and avoids improvement work being reduced to the use of a decontextualised toolkit

Online Resource

2046-9292

Undetermined

Foundation of Nursing Studies

2023

2684658-5

Journal of Ophthalmology, Hindawi Limited, Vol. 2015 ( 2015), p. 1-12

Background . To evaluate the efficacy and acceptability of orthokeratology for slowing myopic progression in children with a well conducted evidence-based analysis. Design . Meta-analysis. Participants . Children from previously reported comparative studies were treated by orthokeratology versus control. Methods . A systematic literature retrieval was conducted in MEDLINE, EMBASE, Cochrane Library, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. The included studies were subjected to meta-analysis using Stata version 10.1. Main Outcome Measures . Axial length change (efficacy) and dropout rates (acceptability) during 2-year follow-up. Results . Eight studies involving 769 subjects were included. At 2-year follow-up, a statistically significant difference was observed in axial length change between the orthokeratology and control groups, with a weighted mean difference (WMD) of −0.25 mm (95% CI, −0.30 to −0.21). The pooled myopic control rate declined with time, with 55, 51, 51, and 41% obtained after 6, 12, 18, and 24 months of treatment, respectively. No statistically significant difference was obtained for dropout rates between the orthokeratology and control groups at 2-year follow-up (OR, 0.79; 95% CI, 0.52 to 1.22). Conclusions . Orthokeratology is effective and acceptable for slowing myopic progression in children with careful education and monitoring.

Online Resource

2090-004X, 2090-0058

English

Hindawi Limited

2015

2546525-9

Annals of Transplantation, International Scientific Information, Inc., Vol. 23 ( 2018-03-06), p. 160-165

Online Resource

2329-0358

English

International Scientific Information, Inc.

2018

2393116-4

Statistics and Its Interface, International Press of Boston, Vol. 1, No. 1 ( 2008), p. 137-153

Online Resource

1938-7989, 1938-7997

English

International Press of Boston

2008

2708379-2

International Journal of Medical Education, International Journal of Medical Education, Vol. 12 ( 2021-02-26), p. 34-35

Online Resource

2042-6372

Undetermined

International Journal of Medical Education

2021

2625890-0

International Journal of Advanced Research, International Journal Of Advanced Research, Vol. 6, No. 2 ( 2018-2-28), p. 1506-1517

Online Resource

2320-5407

Undetermined

International Journal Of Advanced Research

2018

2733321-8

International Journal of Ophthalmology, Press of International Journal of Ophthalmology (IJO Press), Vol. 14, No. 10 ( 2021-10-18), p. 1508-1517

AIM: To investigate the protective effect of human umbilical cord mesenchymal stem cells (hUCMSCs) modified by the LIF gene on the retinal function of diabetic model rats and preliminarily explore the possible mechanism. METHODS: A stably transfected cell line of hUCMSCs overexpressing leukemia inhibitory factor (LIF) was constructed. Overexpression was verified by fluorescent quantitative polymerase chain reaction (qPCR). Forty-eight adult Sprague-Dawley rats were randomly divided into a normal control group (group A), streptozotocin-induced diabetic control group (group B), diabetic rats at 3mo injected with empty vector-transfected hUCMSCs (group C) or injected with LIF-hUCMSCs (group D). Four weeks after the intravitreal injection, analyses in all groups included retinal function using flash electroretinogram (F-ERG), retinal blood vessel examination of retinal flat mounts perfused with fluorescein isothiocyanate-dextran (FITC-dextran), and retinal structure examination of sections using hematoxylin and eosin staining. Expression levels of adiponectin (APN), high-sensitivity C-reactive protein (hs-CRP), and neurotrophin-4 (NT-4) in each group was detected using immunohistochemistry, PCR, Western blotting, and ELISA, respectively. RESULTS: A stable transgenic cell line of LIF-hUCMSCs was constructed. F-ERG and FITC-dextran examinations revealed no abnormalities of retinal structure and function in group A, severe damage of the retinal blood vessels and function in group B, and improved retinal structure and function in group C and especially group D. qPCR, ELISA, and Western blot analyses revealed progressively higher APN and NT-4 expression levels in groups B, C, and D than in group A. hs-CRP expression was significantly higher in group B than in groups A, C, and D, and was significantly higher in group C than in group D (P 〈 0.05). CONCLUSION: LIF-hUCMSCs protect the retina of diabetic rats by upregulating APN and NT-4 expression and downregulating hs-CRP expression in the retina.

