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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Much has been achieved in clinical and scientific research in the past 130 years by Beijing Tongren Hospital, which has evolved from an eye clinic to a comprehensive hospital with an ophthalmology department known as one of the best in China. This article presents the most historic moments and events in the development of a hospital with the largest eye care service volume. In addition, given the leading position of Tongren, the development of ophthalmology in Tongren is also the epitome of the development of modern ophthalmology in China. Beijing Institute of Ophthalmology (BIO) was established in 1959 as an affiliated institution under Tongren, aiming at carrying out applied science and basic science research, and directors of BIO have thus far served 4 terms as president of the Chinese Ophthalmological Society. In 2002, Beijing Tongren Eye Center (hereafter referred to as the Eye Center) was established to combine all the ophthalmic resources within Tongren. In 2017, the Eye Center alone had a surgical volume of 78,223, with surgeries for cataract, refractive errors, fundus, glaucoma, and corneal disease being the 5 most common, and 902,409 outpatient visits. Equipped with the leading experts and equipment, Tongren is dedicated to the battle against major eye diseases by carrying out large population-based epidemiological surveys and basic science research on pathogenesis and effective treatments, thereby making contributions to the development of the science of ophthalmology along with the delivery of eye care services in China and beyond.
Asia Pac J Ophthalmol (Phila)
PMID:Pioneer of Chinese Ophthalmology--130th Anniversary of Beijing Tongren Hospital. 2995 51

Laser capsulotomy is accepted as a standard and effective treatment for posterior capsule opacification. It is generally believed that neodymium:YAG (Nd:YAG) capsulotomy is related to an increased risk of retinal detachment (RD). The aim of this study was to evaluate the association between Nd:YAG capsulotomy and risk for developing RD. A PubMed and Medline search was conducted using the terms "retinal detachment" and "Nd:YAG laser capsulotomy." Of the articles retrieved by this method, all publications in English and abstracts of non-English publications were reviewed. The literature analysis presented no convincing evidence supporting the association between Nd:YAG capsulotomy and increased risk for developing RD. The existing discrepancy between some studies might be related to inadequate group sizes, short observation period, and co-existing disorders. We also reviewed the possible risk factors for RD after Nd:YAG capsulotomy and found no association with preceding surgical approach, existing posterior vitreous detachment, and intraocular lens design. Myopic patients should be treated with caution, as it cannot be concluded that Nd:YAG capsulotomy does not increase RD rate in this cohort. Treatment energy should be as low as possible, as high energy levels and anterior hyaloid damage might increase the chance for RD development. Cataract surgery itself is a potential RD risk factor, particularly after intraoperative capsule complications.
Asia Pac J Ophthalmol (Phila)
PMID:Does Nd:YAG Capsulotomy Increase the Risk of Retinal Detachment? 3004 56

Phacoemulsification (phaco) for cataract extraction is 1 of the most commonly performed ophthalmic surgeries. With increasing evidence of significant intraocular pressure (IOP) reduction after phaco, the paradigm for glaucoma treatment has been shifting toward more cataract extraction instead of glaucoma surgery; thus, the population of glaucoma patients undergoing phaco is likely to continue to increase in the coming years. Although the safety of surgery has improved over the years with newer technologies and machines, postoperative IOP spike remains an important condition even after an uneventful operation. Glaucoma patients undergoing phacoemulsification are particularly at risk of further glaucomatous optic nerve damage from the transient yet potentially high pressures after phaco. Common treatments include topical, intracameral, oral, and systemic IOP-lowering medications; postoperative anterior chamber paracentesis (ACP); and so on. No single treatment to date can guarantee effective prevention or control IOP rise in the first 24 hours after phaco. Sometimes, the IOP remains high despite all of the above treatments and the risk for further glaucomatous damage may be unavoidable. In this perspective article, we discuss the incidence, causes, and treatments of IOP rise after phaco and introduce a new technique, a non-self-sealing (leaky) ACP that may be of use in regulating postoperative IOP rise, especially for patients with glaucoma.
Asia Pac J Ophthalmol (Phila)
PMID:Non-Self-Sealing (Leaky) Anterior Chamber Paracentesis: A New Technique in Managing Postphacoemulsification Intraocular Pressure Rise in Glaucoma and Normal Eyes. 3025 69

