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Cataract Surgery in Very Old Patients: A Case-Control Study

Advancements in surgical techniques and increased life expectancy have made cataract surgery more common among very old patients. However, surgical outcomes seem impaired in patients older than 90 years, especially with ocular comorbidities. A retrospective case-control study of 53 eyes of 53 very o...

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Autores principales: Nussinovitch, Hanan, Tsumi, Erez, Tuuminen, Raimo, Malyugin, Boris, Lior, Yotam, Naidorf Rosenblatt, Hadar, Boyko, Matthew, Achiron, Asaf, Knyazer, Boris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537740/
https://www.ncbi.nlm.nih.gov/pubmed/34682778
http://dx.doi.org/10.3390/jcm10204658
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author Nussinovitch, Hanan
Tsumi, Erez
Tuuminen, Raimo
Malyugin, Boris
Lior, Yotam
Naidorf Rosenblatt, Hadar
Boyko, Matthew
Achiron, Asaf
Knyazer, Boris
author_facet Nussinovitch, Hanan
Tsumi, Erez
Tuuminen, Raimo
Malyugin, Boris
Lior, Yotam
Naidorf Rosenblatt, Hadar
Boyko, Matthew
Achiron, Asaf
Knyazer, Boris
author_sort Nussinovitch, Hanan
collection PubMed
description Advancements in surgical techniques and increased life expectancy have made cataract surgery more common among very old patients. However, surgical outcomes seem impaired in patients older than 90 years, especially with ocular comorbidities. A retrospective case-control study of 53 eyes of 53 very old patients (mean 92.6 ± 3.0) and 140 eyes of 140 matched patients (mean 75.2 ± 7.6) was undertaken. Groups were matched in terms of gender and systemic and ocular comorbidities. In very old patients, higher phacoemulsification energy (cumulative dissipated energy [CDE], 25.0 ± 22.4 vs. 16.1 ± 10.7, p = 0.01) and rate of intraoperative floppy iris syndrome (IFIS, 9.4% vs. 1.4%, p = 0.02) were observed compared to controls. Uncorrected (UCVA) and best-corrected distance visual acuity (BCVA) gains were significantly poorer among the very old patients than among the control at postoperative day 30 (0.20 ± 0.70 vs. 0.56 ± 0.61 logMAR, p < 0.001 and 0.27 ± 0.64 vs. 0.55 ± 0.62 logMAR, p = 0.006, respectively). Even after including CDE and IFIS as covariates, age remained an independent factor for poor visual gain at 30 days (p < 0.001). Cataract surgery in very old patients may demand more experienced surgeons due to higher nuclear density and the rates of IFIS. Expectations in visual acuity gains should be aligned with the patient’s age.
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spelling pubmed-85377402021-10-24 Cataract Surgery in Very Old Patients: A Case-Control Study Nussinovitch, Hanan Tsumi, Erez Tuuminen, Raimo Malyugin, Boris Lior, Yotam Naidorf Rosenblatt, Hadar Boyko, Matthew Achiron, Asaf Knyazer, Boris J Clin Med Article Advancements in surgical techniques and increased life expectancy have made cataract surgery more common among very old patients. However, surgical outcomes seem impaired in patients older than 90 years, especially with ocular comorbidities. A retrospective case-control study of 53 eyes of 53 very old patients (mean 92.6 ± 3.0) and 140 eyes of 140 matched patients (mean 75.2 ± 7.6) was undertaken. Groups were matched in terms of gender and systemic and ocular comorbidities. In very old patients, higher phacoemulsification energy (cumulative dissipated energy [CDE], 25.0 ± 22.4 vs. 16.1 ± 10.7, p = 0.01) and rate of intraoperative floppy iris syndrome (IFIS, 9.4% vs. 1.4%, p = 0.02) were observed compared to controls. Uncorrected (UCVA) and best-corrected distance visual acuity (BCVA) gains were significantly poorer among the very old patients than among the control at postoperative day 30 (0.20 ± 0.70 vs. 0.56 ± 0.61 logMAR, p < 0.001 and 0.27 ± 0.64 vs. 0.55 ± 0.62 logMAR, p = 0.006, respectively). Even after including CDE and IFIS as covariates, age remained an independent factor for poor visual gain at 30 days (p < 0.001). Cataract surgery in very old patients may demand more experienced surgeons due to higher nuclear density and the rates of IFIS. Expectations in visual acuity gains should be aligned with the patient’s age. MDPI 2021-10-11 /pmc/articles/PMC8537740/ /pubmed/34682778 http://dx.doi.org/10.3390/jcm10204658 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nussinovitch, Hanan
Tsumi, Erez
Tuuminen, Raimo
Malyugin, Boris
Lior, Yotam
Naidorf Rosenblatt, Hadar
Boyko, Matthew
Achiron, Asaf
Knyazer, Boris
Cataract Surgery in Very Old Patients: A Case-Control Study
title Cataract Surgery in Very Old Patients: A Case-Control Study
title_full Cataract Surgery in Very Old Patients: A Case-Control Study
title_fullStr Cataract Surgery in Very Old Patients: A Case-Control Study
title_full_unstemmed Cataract Surgery in Very Old Patients: A Case-Control Study
title_short Cataract Surgery in Very Old Patients: A Case-Control Study
title_sort cataract surgery in very old patients: a case-control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537740/
https://www.ncbi.nlm.nih.gov/pubmed/34682778
http://dx.doi.org/10.3390/jcm10204658
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