Abstract
Purpose :
Ocular surgery must accommodate many variations in patient anatomy. The median age for cataract extraction in the U.S. is 67 [2]. Hyperkyphosis is one anomaly that inhibits patients from laying flat on a standard surgical gurney and represents a significant challenge towards positioning for ophthalmic surgery including cataract extraction. It is estimated some variation of hyperkyphosis is prevalent in between 20% to 40% of older adults [3]. Several methods have been proposed to improve patient safety and outcome that primarily focus on positioning of patient i.e., heads-up display (HUD), bridle sutures, or a variety of positioning apparatuses [4,5]. Here we propose a novel positioning method that is also economic and can easily be implemented in virtually any standard ophthalmic surgical setting. Furthermore, we endeavor to compare outcomes of cataract surgery utilizing this novel method of positioning versus outcomes of a typical cataract surgery.
Methods :
Surgical outcomes are measured in form of key indicators typically documented in post-operative note and subsequent clinic follow-up visits. Chiefly, visual acuity and intra-ocular pressure measured at 1 week, 2 week, and 3 month follow-up visits. Qualitative indicators include presence of corneal edema, non-centered lens placement or retained native lens material. Immediate post-operative measures include cumulative dissipated energy (CDE), capsular membrane rupture, use Malyugin ring or iris hooks, and wound sutures which theoretically could serve as indicators of intra-operative challenges experienced by cataract surgeons.
Results :
Initial analysis demonstrates outcomes of patients with hyperkyphosis who received cataract surgery with the proposed novel positioning were non-inferior to outcomes of cataract surgery on non-hyperkyphotic patients.
Conclusions :
We anticipate this novel positioning method proposed by Dr. Abraham White will offer a cost-effective alternative that will improve visual outcomes for cataract patients with spinal deformations.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.