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Results: 1 to 20 of 274

Topical anaesthesia using eye drops alone compared with a combination of eyedrops and anaesthesia within the eye for cataract surgery

There are many different options for anaesthesia during cataract surgery. Using anaesthetic eye drops (topical anaesthesia) has become an increasingly popular option in modern, rapid‐turnover day case cataract surgery as it is minimally invasive, cost effective, less prone to complications and provides for faster patient rehabilitation. Many surgeons who use topical anaesthesia supplement this with anaesthetic administered within the eye (intracameral) during the surgery. This review has found that the use of intracameral lidocaine as a supplement to topical anaesthesia significantly reduces intraoperative pain perception when compared to the use of topical anaesthesia alone. No significant difference was demonstrated between the groups receiving topical anaesthesia alone and topical eye drops combined with intracameral anaesthesia in terms of the need for supplemental anaesthesia, intraoperative adverse events or corneal toxicity. We conclude that the administration of intracameral anaesthetic during surgery is an effective and safe supplementation to topical anaesthesia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Curative effects of small incision cataract surgery versus phacoemulsification: a meta-analysis

Bibliographic details: Yang CJ, Zeng LT, Jiang M.  Curative effects of small incision cataract surgery versus phacoemulsification: a meta-analysis. International Eye Science 2013; 13(8): 1550-1554

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Adjustable versus non‐adjustable sutures for the eye muscles in strabismus surgery

Strabismus occurs when the eye deviates from its normally perfect alignment, and can be corrected with surgery. A variety of surgical techniques are available, including the use of adjustable or non‐adjustable sutures for the muscles surrounding the eye. There is uncertainty as to which of these suture techniques results in a more accurate alignment of the eye, and whether there are specific situations in which it is of benefit to use a particular technique. This review could not find enough evidence to answer these questions and suggests that more research is needed. The review authors used existing evidence to propose that future randomised controlled trials should directly compare the adjustable to the non‐adjustable suture technique, in co‐operative patients with any type of strabismus. Trials should have a minimum of six months follow‐up and should include important outcome measures such as re‐operation rates, accuracy of ocular alignment, complications, economics and patient satisfaction. The information generated from well‐designed studies could support a change in the conventional surgical management of strabismus and help to direct planning of surgical training.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Surgery to remove tumour so that it is not visible with the naked eye prolongs survival in women with recurrent epithelial ovarian cancer

Epithelial ovarian cancer is a disease in which malignant cells form in the tissue covering the ovary. It accounts for about 90% of ovarian cancers; the remaining 10% arise from germ cells or the sex cords and stroma of the ovary. Women with epithelial ovarian cancer that has returned after primary treatment (recurrent disease) may need secondary surgery to remove all or part of the cancer. When ovarian cancer recurs after more than six months it is considered suitable for further treatment with platinum chemotherapy (platinum sensitive).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions for trachoma trichiasis, in‐turning of the upper eye lashes caused by a chronic infectious inflammation of the conjunctiva of the eye that can lead to blindness

Trachoma is a form of chronic inflammation of the transparent mucous membrane that lines the eyelids and covers the white of the eye (conjunctiva). It is a bacterial infection caused by Chlamydia trachomatis that is associated with poverty and is most prevalent in hot dry areas. Repeated infections cause scarring of the conjunctiva of the upper eyelid, which causes the eyelid to turn in (entropion) so that the eyelashes touch the cornea at the front of the eye. This is known as trachoma trichiasis. Every movement of the eye or eyelids causes trauma to the corneal surface so that it eventually turns opaque and the person becomes blind. Improved facial cleanliness and environmental hygiene may reduce the spread of trachoma. Antibiotic treatment may also be useful but surgery to correct the eye lid deformity is the only treatment that is likely to be helpful in the late stages of the disease. The review authors searched the medical literature and identified seven randomised controlled studies (2331 participants) investigating surgical and non‐surgical treatments as a way of reducing the recurrence of trichiasis. Three studies compared different surgical interventions. These trials suggested that the most effective surgery requires full‐thickness incision and rotation of the edge of the eyelid. Community‐based surgery was more convenient for patients by reducing the time and expense of travelling to a conventional hospital and it did not increase the risk of complications or recurrence. Surgery performed by ophthalmologists and by integrated eye workers were both similarly effective. The addition of azithromycin treatment at the time of surgery did not reduce the recurrence of trichiasis in a single study (426 participants). Non‐surgical methods included removing the eye lashes (epilation) using electrolysis or cryotherapy and taping the eyelid back. One trial found that the use of double‐sided sticking plaster was more effective than removing the eye lashes as a temporary measure but the tape had to be replaced weekly. Destroying the lashes appeared to have low success rates and the equipment required is costly and can be difficult to maintain. The included studies were carried out in China, Gambia, Ethiopia and Oman.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

