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By allowing the surgeon to measure and modify corneal curvature during wound closure, intraoperative keratometry can reduce postoperative astigmatic errors. A number of keratometric devices have been developed over the last 10 years, each offering a compromise between cost, accuracy and ease of use. The Barrett keratoscope is a simple, inexpensive hand-held device which gives a qualitative indication of the degree of astigmatism. Addition of a transparent overlay, as described in this paper, sets the distance at which the keratoscope is held and allows the magnitude of the astigmatism to be determined, thereby enabling refined adjustment of the suture tension during wound closure. We describe the error in estimation of astigmatism due to the effect of the distance at which the keratoscope is held from the cornea. [ABSTRACT FROM AUTHOR]

Purpose: To describe trends, risk factors and outcomes of anterior vitrectomy during cataract and intraocular lens (IOL) surgery., Methods: All patients 16 years and older undergoing cataract and IOL surgery in Western Australia (WA) from January 1980 to December 2001 (n = 115 815) were included. Hospital administrative data were used to identify all cataract and IOL procedures and subsequent admissions for retinal detachment, IOL dislocation, endophthalmitis and pseudophakic corneal oedema. Data were validated with chart review and analysed to identify trends and risk factors for anterior vitrectomy and the risk of subsequent complications., Results: In total, 1390 (1.2%) anterior vitrectomies were performed. The rate increased with change in surgical technique. Significant risk factors for anterior vitrectomy were age <50 years (OR 1.31), male sex (OR 1.23), IOL procedure (OR 11.45) and operations in public hospitals (OR 1.99) or rural/remote (OR 1.40) areas. Anterior vitrectomy was strongly associated with increased risk of retinal detachment (RD) (RR 18.5), endophthalmitis (RR 3.6), IOL dislocation (RR 21.1) and pseudophakic corneal oedema (RR 17.3). Retinal detachments and IOL dislocations occur earlier after anterior vitrectomy., Conclusion: Anterior vitrectomy rates have remained stable since the introduction of phacoemulsification. Anterior vitrectomy is a major risk factor for serious complications compared with uncomplicated surgery, particularly RD and IOL dislocation. We identified an increasing trend in anterior vitrectomy being performed during extracapsular and IOL surgery., (© 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: Cataract is the leading cause of reversible blindness worldwide, and the incidence of cataract surgery is projected to increase as the population ages. Gaining an understanding of the effects of cataract surgery on a range of health outcomes is important for maintaining the health and safety of older adults., Methods: A before and after cohort study was conducted using the Western Australian Hospital Morbidity Data System, Mental Health Information System and the Western Australian Death Registry., Results: Of the 21 110 patients who underwent cataract surgery in one eye only, 295 had mental health contacts for depression and/or anxiety 1 year before (n = 158) or 1 year after (n = 137) surgery. Results from Poisson generalized estimating equations showed a significant decrease of 18.80% (p ≤ 0.001) in the number of mental health contacts for depression and/or anxiety the year after cataract surgery after accounting for potential confounding factors. A 27.46% increase in mental health contacts the year after cataract surgery was reported by women compared with men (95% CI: 1.08-1.50). Those living in remote areas had less contact with mental health services compared with those living in metropolitan areas (adjusted risk ratio 0.62, 95% CI: 0.46-0.84). The corresponding reduction in health care costs for treatment of depression and/or anxiety was 28%., Conclusion: Further research should be conducted to collect information on the utilization of health care resources not captured in this study, namely community-based services, visits to general practitioners and/or emergency departments as well as medication usage such as antidepressants., (© 2013 Acta Ophthalmologica Scandinavica Foundation. Published by Blackwell Publishing Ltd.)