| 1. |
- De Lima, Sara, et al.
(författare)
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Congenital cataract in newborns : A qualitative study on parents' experiences of the surgery and subsequent care
- 2020
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 98:6, s. 585-591
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Having a child with congenital cataract that requires surgery, contact lens treatment, and frequent medication is a life-altering experience. The aim of this study was to provide more in-depth knowledge of parents' experiences of diagnosis, surgery, and subsequent care, in order to find the areas for improvement.METHODS: Data were collected via semi-structured interviews with parents recruited from St. Erik Eye Hospital, Sweden. The children were operated for congenital cataract before 3 months of age and were aged 12-24 months at the time of the interviews. The interviews were analysed using qualitative content analysis with an inductive approach.RESULTS: Three themes emerged from the data: living in a turbulent time before the diagnosis, coping during the time of initial treatment, and managing the responsibility of their child's visual development. All parents expressed confidence in the operating unit. However, there was a clear need for reliable information on the condition, the surgery, and likely the long-term outcome in the time between receiving the preliminary diagnosis at the maternity ward and getting it confirmed by a paediatric ophthalmologist.CONCLUSION: Much of the parents' concern in this turbulent time is linked to poor information before the visit to the eye hospital. We, therefore, recommend earlier contact with the eye hospital, preferably at the time of writing the referral. Moreover, the possibility of providing up-to-date information via alternative information channels such as smartphone apps should be investigated.
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| 2. |
- De Lima, Sara, et al.
(författare)
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Swedish parents' experiences and their need for support when having a child with congenital cataract : A qualitative study
- 2021
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Ingår i: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 60, s. 109-115
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore parents' experiences of living with a child with congenital cataract, with the intention of identifying how to improve the parental support.DESIGN AND METHOD: A qualitative descriptive design using semi-structured interviews. The parents were interviewed when the children were aged 12-24 months. All children were operated on for congenital cataract before three months of age. The interviews were transcribed and analysed using qualitative content analysis with an inductive approach. Findings were reported following the Standard for Reporting Qualitative Research (SRQR) checklist.RESULTS: Three categories emerged from the data: trying to survive during a chaotic time; adapting to a different normal; being in need of support. When receiving the preliminary diagnosis, most of the parents were upset but managed well once the initial shock had subsided. However, some described feelings of despair, difficulties in accepting the situation and in connecting with the child. All parents stated that, to be valuable, a counsellor needed to have insights in how the eye works and the function of visual development.CONCLUSION: The parents' need for psychosocial support in the early post-diagnostic stage varied greatly. Early identification of those in need of specialized counselling is therefore of importance, preferably at the maternity ward or by the regional ophthalmologist when the referral is made.CLINICAL IMPLICATIONS: The study provides understanding of the importance to take the parents' well-being beyond the medical issues into consideration. This knowledge can be used to provide support at an earlier stage in the treatment programme than is currently the case.
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| 3. |
- Behndig, Anders, et al.
(författare)
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Aiming for emmetropia after cataract surgery: Swedish National Cataract Register study
- 2012
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Ingår i: Journal of Cataract and Refractive Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 1873-4502 .- 0886-3350. ; 38:7, s. 1181-1186
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess and analyze refractive outcome after cataract surgery in Sweden from 2008 though 2010. SETTING: Swedish cataract surgery units participating in outcome registration of National Cataract Register. DESIGN: Cohort study. METHODS: Planned and actual postoperative refractions were analyzed for cataract procedures and preoperative and postoperative corneal astigmatism for procedures performed in 2008 though 2010. Induced astigmatism was calculated with Naeser and Behrens polar coordinates. RESULTS: Postoperative refraction was analyzed for 17 056 procedures and corneal astigmatism for 7448 procedures. Emmetropia was targeted in 78.1% of eyes and achieved in 52.7%; 43.0% had less than 1.00 diopter (D) of astigmatism. "Reading myopia" of -3.5 to -1.6 D was targeted in 7.0% of eyes and achieved in 7.8%. Planned hyperopia greater than 1.0 D or myopia greater than -3.5 D was rare. The mean absolute biometry prediction error was 0.402 D +/- 0.338 (SD) in all eyes; however, astigmatic eyes and eyes planned for myopia or hyperopia had higher biometry prediction errors. Younger patients were more often astigmatic and planned for a more myopic outcome. Preoperatively, one third of eyes had more than 1.0 D of corneal astigmatism; postoperatively this figure was largely unaltered. The mean induced astigmatism was 0.525 +/- 0.804 D in all eyes. CONCLUSIONS: Emmetropia (spherical equivalent -0.5 to + 0.5 D and <1.0 D astigmatism) is the goal in most cataract cases but was reached in only 55% of eyes planned for emmetropia. Factors precluding emmetropia included remaining corneal astigmatism and biometry prediction errors in astigmatic and ametropic eyes.