Online Resource

2222-3959, 2227-4898

Undetermined

Press of International Journal of Ophthalmology (IJO Press)

2021

2663246-9

International Journal of Ophthalmology, Press of International Journal of Ophthalmology (IJO Press), Vol. 14, No. 3 ( 2021-3-18), p. 430-435

AIM: To investigate and evaluate healing patterns around flaps made with different side-cut angulations after femtosecond laser in situ keratomileusis (FS-LASIK). METHODS: Thirty-four patients (68 eyes) received a 90° side-cut (n=34) or a 120° side-cut flaps (n=34) made with a femtosecond laser. One day, 1wk, 1 and 3mo postoperatively, side-cut scar was evaluated under slit-lamp photography according to a new grading system (Grade 0=transparent scar, 1=faint healing opacity, and 2=evident healing opacity). In vivo corneal confocal microscopy and anterior segment optical coherence tomography (AS-OCT) were used to observe wound-healing patterns around flap margin in the two groups. Sirius Scheimpflug Analyzer was also used to analyze higher order aberrations 3mo after surgery. RESULTS: There were no significant differences in flap wound-healing patterns at each follow up between the two groups (P 〉 0.05). Three months after surgery, the flap edge scar classified as Grade 0 had excellent apposition and rapid nerve regeneration. At 3 mm and 5 mm pupil diameters, there were significant differences in trefoil aberrations between the two groups (P 〈 0.05), but no statistically significant differences were found in total higher order aberrations (HOAs), spherical aberrations or coma in any of the pupil size conditions (P 〉 0.05). CONCLUSION: Flap edge scars classified as Grade 0 have excellent apposition and rapid nerve regeneration, and 120° side-cut angle flaps induce less trefoil aberrations after FS-LASIK.

Online Resource

2222-3959, 2227-4898

Undetermined

Press of International Journal of Ophthalmology (IJO Press)

2021

2663246-9

Diabetes, American Diabetes Association, Vol. 68, No. Supplement_1 ( 2019-06-01)

Early detection and treatment of diabetic retinopathy (DR) can reduce blindness risk by & gt;90%. Due to limitations in access to specialized eye care, the majority of people with diabetes (PWD) are not screened routinely. This project aims to determine if implementation of a point-of-care retinal screening program for PWD not routinely followed by ophthalmology would be effective in detecting DR in the Intermountain West region of the U.S. PWD who had not had a dilated eye exam within the last year underwent fundus photography during a regularly scheduled diabetes visit at the University of Utah Diabetes and Endocrinology Center. Non-mydriatic retinal images were classified by a vitreoretinal specialist as to DR severity based on the International Clinical Diabetic Retinopathy and Macular Edema Severity Scale. Abnormal findings were present in 49% of 116 patients imaged: Mild-moderate non-proliferative diabetic retinopathy (NPDR) in 16%, moderate-severe NPDR in 13%, proliferative retinopathy in 4% and hypertensive retinopathy in 13%. Point-of-care retinal imaging effectively identified DR and other retinal conditions in the Intermountain West. The finding of serious eye conditions in PWD not routinely followed by ophthalmologists supports the importance of improving ease of access for eye screening in diabetes care. Disclosure M. Wahl: None. A. Haynes: None. M.L. Litchman: None. A. Fagerlin: None. R.K. Delaney: None. J. Neuberger: None. G.S. Adjei-Poku: None. M. Serrato: None. M. Hartnett: None. S. Fisher: None.

Online Resource

0012-1797, 1939-327X

English

American Diabetes Association

2019

1501252-9

Veterinary Ophthalmology, Wiley, Vol. 7, No. 5 ( 2004-09), p. 348-351

Phaco chop is a bimanual phacoemulsification technique to remove cataracts. The technique was first presented at the 1993 3rd American–International Congress on Cataract, IOL, and Refractive Surgery in Seattle by Dr Kunihiro Nagahara. He compared the lens with a block of wood and by applying chopping forces parallel to the natural planes of the lens lamellae, as one does in splitting wood, a nucleus can be cleaved with surprisingly little force and time. Dr Nagahara used the phaco tip to impale and high vacuum to hold the nucleus while a second instrument, or chopper, hooked the equator and was pulled centrally, splitting the nucleus along its natural cleavage planes. This was a breakthrough for surgeons who had been utilizing several minutes of phaco energy sculpting grooves and bowls in a lens. Studies have shown that compared with four‐quadrant ‘divide and conquer’, the phaco chop technique uses less phaco time and energy, significantly reducing endothelial cell damage. Other advantages of phaco chop include reduction of zonular and capsular stress because forces are directed toward an opposing instrument and the phaco tip is kept in a central ‘safe zone’ in the middle of the pupil. This technique has also been successfully adapted to the canine phacoemulsification procedure. The larger canine lens requires some modifications, and lenses with hard nuclear and cortical material may not be amenable to this procedure.