Contemporary anterior segment and retinal optical coherence tomography (OCT) systems only image their particular designated region of the eye and cannot image both areas of the eye at once. This separation is due to the differences in optical system design needed to properly image the front or back of the eye and also due to limitations in the imaging depth of current commercial OCT systems. More recently, research and commercial OCT systems capable of "whole-eye" imaging have been described. These whole-eye OCT systems enable applications such as ocular biometry for cataract surgery, ocular shape analysis for myopia, and others. Further, these whole-eye OCT systems allow us to image the eye as an integrated whole rather than as separate, independent divisions.
Asia Pac J Ophthalmol (Phila) 2019 Mar 25
PMID:Advances in Whole-Eye Optical Coherence Tomography Imaging. 3090 77

The actual numbers of people blind or with poor vision continue to increase despite so excellent progress that is being made in reducing the prevalence or percentage of people affected. More attention is required to provide quality outcomes for cataract surgery, prevent and manage myopia, detect and treat diabetic retinopathy, glaucoma, and age-related macular degeneration (AMD). Although more ophthalmologists are needed to provide this eye care, it is important that ophthalmologists work in effective teams with allied eye health personal to be able to meet the community needs.
Asia Pac J Ophthalmol (Phila)
PMID:Global Blindness: The Progress We Are Making and Still Need to Make. 3178 42

The light-adjustable lens is the first Food and Drug Administration (FDA)-approved product from an entirely new category of intraocular lenses (IOLs). The 3-piece foldable silicone light-adjustable lens is implanted through a small incision after phacoemulsification. A slit-lamp-based digital light delivery device is used to adjust and then lock-in the IOL power during the first postoperative month. Up to 4.5 diopters (D) of cylindrical or spherical adjustment can be achieved. This should offer significant advantages in difficult IOL power calculation cases, such as postrefractive eyes. In addition to achieving better refractive accuracy, an adjustable IOL will now allow patients to test and elect a different refractive target postoperatively. This paradigm shift will change how cataract patients choose their refractive objectives, and how ophthalmologists will be able to achieve them. For example, adjustable IOLs may increase the popularity of pseudophakic monovision and bilateral same-day sequential surgery. For those electing adjustable IOL, preoperative patient counseling will change and certain pre- and intraoperative technologies, such as intraoperative aberrometry and digital astigmatic axis marking, would become superfluous.
Asia Pac J Ophthalmol (Phila)
PMID:Disruptive Innovation and Refractive IOLs: How the Game Will Change With Adjustable IOLs. 3178 44

Vitreous floaters are a common cause for presentation to ophthalmologists, and may significantly affect visual function. In the absence of some more serious underlying pathology such as uveitis, many patients may not experience significant persistent visual impairment from floaters. For some patients, the symptomatic effects of floaters may persist. For these patients, treatment options are available, of which the most commonly reported is vitrectomy. Other treatment modalities have also become more common, notably YAG vitreolysis. Selection of appropriate patients for surgery is often difficult, in part due to the relative lack of objective outcomes with which to measure both visual impairment and improvement post-procedure. Although well-tolerated, vitrectomy does carry with it risks, including iatrogenic retinal breaks, retinal detachment, and in phakic patients, subsequent cataract formation. Techniques such as small gauge vitrectomy, intraoperative examination and treatment of breaks or other worrying lesions, and careful consideration of the need for posterior vitreous detachment induction may help limit the incidence of these adverse events. For other treatment options such as YAG vitreolysis, research and clinical experience remain more limited, and as such the long-term efficacy and risks of these therapies are still unclear. Here, we review the evidence surrounding the role of vitrectomy and YAG vitreolysis in the treatment of vitreous floaters and potential means to minimize therapeutic complications.
Asia Pac J Ophthalmol (Phila)
PMID:To Treat or Not to Treat: Management Options for Symptomatic Vitreous Floaters. 3209 27

