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Dot C, Schweitzer C, Labbe A, Lignereux F, Rozot P, Goguillot M, Bugnard F, Brezin AP. Reply. Ophthalmology 2023; 130:e43-e44. [PMID: 37737813 DOI: 10.1016/j.ophtha.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/24/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Affiliation(s)
- Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.
| | - Cédric Schweitzer
- CHU Bordeaux, Department of Ophthalmology, Univ. Bordeaux, ISPED, INSERM, U1219 - Bordeaux Population Health Research Centre, Bordeaux, France
| | - Antoine Labbe
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - François Lignereux
- Department of Ophthalmology Santé Atlantique, Nantes Polyclinic, Nantes, France
| | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
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Brézin AP, Monnet D, Lignereux F, Rozot P, Jilet L, Abdoul H. Impact of a handpiece with a built-in fluidics pressure sensor on phacoemulsification: a multicentre prospective comparative study. BMJ Open Ophthalmol 2023; 8:e001431. [PMID: 37973548 PMCID: PMC10661016 DOI: 10.1136/bmjophth-2023-001431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE We assessed whether the immediate pressure adjustments provided by a phacoemulsification handpiece with a built-in pressure sensor (Active Sentry, AS) could decrease the amount of energy delivered in the eye during cataract surgery. METHODS AND ANALYSIS The Study of Active Sentry in Cataract Surgery was a multicentre prospective clinical trial. The Centurion system (Alcon Labs) was used and we compared phacoemulsifications performed with the AS handpiece with procedures using a sensor placed in the phacoemulsifier (non-AS). The primary outcome measure was the cumulative dissipated energy (CDE) used during the procedures. The secondary outcome measures were the total, longitudinal and torsional ultrasound (US) times, the duration of the surgery and the amount of fluid used during the surgeries. RESULTS The study analysed 1432 (800 AS and 632 non-AS) procedures. The mean patient age was 72.4±10.0 years. The median CDE was respectively 6.3 (IQR 3.5-9.9) and 6.7 (IQR 4.5-11.5) with and without AS (p=0.0001). The median US time was, respectively, 48.0 s (IQR 34.0-68.0) and 55.0 s (IQR 38.0-80.0) with and without AS (p<0.0001). Torsional and longitudinal US times were reduced with AS. The median duration of the procedure was, respectively, 9.0 min (IQR 7.0-12.0) and 10.0 min (IQR 7.0-13.0) (p=0.0002) with and without AS. The median balanced salt solution volume used was 52.0 cm3 (IQR 41.0-72.0) and 57.0 cm3 (IQR 42.0-81.0) with and without AS (p=0.0018). CONCLUSION The phacoemulsifications performed with a pressure sensor built in the handpiece delivered less energy in the eye and were shorter. TRIAL REGISTRATION NUMBER NCT04732351.
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Affiliation(s)
- Antoine P Brézin
- Université Paris Cité, Ophtalmologie, Hôpital Cochin, Paris, France
| | - Dominique Monnet
- Université Paris Cité, Ophtalmologie, Hôpital Cochin, Paris, France
| | | | | | - Lea Jilet
- Université Paris Cité, URC Paris Centre, Paris, France
| | - Hendy Abdoul
- Université Paris Cité, URC Paris Centre, Paris, France
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Brézin AP, Labbe A, Schweitzer C, Lignereux F, Rozot P, Goguillot M, Bugnard F, Dot C. Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study - FreYAG1 study. BMC Ophthalmol 2023; 23:417. [PMID: 37845645 PMCID: PMC10578013 DOI: 10.1186/s12886-023-03134-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
RATIONALE Nd:YAG (neodymium:yttrium-aluminum-garnet) capsulotomy (Nd:YAG-caps) is the gold standard for the treatment of PCO (Posterior Capsule Opacification). There is a lack of real-world data about Nd:YAG-caps use. PURPOSE This study's objectives were to estimate Nd:YAG-caps incidence in France, to describe the patient characteristics, and to analyze the time between surgeries and capsulotomies. SETTING The study was based on data extracted from the EGB database, a 1/97th sample representative of the French population. DESIGN observational, retrospective, cohort study using national claims data. METHODS French adult patients who underwent Nd:YAG-caps between 2014 and 2017 were selected. Main outcomes were the number of patients and procedures performed and the risk factors associated with early Nd:YAG-caps. RESULTS During the study period, Nd:YAG-caps were performed in 8,425 patients accounting for 10,774 procedures. The extrapolation to the French population led to estimate that 253.103 patients had Nd:YAG-caps, representing 312.103 procedures in 2017. The mean age at Nd:YAG-caps was 75.1 (± 10.2) years. About 36% of patients presented at least one ocular comorbidity. Nd:YAG-caps was performed within 2 years after surgery in 33.0% of patients and within one year in 9.8% of patients. Patients with Nd:YAG-caps within the first year (OR CI95 0.721 [0.673-0.772]) or in the first two years (OR CI95 0.721 [0.673-0.772]) were younger than patients with later Nd:YAG-caps and had a more frequent history of treated ocular diseases (OR 1.516 and 1.178, respectively). CONCLUSIONS This study brought new real-world and large-scale data regarding Nd:YAG-caps use and gave an updated insight into the patients' characteristics.
