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Chua P.Y.,University of Aberdeen | Azuara-Blanco A.,Queens University of Belfast | Hulme W.,NHS Blood and Transplant | Jones M.N.A.,NHS Blood and Transplant | And 2 more authors.
Ophthalmology | Year: 2013

Objective To investigate the effect of socioeconomic deprivation on cornea graft survival in the United Kingdom. Design Retrospective cohort study. Participants All the recipients (n = 13 644) undergoing their first penetrating keratoplasty (PK) registered on the United Kingdom Transplant Registry between April 1999 and March 2011 were included. Methods Data of patients' demographic details, indications, graft size, corneal vascularization, surgical complication, rejection episodes, and postoperative medication were collected at the time of surgery and 1, 2, and 5 years postoperatively. Patients with endophthalmitis were excluded from the study. Patients' home postcodes were used to determine the socioeconomic status using a well-validated deprivation index in the United Kingdom: A Classification of Residential Neighborhoods (ACORN). Kaplan-Meier survival and Cox proportional hazards regression were used to evaluate the influence of ACORN categories on 5-year graft survival, and the Bonferroni method was used to adjust for multiple comparisons. Main Outcome Measures Patients' socioeconomic deprivation status and corneal graft failure. Results A total of 13 644 patients received their first PK during the study periods. A total of 1685 patients (13.36%) were lost to follow-up, leaving 11 821 patients (86.64%) for analysis. A total of 138 of the 11 821 patients (1.17%) developed endophthalmitis. The risk of graft failure within 5 years for the patients classified as hard-pressed was 1.3 times that of the least deprived (hazard ratio, 1.3; 95% confidence interval, 1.1-1.5; P = 0.003) after adjusting for confounding factors and indications. There were no statistically significant differences between the causes of graft failure and the level of deprivation (P = 0.14). Conclusions Patients classified as hard-pressed had an increased risk of graft failure within 5 years compared with the least deprived patients. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2013 by the American Academy of Ophthalmology Published by Elsevier Inc. Source


Todd C.,University of Wollongong in Dubai | Mallya S.,University of Wollongong in Dubai | Majeed S.,University of Wollongong in Dubai | Rojas J.,University of Wollongong in Dubai | Naylor K.,Moorfields Eye Hospital Dubai
Journal of Assistive Technologies | Year: 2015

Purpose – VirtuNav is a haptic-, audio-enabled virtual reality simulator that facilitates persons with visual impairment to explore a 3D computer model of a real-life indoor location, such as a room or building. The purpose of this paper is to aid in pre-planning and spatial awareness, for a user to become more familiar with the environment prior to experiencing it in reality. Design/methodology/approach – The system offers two unique interfaces: a free-roam interface where the user can navigate, and an edit mode where the administrator can manage test users, maps and retrieve test data. Findings – System testing reveals that spatial awareness and memory mapping improve with user iterations within VirtuNav. Research limitations/implications – VirtuNav is a research tool for investigation of user familiarity developed after repeated exposure to the simulator, to determine the extent to which haptic and/or sound cues improve a visually impaired user’s ability to navigate a room or building with or without occlusion. Social implications – The application may prove useful for greater real world engagement: to build confidence in real world experiences, enabling persons with sight impairment to more comfortably and readily explore and interact with environments formerly unfamiliar or unattainable to them. Originality/value – VirtuNav is developed as a practical application offering several unique features including map design, semi-automatic 3D map reconstruction and object classification from 2D map data. Visual and haptic rendering of real-time 3D map navigation are provided as well as automated administrative functions for shortest path determination, actual path comparison, and performance indicator assessment: exploration time taken and collision data. © Emerald Group Publishing Limited. Source


Febbraro J.-L.,Rothschild | Wang L.,Baylor College of Medicine | Borasio E.,Moorfields Eye Hospital Dubai | Richiardi L.,University of Turin | And 6 more authors.
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2014

Purpose: To evaluate the astigmatic effects of 2.2-mm and 1.8-mm cataract incisions.Methods: A randomized prospective study of 190 eyes of 151 patients undergoing superior clear corneal incision (SCCI) was divided into three groups: 61 eyes with a control 3.2-mm SCCI; 66 eyes with a 2.2-mm SCCI; and 63 eyes with a 1.8-mm SCCI. The corneal astigmatism was measured with an autokeratometer preoperatively and 1 month after surgery. The with-the-wound (WTW), against the-wound (ATW), and WTW-ATW changes were calculated using the Holladay-Cravy-Koch formula.Results: The WTW, ATW, and WTW-ATW changes were significantly higher for the control 3.2-mm SCCI than for the 2.2- and 1.8-mm SCCI (all p < 0.001), and no difference was found between the 2.2- and 1.8-mm SCCI incision groups.Conclusion: In our study, the astigmatic effects were the same for the 2.2 mm and 1.8 mm incisions and as expected, were significantly lower than the control 3.2 mm incision group. © 2014, Springer-Verlag Berlin Heidelberg. Source


Lawuyi L.E.,Moorfields Eye Hospital Dubai | Gurbaxani A.,Moorfields Eye Hospital Dubai
Clinical Ophthalmology | Year: 2015

The maintenance of mydriasis throughout cataract extraction surgery and the control of ocular inflammation are crucial for successful surgical outcomes. The development of miosis during cataract surgery compromises the visualization of the surgical field and working space for surgeons. This may lead to complications that include posterior capsular tear and associated vitreous loss, longer surgical time, and postoperative inflammation. Postoperative inflammation is often uncomfortable and frustrating for patients. It causes pain, redness, and photophobia. This compromises the best-uncorrected vision following surgery and often leads to multiple clinic visits. This article examines the literature published on the current treatments used to manage mydriasis, pain, and inflammation in cataract extraction surgery. Combination phenylephrine/ketorolac injection offers an exciting new class of medication for use in cataract surgery. With the recent approval of Omidria™ (combination of phenylephrine 1% and ketorolac 0.3%) by the US Food and Drug Administration (FDA) for intraocular use, we review the clinical utility of this new combination injection in cataract surgery. PubMed, MEDLINE, and conference proceedings were searched for the relevant literature using a combination of the following search terms: cataract extraction surgery, pupil dilation (mydriasis), miosis, phenylephrine, ketorolac, Omidria™, intracameral mydriatic. Relevant articles were reviewed and their references checked for further relevant literature. All abstracts were reviewed and full texts retrieved where available. © 2015 Lawuyi and Gurbaxani. Source

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