Online Resource

1463-5216, 1463-5224

English

Wiley

2004

2011043-1

22

Clinical & Experimental Ophthalmology, Wiley, Vol. 33, No. 4 ( 2005-08), p. 395-401

Background:  Demonstrations were held all over the Philippines to teach local microscope operators basic maintenance skills and troubleshooting for their portable microscopes. Methods:  Fifteen microscopes were examined and feedback was obtained from 16 microscope operators. The different parameters of the microscope were evaluated as follows: (i) user‐friendliness, (ii) demand and availability of technical services and spare parts, (iii) portability and (iv) frequent problems encountered. Some suggestions for improvement are proposed. Results:  There was a general satisfaction among the operators with their microscopes; however, there was a lack of technical support services. Most microscopes were portable and the original casing was adequate for transport. Even though most microscopes were functioning, their quality could be improved with maintenance. The three most common problems identified were: mouldy/dirty lenses, expired mould pellets and poor alignment. Conclusions:  The portable operating ophthalmic microscope has an important role in the prevention of international blindness. The archaic attitude of sending microscopes to professional technicians for simple maintenance and repair should be abandoned. Instead demonstrations aimed at teaching these skills to local operators and surgeons should be held, in order to improve the technical support available. Different microscope operators can help provide microscope designers with feedback for future improvements. Similar demonstrations could be considered for other countries with a similar scarcity of technical support services.

Online Resource

1442-6404, 1442-9071

English

Wiley

2005

2094910-8

Journal of Ophthalmology, Hindawi Limited, Vol. 2015 ( 2015), p. 1-6

Purpose . To validate clinically a new method for estimating the corneal power ( P c ) using a variable keratometric index ( n k adj ) in eyes with previous laser refractive surgery. Setting . University of Alicante and Medimar International Hospital (Oftalmar), Alicante, (Spain). Design . Retrospective case series. Methods . This retrospective study comprised 62 eyes of 62 patients that had undergone myopic LASIK surgery. An algorithm for the calculation of n k adj was used for the estimation of the adjusted keratometric corneal power ( P k adj ). This value was compared with the classical keratometric corneal power ( P k ), the True Net Power (TNP), and the Gaussian corneal power ( P c Gauss ). Likewise, P k adj was compared with other previously described methods. Results . Differences between P c Gauss and P c values obtained with all methods evaluated were statistically significant ( p 〈 0.01 ). Differences between P k adj and P c Gauss were in the limit of clinical significance ( p 〈 0.01 , loA [−0.33,0.60] D). Differences between P k adj and TNP were not statistically and clinically significant ( p = 0.319 , loA [−0.50,0.44] D). Differences between P k adj and previously described methods were statistically significant ( p 〈 0.01 ), except with P c HaigisL ( p = 0.09 , loA [−0.37,0.29] D). Conclusion . The use of the adjusted keratometric index ( n k adj ) is a valid method to estimate the central corneal power in corneas with previous myopic laser refractive surgery, providing results comparable to P c HaigisL .

Online Resource

2090-004X, 2090-0058

English

Hindawi Limited

2015

2546525-9

Clinical & Experimental Ophthalmology, Wiley, Vol. 33, No. 3 ( 2005-06), p. 288-293

Professor Peter Choyce, FRCS, DOMS, MS, was one of the pioneers of intraocular lens implant surgery. He developed an interest in artificial lens implantation following cataract surgery, a procedure that was widely criticized by the ophthalmic establishment in the UK, Europe, North America and other countries. Owing to the opposition to the intraocular lenses, Peter Choyce together with Sir Harold Ridley cofounded the International Intraocular Implant Club in 1966, which was responsible for the gradual acceptance of artificial lens implantation. Peter Choyce developed several models of intraocular lens, but did not patent the majority of them. The Choyce Mark IX, manufactured by Rayner Intraocular Lenses, became the first US Food and Drug Administration‐approved intraocular lens in 1981. A review of Peter Choyce's record confirms a significant number of original innovations in the field of anterior segment surgery, including many procedures taken for granted today, but not associated with his name. These include early work on both kerato‐ and intraocular lens‐refractive procedures, keratoprosthesis, pioneering paediatric implant procedures and others. Unfortunately his tenacious adherence to anterior chamber lens technology, while in general clinically sound, caused many to question his influence and hence he remained poorly understood even until after his death. He passed away on 8 August 2001 after a long fight with colon cancer. In this article, we provide evidence and elaborate Peter Choyce's accomplishments, which places him as one of the most innovative ophthalmologist in his surgical field in the twentieth century.