The effect of hinge location on corneal sensation and dry eye after LASIK: a systematic review and meta-analysis

BACKGROUND: The aim of this meta-analysis is to investigate the possible effect of hinge location on corneal sensation and dry eye syndrome after laser-assisted in situ keratomileusis (LASIK).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Different treatments for a squint (deviation of the eye) that occurs within the first six months of life

Infantile esotropia can affect the vision in the eye, the ability to use the two eyes together (binocularity) and also be a cosmetic issue to the child/parents. Treatment includes surgical and non‐surgical interventions to reduce the squint and to enhance/aid binocularity in children. This review looks at the various interventions and also the timing of such treatment. The review did not find any randomised trials that compared treatment to another treatment or to no treatment. A large, multi‐centre, non‐randomised trial found that children operated on earlier had better binocularity at age six compared to the late surgery group. This group had been operated on more frequently however and there was no significant difference in the angle of the squint after surgery in either group. This review does not resolve the controversy regarding the best type of surgery, the value of non‐surgical interventions and the optimal timing of either type of intervention. It highlights a need for further research in this area.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Interventions for prevention of giant retinal tear in the fellow eye

A giant retinal tear is a full‐thickness retinal break that extends for 90 degrees or more around the circumference of the retina, in the presence of posterior vitreous detachment (when the vitreous comes away from the retina). Giant retinal tears cause visual loss as a result of the associated retinal detachment. They can be difficult to treat due to the large area of retinal involvement and the high risk of re‐detachment following vitreoretinal surgery, often related to the development of proliferative vitreoretinopathy (a scarring process that can happen on the inner or outer surface of the retina and in the vitreous cavity after retinal detachment). As the fellow eye has an increased risk of developing giant retinal tear and retinal detachment, prophylactic 360‐degree treatments with laser photocoagulation, cryotherapy or encircling scleral buckling have been proposed to reduce this risk. This review did not find any strong evidence in the form of prospective randomised controlled trials or case‐control studies to support or refute these prophylactic treatments.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Rituximab for the treatment of thyroid eye disease

Thyroid eye disease affects 50% of patients with the autoimmune condition, Graves' disease. Symptoms include eye pain, redness, swelling, protrusion (proptosis), double vision, and in severe cases, reduction in vision. Currently treatment options include steroids and radiotherapy, but relapses are common. Surgery is reserved for severe cases. Rituximab is a medication given by intravenous infusion which has been shown to benefit patients with other autoimmune conditions like rheumatoid arthritis. This review was designed to investigate whether rituximab is effective and safe as a treatment option for patients with thyroid eye disease. There is a lack of evidence from randomised controlled trials to support the use of rituximab for thyroid eye disease. Rigorous studies looking at patients with active thyroid eye disease, comparing rituximab treatment with either steroids or placebo, need to be conducted in order to answer this question.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Comparison of two surgical techniques for the control of eye pressure in people with glaucoma

