Towards the Identification and Characterization of Putative Adult Human Lens Epithelial Stem Cells.

The anterior lens epithelium has the ability to differentiate into lens fibres throughout its life. The present study aims to identify and functionally characterize the adult stem cells in the human lens epithelium. Whole mounts of lens epithelium from donor eyes (normal/cataract) were immunostained for SOX2, gap junction protein alpha 1 (GJA1), PAX6, α, β and γ-crystallins, followed by a confocal analysis.

A systematic approach to the management of microspherophakia.

Microspherophakia is a rare developmental abnormality of the crystalline lens with a myriad of ocular and systemic associations. Glaucoma is a serious complication associated with this disorder. Early identification of the disease, timely visual rehabilitation, and appropriate management of the lens and glaucoma can help us prevent blindness from this condition.

Reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic.

Purpose: To analyze the reasons for delay in cataract surgery in patients with advanced cataracts during the COVID-19 pandemic.

Methods: This was a prospective, cross-sectional, multicenter questionnaire study which included patients with mature cataract, nuclear sclerotic cataract grade IV, and cataracts with best corrected visual acuity (BCVA) <5/60, during the COVID-19 pandemic from December 2020 to April 2021. Reasons for delay in presentation to the hospital were analyzed.

Three Learning Organizations in Cataract Surgery: The Example of Intracameral Antibiotic Injection.

Background: The recent systematic adoption of intracameral antibiotic injection during cataract surgery in Sweden, India, and the US serves as a model for the successful transitioning of local quality improvement initiatives to organization-wide implementation. Although the delivery of eye care in the 3 countries is distinctly organized with differing governances and technological infrastructure, each contains elements of a learning organization (ie, an organization that has adopted a culture of creating, acquiring, and transferring knowledge into practice through system-level and clinician-level change).

Methods: We describe a retrospective and organizational implementation study of intracameral antibiotic injection in Sweden, through the efforts of the National Cataract Registry; in the US by Kaiser Permanente; and in India by the Aravind Eye Hospital System.

Changing operating room practices: the effect on postoperative endophthalmitis rates following cataract surgery.

Purpose: To determine whether four new operating room (OR) protocols instituted because of COVID-19 reduced the cataract surgical postoperative endophthalmitis rate (POE).

Design: Retrospective, sequential, clinical registry study.

Methods: 85 552 sequential patients undergoing cataract surgery at the Aravind Eye Hospitals between 1 January 2020 and 25 March 2020 (56 551 in group 1) and 3 May 2020 and 31 August 2020 (29 011 in group 2).

Acute postoperative endophthalmitis after resurgery following primary cataract surgery: 9 years experience from a tertiary eyecare center.

Purpose: To report the incidence, risk factors, and visual outcomes of acute postoperative endophthalmitis in patients undergoing resurgery after cataract surgery.

Setting: Tertiary eye hospital in southern India.

Design: Retrospective, clinical registry.

Dropped Nucleus during Cataract Surgery in South India: Incidence, Risk Factors, and Outcomes.

Purpose: To determine incidence, risk factors for, and outcomes of dropped nucleus (DN) during cataract surgery.

Methods: This is a matched case-control study at the Aravind Eye Hospital in Madurai, India. Out of 184 consecutive DN cases, 171 were included.

Differences Between Male and Female Residents in Case Volumes and Learning in Cataract Surgery.

Objective: It is important that ophthalmology residency programs are structured to provide opportunities for all residents to gain adequate surgical experience. The aim of this study is to examine differences between female and male residents in number of cataract surgeries performed, surgical outcomes, and rate of learning, and to draw implications for the training of ophthalmology residents.

Design: In this hospital-based retrospective cohort study we examined the cumulative number of surgeries performed, and the intraoperative complications rate, of male and female residents over time.

Comparison of surgical repositioning rates and outcomes for hydrophilic vs hydrophobic single-piece acrylic toric IOLs.

Purpose: To evaluate the comparative rotational stability and the repositioning rates and outcomes of a hydrophilic and hydrophobic acrylic monofocal toric intraocular lens (IOLs).

Setting: Single center, Aravind Eye Hospital in Madurai, India.

Design: Retrospective cohort study.

Seven-year trends in cataract surgery indications and quality of outcomes at Aravind Eye Hospitals, India.

Purpose: To report trends in cataract surgery indications, visual acuity outcomes, complication rates and reoperation rates at ten Aravind Eye Hospitals in Tamil Nadu, India.