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Affiliation(s)
- Antoine P Brézin
- Department of Ophthalmology, Université Paris Cité, Cochin Hospital, APHP, 27 rue du faubourg Saint-Jacques, Paris, 75014, France.
| | - Antoine Labbe
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Cédric Schweitzer
- Department of Ophthalmology, CHU Bordeaux, Univ. Bordeaux, ISPED, INSERM, U1219 - Bordeaux Population Health Research Centre, Bordeaux, F-33000, France
| | | | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
| | | | | | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
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Dot C, Schweitzer C, Labbé A, Lignereux F, Rozot P, Goguillot M, Bugnard F, Brézin AP. Incidence of Retinal Detachment, Macular Edema, and Ocular Hypertension after Neodymium:Yttrium-Aluminum-Garnet Capsulotomy: A Population-Based Nationwide Study-The French YAG 2 Study. Ophthalmology 2022; 130:478-487. [PMID: 36581227 DOI: 10.1016/j.ophtha.2022.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/29/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To estimate the incidence and assess the risk factors associated with 3 adverse events (AEs) after neodymium:yttrium-aluminum-garnet posterior capsulotomy (Nd:YAG-caps): ocular hypertension (OHT), macular edema (ME), and retinal detachment (RD). DESIGN Observational cohort study using a nationwide claims database. PARTICIPANTS Adults who underwent Nd:YAG-caps between 2014 and 2017, with no ocular disease history in the year before. METHODS Patients who underwent Nd:YAG-caps were identified using data from the French national representative sample and followed up for 12 months postprocedure. The time to AE was assessed using the Kaplan-Meier method. Factors associated with AE were assessed using Cox models. MAIN OUTCOME MEASURES Neodymium:YAG-caps epidemiology, patients' characteristics, proportion of patients with AE, and hazard ratios (HRs) associated with variables identified as factors associated with AEs. RESULTS During the study period, 6210 patients received Nd:YAG-caps (7958 procedures). The mean age (± standard deviation) at Nd:YAG-caps was 75.0 (± 10.3) years. The 3-month and 12-month overall AE rates (≥ 1 AE of interest) were 8.6% and 13.3%, respectively. Among patients with ≥ 1 AE of interest, 68.4% of AEs occurred within 3 months post-Nd:YAG-caps. Three-month rates were ≈5% for OHT and ME. Retinal detachment remained ≤ 0.5% over follow-up. Cox models showed that patients with Nd:YAG-caps performed within 1 year after cataract surgery had a higher risk of AEs than those with later Nd:YAG-caps (hazard ratio [HR], 1.314 [1.034-1.669], P = 0.0256), notably ME (HR, 1.500 [1.087-2.070], P = 0.0137). Diabetic patients were more at risk of OHT (HR, 1.233 [1.005-1.513], P = 0.0448) and ME (HR, 1.810 [1.446-2.266], P < 0.0001) than nondiabetic patients. Patients with Nd:YAG-caps performed between 1 and 2 years after cataract surgery were more at risk of OHT than patients with later Nd:YAG-caps (HR, 1.429 [1.185-1.723], P = 0.0002). CONCLUSIONS According to a national claims database, OHT and ME were the most frequent AEs of interest post-Nd:YAG-caps, mainly observed within 3 months postprocedure, highlighting the need for a close follow-up during this period or a delayed capsulotomy. Diabetes and an early Nd:YAG-caps after cataract surgery were among the main drivers for AE occurrence. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.
| | - Cédric Schweitzer
- CHU Bordeaux, Department of Ophthalmology, University of Bordeaux, ISPED, INSERM, U1219-Bordeaux Population Health Research Centre, Bordeaux, France
| | - Antoine Labbé
- Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - François Lignereux
- Department of Ophthalmology Santé Atlantique, Nantes Polyclinic, Nantes, France
| | - Pascal Rozot
- Department of Ophthalmology, Juge Clinic, Marseille, France
| | | | | | - Antoine P Brézin
- Department of Ophthalmology, Cochin Hospital, APHP, Paris, France
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Katz G, Rouquette A, Lignereux F, Mourgues T, Weber M, Lundström M. Validity of the French version of Catquest-9SF and use of an electronic notepad for entering patient-reported outcome measures. Eye Vis (Lond) 2021; 8:11. [PMID: 33789766 PMCID: PMC8015069 DOI: 10.1186/s40662-021-00233-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 03/02/2021] [Indexed: 11/29/2022]
Abstract
Background The Catquest-9SF questionnaire is a patient reported outcome measure that quantifies the visual benefits from cataract surgery. The purpose of this study was to translate and adapt the Catquest-9SF questionnaire for France, to assess its psychometric properties via Rasch analysis, and to assess its validity when completed using an electronic notepad. Methods The Catquest-9SF questionnaire was translated following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Catquest-9SF and clinical data were collected from patients before and after routine cataract surgery. All questionnaire data were collected via an electronic notepad. Rasch analysis was performed to assess psychometric properties, and sensitivity to change was analysed for patients with complete paired pre- and post-operative questionnaires. Results A complete filled-in preoperative questionnaire was obtained for 848 patients. Rasch analysis showed good precision (person separation: 2.32, person reliability: 0.84), ordered category probability curves, no item misfit, and unidimensionality. The respondents were slightly more able than the level of item difficulty (targeting: −1.12 logits). Sensitivity was analysed on 211 paired questionnaires, and the postoperative questionnaires showed a clear ceiling effect. The effect size was 2.6. The use of an electronic notepad for completing the questionnaire worked out very well after some adjustments. Conclusions The French version of Catquest-9SF has good psychometric properties and is suitable for use in French-speaking patients. The use of the Catquest-9SF questionnaire in an electronic format showed good validity. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00233-7.