Increased eye pressure is the major risk factor for developing glaucoma (a group of eye diseases that lead to progressive, irreversible damage to the optic nerve (the nerve that transmits visual information from the retina to the brain)). Glaucoma is the second biggest cause of blindness worldwide. Eye pressure can be controlled surgically. Trabeculectomy (penetrating eye surgery) is the removal of a full‐thickness block of the trabecular meshwork (eye filtration tissue) to make a hole that allows aqueous (watery fluid present in the front part of the eyes and partly responsible for eye pressure) to filter out of the eye. It is the standard surgical procedure and has been widely practised for over 40 years. Non‐penetrating filtering surgical procedures, in which aqueous is allowed to filter out without the removal of a full‐thickness block of trabecular tissue, also aim to control eye pressure and have the reputation of being safer than trabeculectomy. The most widely practised non‐penetrating surgical procedures for glaucoma are viscocanalostomy and deep sclerectomy. Each procedure involves a different level of partial‐thickness surgical dissection into the eye filtration tissue. Surgical success is defined as lowering the eye pressure to normal limits (less than 21 mmHg) for at least 12 months after surgery. This review included five trials with 311 eyes (267 participants). These studies included 160 eyes which had trabeculectomy compared to 151 eyes that had non‐penetrating glaucoma surgery, of which 101 eyes had deep sclerectomy and 50 eyes had viscocanalostomy. This review showed that trabeculectomy is better in terms of achieving total success (pressure controlled without eyedrops) than non‐penetrating filtering procedures. Although when we looked at the outcome of partial success (pressure controlled with additional eyedrops) it was more imprecise and our results could not exclude one surgical approach being better than the other. However, the review noted that these studies had some limitations regarding their design and were too small to give definitive information on differences in complications following surgery. None of the studies measured quality of life.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Fact sheet: Amblyopia in children – when one eye sees better than the other

Normally, the brain processes the information coming in from both eyes equally. This is needed for the best possible vision. In some children, however, one eye is favored by the brain because it provides a better image. If this happens, the other eye is neglected from childhood on, and it does not get the chance to develop well. This is known as amblyopia or “lazy eye”.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 26, 2011

Surgical removal of bony wall or orbital fat for thyroid eye disease

Thyroid eye disease is an autoimmune disorder affecting 30% to 50% of patients with Graves' disease. Severe forms present in 3% to 5% of patients with reduced vision due to pressure on the optic nerve. The disease is more frequent in women and it significantly impairs the quality of life of affected patients. The clinical presentation is characterised by inflammation of the orbital contents which increases the volume of fat and muscles, resulting in forward placement of the eyes (exophthalmos), retraction of the eyelids and double vision. Multiple surgical procedures may be required for correction after initial medical treatment has proven ineffective.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Screening programs: Are there more advantages than disadvantages to having eye tests for all preschool children?

It is important to find out whether children have vision problems, but not enough research has been done to be able to determine the benefits and harms of routine eye tests in preschool children.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 27, 2011

Type 1 Diabetes in Adults: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care

Type 1 diabetes can, if poorly controlled, produce devastating problems in both the short and the long term. Good control of blood glucose levels reduces the risk of these problems arising, but can be very difficult for patients and carers to achieve. This guideline emphasises that the NHS should provide all patients with the means – and the necessary understanding – to control their diabetes, and that it should help patients integrate the disease management with their other activities and goals. It argues that every person with diabetes should be able to develop their own care plan and utilise effective treatment in a way agreeable to them. The input of various health professionals may be needed to achieve this, and should be readily available. A system of regular monitoring, so that any complications which do develop are picked up at an early stage and treated appropriately, should also be provided.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2004
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Type 2 Diabetes: National Clinical Guideline for Management in Primary and Secondary Care (Update)

