Eye
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Multicenter Study
Trabeculectomy training in England: are we safe at training? Two year surgical outcomes.
To define the safety profile of trainee trabeculectomy surgery in the United Kingdom. Surgical exposure for trainees in England is limited due to service requirements, the European working time directive constraints and increasing sub-specialisation of glaucoma surgery. Limited knowledge exists on the outcomes of supervised glaucoma surgery. The aim is to determine the safety of supervised trabeculectomy surgery performed by trainee ophthalmologists. ⋯ The outcomes of supervised trainee trabeculectomy compare favourably with consultant cases after 2 year follow up. Trainee cases had higher complication rates than consultant cases. Bleb leaks are a common complication of trainee cases, where closer supervision may be required. There is potential for surgical simulation to help increase the success of such cases. These findings may encourage trainee participation in glaucoma surgery.
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Multicenter Study
Validity of EuroQOL-5D, time trade-off, and standard gamble for age-related macular degeneration in the Singapore population.
Utility values of age-related macular degeneration (AMD) in Asian patients are unknown. This study aims to assess utility values and construct validity of the EuroQOL-5D (EQ-5D), time trade-off (TTO), and standard gamble (SG) instruments in the Singapore multi-ethnic AMD population. ⋯ AMD has a negative impact on utilities, although utility scores were high compared with Western cohorts. EQ-5D, TTO, and SG showed suboptimal construct validity, suggesting that health status utilities may not be sufficiently robust for cost-utility analyses in this population.
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Randomized Controlled Trial Multicenter Study
Pilot randomised controlled trial of face-down positioning following macular hole surgery.
This was a pilot randomised controlled trial (RCT) to investigate the effect of post-operative face-down positioning on the outcome of macular hole surgery and to inform the design of a larger definitive study. ⋯ Post-operative face-down positioning may improve the likelihood of macular hole closure, particularly for holes larger than 400 μm. These results support the case for a RCT.
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Multicenter Study
The Cataract National Dataset electronic multi-centre audit of 55,567 operations: variation in posterior capsule rupture rates between surgeons.
To demonstrate variations in posterior capsule rupture (PCR) rate between surgeons of the same and different grades as a by-product of routine clinical care. ⋯ Considerable variation in PCR rate exists both between and within surgical grades. Routine electronic collection of the CND allows detailed analysis of variations in PCR rates between individual surgeons. To define acceptable limits for this benchmark complication of cataract surgery, further work is needed to adjust surgeons' outcomes for the case mix complexity.
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Multicenter Study
The Cataract National Dataset Electronic Multi-centre Audit of 55,567 operations: anaesthetic techniques and complications.
The primary aim of this study was to detail anaesthetic techniques and complications for cataract surgery in the UK. ⋯ Subtenons anaesthesia was the most widely used anaesthetic technique for cataract surgery but wide variation existed by site. There was a low rate of reported LA complications. There was a statistically significant increased risk of serious complications with sharp needle anaesthesia compared with subtenons technique.