Artificial intelligence (AI) has been studied in ophthalmology since availability of digital information in ophthalmic care. The significant turning point was availability of commercial digital color fundus photography in the late 1990s, which caused digital screening for diabetic retinopathy (DR) to take off. Automated Retinal Disease Assessment software was then developed using machine learning to detect abnormal lesions in fundus to screen DR. The use of this version of AI had not been generalized because the specificity at 45% was not high enough, although the sensitivity reached 90%. The recent breakthrough in machine learning is the invent of deep learning, which accelerates its performance to be on par with experts. The first 2 breakthrough studies on deep learning for screening DR were conducted in Asia. The first represented collaboration of datasets between Asia and the United States for algorithms development, whereas the second represented algorithms developed in Asia but validated in different populations across the world. Both found accuracy for detecting referable DR of >95%. Diversity and variety are unique strengths of Asia for AI studies. There are many more studies of AI ongoing in Asia not only as prospective deployments in DR but in glaucoma, age-related macular degeneration, cataract, and systemic disease, such as Alzheimer's disease. Some Asian countries have laid out plans for digital health care system using AI as one of the puzzle pieces for solving blindness. More studies on AI and digital health are expected to come from Asia in this new decade.
Asia Pac J Ophthalmol (Phila)
PMID:Artificial Intelligence in Ophthalmology: Evolutions in Asia. 3234 14

The rising popularity of artificial intelligence (AI) in ophthalmology is fuelled by the ever-increasing clinical "big data" that can be used for algorithm development. Cataract is one of the leading causes of visual impairment worldwide. However, compared with other major age-related eye diseases, such as diabetic retinopathy, age-related macular degeneration, and glaucoma, AI development in the domain of cataract is still relatively underexplored. In this regard, several previous studies explored algorithms for automated cataract assessment using either slit lamp of color fundus photographs. However, several other study groups proposed or derived new AI-based calculation for pre-cataract surgery intraocular lens power. Along with advancements in digitization of clinical data, data curation for future cataract-related AI developmental work is bound to undergo significant improvements in the foreseeable future. Even though most of these previous studies reported early promising performances, limitations such as lack of robust, high-quality training data, and lack of external validations remain. In the next phase of work, apart from algorithm's performance, it will also be pertinent to evaluate deployment angles, feasibility, efficiency, and cost-effectiveness of these new cataract-related AI systems.
Asia Pac J Ophthalmol (Phila)
PMID:Artificial Intelligence for Cataract Detection and Management. 3234 16

Investigators, scientists, and physicians continue to develop new methods of intraocular lens (IOL) calculation to improve the refractive accuracy after cataract surgery. To gain more accurate prediction of IOL power, vergence lens formulas have incorporated additional biometric variables, such as anterior chamber depth, lens thickness, white-to-white measurement, and even age in some algorithms. Newer formulas diverge from their classic regression and vergence-based predecessors and increasingly utilize techniques such as exact ray-tracing data, more modern regression models, and artificial intelligence. This review provides an update on recent literature comparing the commonly used third- and fourth-generation IOL formulas with newer generation formulas. Refractive outcomes with newer formulas are increasingly more and more accurate, so it is important for ophthalmologists to be aware of the various options for choosing IOL power. Historically, refractive outcomes have been especially unpredictable in patients with unusual biometry, corneal ectasia, a history of refractive surgery, and in pediatric patients. Refractive outcomes in these patient populations are improving. Improved biometry technology is also allowing for improved refractive outcomes and surgery planning convenience with the availability of newer formulas on various biometry platforms. It is crucial for surgeons to understand and utilize the most accurate formulas for their patients to provide the highest quality of care.
Asia Pac J Ophthalmol (Phila)
PMID:Update on Intraocular Lens Formulas and Calculations. 3250 96


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