Over 90% of people with diabetes have Type 2 diabetes. This is still perceived as the milder form, and while this may be true in some respects, such as the risk of ketoacidosis, the causation of Type 2 diabetes is more complex and the management is not necessarily easier. Type 2 diabetes can cause severe complications, affecting the eye, the nervous system and the kidney. The overall risk of cardiovascular disease is more than doubled, and life expectancy is reduced by an average 7 years. In 2002, NICE published a suite of five guidelines dealing with different aspects of the care of Type 2 diabetes. The rising prevalence of the disease, and the range of complications which can arise, reinforce the importance of up-to-date guidance and accordingly NICE have asked the National Collaborating Centre for Chronic Conditions (NCC-CC) to produce this guideline, amalgamating and updating the previously published work.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2008
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Glaucoma: Diagnosis and Management of Chronic Open Angle Glaucoma and Ocular Hypertension

This guideline covers adults (18 and older) with a diagnosis of chronic open angle glaucoma or ocular hypertension and those with chronic open angle glaucoma or ocular hypertension associated with pseudoexfoliation or pigment dispersion. In addition, the guideline will cover populations who have a higher prevalence of glaucoma and may have worse clinical outcomes including people with a family history of glaucoma, younger people (<50 years) and people who are of black African or black Caribbean descent. Options for pharmacological, surgical, laser and complimentary or alternative treatments are considered in terms of clinical effectiveness and cost effectiveness.

NICE Clinical Guidelines - National Collaborating Centre for Acute Care (UK).

Version: April 2009
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Postoperative pain after cataract surgery

Cataract extraction surgery is the most common surgical procedure, but knowledge of postoperative pain related to cataract surgery is sparse. In this systematic review, the incidence, prevalence, and management of pain after phacoemulsification surgery were identified using PubMed and Scopus. Selected studies were restricted to randomized controlled trials with interventions on postoperative inflammation and pain. Data from 105 articles were extracted and 21 studies met the final inclusion criteria. Most studies reported no or only mild postoperative pain, but some reported moderate and severe pain and pain lasting several weeks. The interventions consisted of drug therapy including topical nonsteroidal antiinflammatory drugs, corticosteroids, paracetamol, perioperative intraocular injections, eye pads used after surgery, and various surgical techniques. The reviewed literature indicates that cataract surgery is associated with significant postoperative pain in some patients, who should be provided with appropriate counseling and pain treatment.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Wernicke encephalopathy after bariatric surgery: a systematic review

OBJECTIVE: To review the clinical essentials of Wernicke encephalopathy (WE) after bariatric surgery.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Efficacy and tolerability of nonpenetrating filtering surgery in the treatment of open-angle glaucoma: a meta-analysis

This generally well-conducted review concluded viscocanalostomy and deep sclerectomy (non-penetrating eye surgery) were significantly less effective than trabeculectomy in treating open-angle glaucoma; deep sclerectomy plus mitomycin C was also less effective than trabeculectomy plus mitomycin C. However, viscocanalostomy and deep sclerectomy had fewer complications than trabeculectomy. Given limitations with the evidence base, the reliability of these conclusions is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Antibiotics at the time of cataract surgery to prevent acute endophthalmitis after surgery

Endophthalmitis (inflammation of the inside of the eyeball due to infection or trauma) is a rare but potentially blinding complication of cataract surgery. It typically is caused by bacteria that enter the eye during surgery or in the first few days after surgery. Multiple preventive measures are used to try to prevent infection after surgery. Several studies have investigated different modes of prevention such as the types of antibiotics used, how the antibiotics are applied or taken, and when the antibiotics are given in the surgical process.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Medical Encyclopedia

  • Lasik eye surgery - series
    The cornea is the transparent part of the eye that covers the iris. It is also the main light bending part of the eye.
  • LASIK eye surgery
    LASIK is eye surgery that permanently changes the shape of the cornea (the clear covering on the front of the eye) in order to improve vision and reduce a person's dependency on glasses or contact lenses.
  • Eye muscle repair
    Eye muscle repair is surgery to correct eye muscle problems that cause crossed (misaligned) eyes. The medical term for crossed eyes is strabismus.
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Systematic Reviews in PubMed

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