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Affiliation(s)
- Gregory Katz
- Chair of Innovation & Value in Health, University of Paris School of Medicine, Paris, France.,Value-Based Health Care Consortium, Paris, France.,Prom-Time, Paris, France
| | - Alexandra Rouquette
- Service de Santé Publique et d'Épidémiologie, AP-HP Paris-Saclay, Le Kremlin-Bicêtre, France.,Centre de recherche en Épidémiologie et Santé des Populations, Inserm, Université Paris-Saclay, Villejuif, France
| | | | - Thierry Mourgues
- Institut Ophtalmologique Sourdille-Atlantique, Elsan Santé Atlantique, Nantes, France
| | - Michel Weber
- Ophthalmology Department, Centre Hospitalier-Universitaire de Nantes, Nantes, France
| | - Mats Lundström
- Department of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.
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Daien V, Turpin C, Lignereux F, Belghobsi R, Le Meur G, Lebranchu P, Pechereau A. Determinants of ocular deviation in esotropic subjects under general anesthesia. J Pediatr Ophthalmol Strabismus 2013; 50:155-60. [PMID: 23451722 DOI: 10.3928/01913913-20130226-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 11/26/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE The authors attempted to identify the determinants of ocular deviation in a population of patients with esotropia under general anesthesia. METHODS Forty-one patients with esotropia were included. Horizontal ocular deviation was evaluated by the photographic Hirschberg test both in the awakened state and under general anesthesia before surgery. Changes in ocular deviation were measured and a multivariate analysis was used to assess its clinical determinants. RESULTS The mean age (± standard deviation [SD]) of study subjects was 13 ± 11 years and 51% were females. The mean spherical equivalent refraction of the right eye was 2.44 ± 2.50 diopters (D), with no significant difference between eyes (P = .26). The mean ocular deviation changed significantly, from 33.5 ± 12.5 prism diopters (PD) at preoperative examination to 8.8 ± 11.4 PD under general anesthesia (P = .0001). The changes in ocular deviation positively correlated with the pre-operative ocular deviation (correlation coefficient r = 0.59, P = .0001) and negatively correlated with patient age (correlation coefficient r = -0.53, P = .0001). These two determinants remained significant after multivariate adjustment of the following variables: preoperative ocular deviation; age; gender; spherical equivalent refraction; and number of previous strabismus surgeries (model r(2) = 0.49, P = .0001). CONCLUSIONS The ocular position under general anesthesia was reported as a key factor in the surgical treatment of subjects with esotropia; therefore, its clinical determinants were assessed. The authors observed that preoperative ocular deviation and patient age were the main factors that influenced the ocular position under general anesthesia.
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Affiliation(s)
- Vincent Daien
- Department of Ophthalmology, Hôpital Gui de Chauliac, Montpellier, France.
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Baron D, Guillemot MN, Lignereux F, Leveque R. [Management of intra-vitreous hemorrhage in diabetes]. Oftalmologia 2003; 55:70-6. [PMID: 12723183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Lignereux F, Weber M, Péchereau A. P 453 Measurement of ocular deviation by photographic analysis of the corneal reflex. Results in 15 normal subjects. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90713-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lignereux F. Measurement of ocular deviation by photographic analysis of the corneal reflex. Results in 15 normal subjects. Vision Res 1995. [DOI: 10.1016/0042-6989(95)98935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Stork L, Lignereux F, Mehel E, Péchereau A. P 175 Comparison of corneal storage at 4°C and 31°C. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90491-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mehel E, Stork L, Lignereux F, Weber M, Pechereau A. P 141 Videokeratoscopic study of central corneal topography in a population of myopes. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90457-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lignereux F, Péchereau A. P 455 Measurement of the anaesthetic test by a photographic method on a series of patients with esotropias never previously operated. Vision Res 1995. [DOI: 10.1016/0042-6989(95)90715-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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