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| 4. |
- Behndig, Anders, et al.
(författare)
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Gender differences in biometry prediction error and intra-ocular lens power calculation formula
- 2014
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 92:8, s. 759-763
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo analyze changes over time in biometry prediction error (BPE) after cataract surgery with special reference to the impact of gender and the intra-ocular lens (IOL) calculation formula.MethodsAbout 65% of Swedish cataract surgery units participating in the outcome registration of the National Cataract Register (NCR) were included in this prospective register study. Data for planned and postoperative refraction and keratometry during the month of March 2004-2013 were analyzed, divided by gender. The newly introduced variables axial length and IOL calculation formula were analyzed for March 2013. Gender differences in BPE with correct sign (BPESign) and absolute biometry prediction error (BPEAbs) were compared for the Haigis' and Sanders-Retzlaff-Kraff T (SRK/T) formulas.ResultsThe BPEAbs decreased throughout the study period. In 2004-2006, the BPEAbs was larger in women than in men (p<0.05), but this difference disappeared from 2007. For 2004 through 2009, the mean BPESign was -0.1050.79D for women, but -0.003 +/- 0.73D for men. After 2009, this myopic error for women gradually diminished. The Haigis' formula performed better in women than the SRK/T formula (p<0.001); the SRK/T formula rendered a BPESign similar to that from 2004 to 2009 in women. Women had steeper corneas and shorter axial lengths than men (p<0.001).ConclusionThe myopic BPE in women - associated with steeper corneas and shorter axial lengths - is decreasing, possibly owing to an increased use of the Haigis' formula. Using the Haigis' formula to a higher extent can potentially further reduce the BPEs after cataract surgery.
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| 5. |
- Behndig, Anders, et al.
(författare)
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One million cataract surgeries : Swedish National Cataract Register 1992-2009
- 2011
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Ingår i: Journal of cataract and refractive surgery. - Fairfax,Va. : American Society of Cataract and Refractive Surgery. - 0886-3350 .- 1873-4502. ; 37:8, s. 1539-1545
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Tidskriftsartikel (refereegranskat)abstract
- This review summarizes data collected by the Swedish National Cataract Register, which now contains data pertaining to more than a million cataract surgery procedures, representing 95.6% of the surgeries performed in Sweden during 1992-2009. During this period, the rate of cataract surgery rose from 4.47 to 9.00 per 1000 inhabitants. The mean patient age increased until 1999 but has slowly decreased since then. Preoperative visual acuity has risen steadily. The distribution between the sexes was stable until 2000, after which the proportion of women slowly decreased. Registration of subjective benefit has brought new knowledge regarding indications and expectations. An improved questionnaire, Catquest-9SF has been used since 2008. The outcome register generally shows good results from the surgery. Endophthalmitis has decreased from 0.10% to below 0.040%.
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| 6. |
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| 7. |
- Bro, Tomas, et al.
(författare)
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Two point four million cataract surgeries : 30 years with the Swedish National Cataract Register, 1992-2021
- 2023
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Ingår i: Journal of cataract and refractive surgery. - : Wolters Kluwer. - 0886-3350 .- 1873-4502. ; 49:8, s. 879-884
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Forskningsöversikt (refereegranskat)abstract
- The present review summarizes data collected by the Swedish National Cataract Register (NCR), which by the end of 2021 contained data for more than 2.4 million cataract surgeries between 1992 and 2021. During these 30 years, the cataract surgery rate rose from 3700 to 12 800. The coverage of NCR is very high including 93% of all cataract procedures in Sweden between 2010 and 2021. Independently of demographic changes, the proportion of operations of patients age 60 to 79 has increased while the proportion of 80 to 90+ has decreased. The median visual acuity of the first eye planned for surgery was 0.1 decimal in 1992 and has increased to 0.5 decimal in 2021. Patient-reported outcome measures have been registered with the Catquest-9SF questionnaire since 2008, demonstrating intervention at an earlier stage, but consistently favorable outcomes. Surgical complications have decreased; endophthalmitis has decreased from 0.10% to below 0.02%, and posterior capsule rupture from 2.8% to 0.6%.
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| 8. |
- Bro, Tomas, et al.