Online Resource

1442-6404, 1442-9071

English

Wiley

2005

2094910-8

Clinical & Experimental Ophthalmology, Wiley, Vol. 44, No. 2 ( 2016-03), p. 121-127

Criteria for screening preterm infants for retinopathy of prematurity vary around the world. We aimed to analyse the efficacy of alternative screening criteria. Design We collected retrospective data at a tertiary level neonatal nursery. Participants Our participants were 1007 babies, born between 1997 and 2011, at 〈 32 weeks gestational age or 〈 1500 g birth weight (as recommended by the National Health and Medical Research Council in 1996), who had completed follow‐up to full retinal vascularization, with defined presence or absence of retinopathy of prematurity. Methods We determined whether disease would be detected using an alternative Australian screening model (gestational age 〈 30 weeks or birth weight 〈 1250 g) or screening criteria utilized in developed countries with similar standards of neonatal care. Main Outcome Measures Detection of retinopathy of prematurity is our main outcome. Results Using several of the alternative criteria, two neonates with clinically significant retinopathy of prematurity, one of whom required laser treatment to preserve sight, would not have been screened, and their disease may have gone undetected. Use of 〈 30 weeks gestational age or 〈 1500 g birth weight as the criteria would still have screened these infants but would have reduced the number of infants screened by 24.9%. Conclusions Some commonly utilized international screening criteria for retinopathy of prematurity may risk clinically significant cases being missed and others may screen babies unnecessarily. Alternative criteria should be considered and ‘ 〈 30 weeks gestational age and/or 〈 1500 g birth weight’ appears a viable option.

Online Resource

1442-6404, 1442-9071

English

Wiley

2016

2094910-8

Lupus Science & Medicine, BMJ, Vol. 7, No. 1 ( 2020-05), p. e000395-

The American Academy of Ophthalmology recommends a maximum hydroxychloroquine (HCQ) dose of ≤5.0 mg/kg/day to reduce the risk of HCQ-induced retinopathy. To determine if this dose adjustment would have an impact on the clinical course of SLE, we compared outcome measures in a cohort of patients with SLE before and after adjusting HCQ dose. Methods Sixty Puerto Ricans with SLE (per 1997 American College of Rheumatology criteria) treated with HCQ who were changed to HCQ ≤5.0 mg/kg/day were studied. Visits were ascertained every 6 months for 2 years before and 2 years after HCQ dose adjustment (baseline visit). Disease activity (per Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)), SLE exacerbations, emergency room visits, hospitalisations, disease damage (per Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), corticosteroids exposure, prednisone dose and immunosuppressive drugs exposure were determined before and after HCQ dose change. Results At baseline visit, the mean age was 43.8±15.1 years. All patients were women. The mean disease duration was 13.8±9.1 years. After HCQ dose adjustment, patients required a lower prednisone dose when compared with visits before HCQ dose reduction. No significant differences were observed for mean SLEDAI scores, lupus exacerbations, emergency room visits, hospitalisations, disease damage and exposure to immunosuppressive drugs before and after HCQ dose adjustment. Conclusions This study suggests that adjustment of daily HCQ dose to ≤5.0 mg/kg/day of actual body weight does not have a significant impact on the short-term and mid-term outcomes in this group of patients with SLE.

Online Resource

2053-8790

English

BMJ

2020

2779620-6

Clinical & Experimental Ophthalmology, Wiley, Vol. 50, No. 3 ( 2022-04), p. 303-311

To compare real‐world 24‐month outcomes of phacoemulsification combined with either iStent inject or Hydrus Microstent. Methods Analysis of data from the Fight Glaucoma Blindness (FGB) international registry. Anonymized data from 344 eyes with mild‐to‐moderate open‐angle glaucoma, normal‐tension glaucoma or ocular hypertension that underwent phacoemulsification combined with either iStent inject (224) or Hydrus Microstent (120) were included. Data were adjusted for baseline characteristics using linear regression and propensity score matching. The primary endpoint was a comparison of mean intraocular pressure (IOP) at 24 months. Results At 24 months, there was no significant difference in IOP reduction between the two groups, consistent across all analyses. The matched cohort showed iStent inject achieved 3.1 mmHg reduction and Hydrus a 2.3 mmHg reduction ( p  = 0.530) and a mean medication reduction of 1.0 for iStent inject versus 0.5 for Hydrus ( p  = 0.081). 5.4% of eyes in the iStent inject group and 7.5% of eyes in the Hydrus group required subsequent procedures to improve IOP control within 24 months. Complications were rare with no significant differences between the groups. Conclusions Twenty‐four‐month outcomes showed sustained IOP reduction with a good safety profile for both groups. There was no significant difference in IOP outcomes between the groups. There may be a small additional reduction in glaucoma medication usage following cataract surgery with iStent inject compared to Hydrus.

Online Resource

1442-6404, 1442-9071

English

Wiley

2022

2094910-8

International Journal of Medical Education, International Journal of Medical Education, Vol. 8 ( 2017-11-02), p. 389-395

Online Resource

2042-6372

Undetermined

International Journal of Medical Education

2017

2625890-0