Methods: In this retrospective database study we analyzed seven years of data of cataract surgeries at Aravind during January 1, 2012 to December 31, 2018. Our main outcome measures were preoperative and 1-month postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA); and rates of intraoperative complications and reoperations.

The Aravind Pseudoexfoliation Study: 5-Year Postoperative Results. The Effect of Intraocular Lens Choice and Capsular Tension Rings.

Purpose: We compared rates of intraocular lens (IOL) decentration, neodymium-doped yttrium aluminum garnet capsulotomy for posterior capsule opacification (PCO), and visual acuity (VA) in eyes with and without pseudoexfoliation (PEX) 5 years after undergoing cataract surgery.

Design: Prospective comparative interventional study.

Methods: This multicenter study population included 1 eye of both 930 cataract patients with and 470 cataract patients without uncomplicated PEX (no small pupils or phacodonesis) all undergoing phacoemulsification by experienced Aravind Eye Care System surgeons.

Endophthalmitis reduction with intracameral moxifloxacin in eyes with and without surgical complications: Results from 2 million consecutive cataract surgeries.

Purpose: To analyze the posterior capsule rupture (PCR) rates among staff and trainee cataract surgeons, and the postoperative endophthalmitis (POE) rates in uncomplicated and complicated eyes both with and without intracameral moxifloxacin prophylaxis (ICMP).

Setting: Ten regional Aravind Eye Hospitals in India.

Design: Retrospective multicenter clinical registry within a single hospital network.

The Aravind Pseudoexfoliation Study: Surgical and First-Year Postoperative Results in Eyes without Phacodonesis and Nonmiotic Pupils.

Purpose: To compare intraoperative complication rates, 1-year visual outcomes, and postoperative complication rates over the first postoperative year in eyes with and without pseudoexfoliation undergoing cataract surgery.

Design: Prospective, comparative, interventional study.

Participants: Nine hundred thirty eyes with cataract and uncomplicated pseudoexfoliation (without phacodonesis, clinically shallow anterior chambers, or pupil size <4 mm) and 476 controls with cataract but without pseudoexfoliation recruited from 4 centers of the Aravind Eye Care System in Southern India.

Residents' Learning Curve for Manual Small-Incision Cataract Surgery at Aravind Eye Hospital, India.

Purpose: The goal of this study was to document the resident learning curve for manual small-incision cataract surgery (MSICS) and to identify implications for the design of ophthalmology residency programs aimed to train surgeons for developing countries.

Design: Hospital-based retrospective cohort study.

Participants: All 38 residents entering 2 postgraduate residency programs at Aravind Eye Hospital, Madurai, in 2012 and 2013.

Development of a rapid point-of-care patient reported outcome measure for cataract surgery in India.

Background: For patient undergoing cataract surgery in India, existing patient-reported outcome (PRO) measures are either not culturally relevant, have not been adequately validated, or are too long to be used in a busy clinical setting. We sought to develop and validate a brief and culturally relevant point-of-care PRO measure to address this need.

Methods: Twelve items from the Indian Visual Functioning Questionnaire (IND-VFQ) were selected based on preliminary data.

Mapping standard ophthalmic outcome sets to metrics currently reported in eight eye hospitals.

Background: To determine alignment of proposed international standard outcomes sets for ophthalmic conditions to metrics currently reported by eye hospitals.

Methods: Mixed methods comparative benchmark study, including eight eye hospitals in Australia, India, Singapore, Sweden, U.K.

Antibiotic prophylaxis in cataract surgery - An evidence-based approach.

Various protocols are being followed for endophthalmitis prophylaxis in cataract surgery, and this subject continues to be a matter of debate. We summarize the most recent evidence-based studies on this topic with additional stress on intracameral (IC) antibiotic prophylaxis. Here, we discuss several large, international clinical studies which discuss the efficacy, adoption, safety, cost, and newer trends in antibiotic prophylaxis.

Intracameral antibiotics during cataract surgery: evidence and barriers.

Purpose Of Review: There is continuing debate regarding the safety, efficacy, and necessity of intracameral antibiotics to prevent postoperative endophthalmitis. We summarize the most recent evidence-based publications that either support or caution against this practice.

Recent Findings: Several additional large, international retrospective clinical studies found a significant reduction in endophthalmitis rates with intracameral antibiotic prophylaxis.