(författare)
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Two point four million cataract surgeries: 30 years with the Swedish National Cataract Register, 1992-2021
- 2023
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Ingår i: Journal of cataract and refractive surgery. - : Wolters Kluwer. - 1873-4502 .- 0886-3350. ; 49:8, s. 879-884
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Tidskriftsartikel (refereegranskat)abstract
- The present review summarizes data collected by the Swedish National Cataract Register (NCR), which by the end of 2021 contained data for more than 2.4 million cataract surgeries between 1992 and 2021. During these 30 years, the cataract surgery rate rose from 3700 to 12800. The coverage of NCR is very high including 93% of all cataract procedures in Sweden between 2010 and 2021. Independently of demographic changes, the proportion of operations of patients age 60 to 79 has increased while the proportion of 80 to 90+ has decreased. The median visual acuity of the first eye planned for surgery was 0.1 decimal in 1992 and has increased to 0.5 decimal in 2021. Patient-reported outcome measures have been registered with the Catquest-9SF questionnaire since 2008, demonstrating intervention at an earlier stage, but consistently favorable outcomes. Surgical complications have decreased; endophthalmitis has decreased from 0.10% to below 0.02%, and posterior capsule rupture from 2.8% to 0.6%.
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| 9. |
- Chang, Anthony, et al.
(författare)
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Comparison of posterior capsule opacification and glistenings with 2 hydrophobic acrylic intraocular lenses : 5-to 7-year follow-up
- 2013
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Ingår i: Journal of cataract and refractive surgery. - : Ovid Technologies (Wolters Kluwer Health). - 0886-3350 .- 1873-4502. ; 39:5, s. 694-698
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To compare posterior capsule opacification (PCO) and glistenings 5 to 7 years after cataract surgery with implantation of 2 hydrophobic acrylic intraocular lenses (IOLs) and evaluate the effects on corrected distance visual acuity (CDVA) and contrast sensitivity. SETTING: St. Erik Eye Hospital, Stockholm, Sweden. DESIGN: Randomized clinical trial. METHODS: Cataract surgery with standard phacoemulsification was performed in 1 eye of patients. The patients were randomized to an Acrysof SA60AT (1-piece IOL group) or a Sensar AR40e (3-piece IOL group), both hydrophobic acrylic IOLs with a sharp-edged design. Five to 7 years postoperatively, retroillumination images were obtained and the PCO area and severity (area affected within the capsulorhexis and severity) were evaluated using computer software. High-contrast (100%) and low-contrast (2.5%) CDVAs were measured. The neodymium:YAG laser capsulotomy rates were recorded. Scheimpflug images were obtained to evaluate glistenings, which were graded subjectively at the slitlamp and quantified objectively by digital image analysis using computer software. RESULTS: The study enrolled 80 patients. There were no significant differences in PCO between the 2 groups. The 3-piece IOL group had significantly fewer glistenings (P<.001). There was good correlation between the subjective grading of glistenings and objective computer-processed image grading. The glistenings were not correlated with IOL power, CDVA, or contrast sensitivity. CONCLUSIONS: There were no significant differences in PCO between the 2 acrylic hydrophobic IOLs 5 to 7 years postoperatively. The 1-piece IOL group developed more glistenings than the 3-piece IOL group.
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| 10. |
- Engström, Linda, et al.
(författare)
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Lipopolysaccharide-Induced Fever Depends on Prostaglandin E2 Production Specifically in Brain Endothelial Cells
- 2012
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Ingår i: Endocrinology. - : Endocrine Society. - 0013-7227 .- 1945-7170. ; 153:10, s. 4849-4861
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Tidskriftsartikel (refereegranskat)abstract
- Immune-induced prostaglandin E2 (PGE2) synthesis is critical for fever and other centrally elicited disease symptoms. The production of PGE2 depends on cyclooxygenase-2 and microsomal prostaglandin E synthase-1 (mPGES-1), but the identity of the cells involved has been a matter of controversy. We generated mice expressing mPGES-1 either in cells of hematopoietic or nonhematopoietic origin. Mice lacking mPGES-1 in hematopoietic cells displayed an intact febrile response to lipopolysaccharide, associated with elevated levels of PGE2 in the cerebrospinal fluid. In contrast, mice that expressed mPGES-1 only in hematopoietic cells, although displaying elevated PGE2 levels in plasma but not in the cerebrospinal fluid, showed no febrile response to lipopolysaccharide, thus pointing to the critical role of brain-derived PGE2 for fever. Immunohistochemical stainings showed that induced cyclooxygenase-2 expression in the brain exclusively occurred in endothelial cells, and quantitative PCR analysis on brain cells isolated by flow cytometry demonstrated that mPGES-1 is induced in endothelial cells and not in vascular wall macrophages. Similar analysis on liver cells showed induced expression in macrophages and not in endothelial cells, pointing at the distinct role for brain endothelial cells in PGE2 synthesis. These results identify the brain endothelial cells as the PGE2-producing cells critical for immune-induced fever.
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