Publications by authors named "Mary Gilbert Lawrence"

2 Publications

  • Page 1 of 1

Glaucoma following cataract surgery in children: surgically modifiable risk factors.

Trans Am Ophthalmol Soc 2005 ;103:46-55

Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, USA.

Purpose: To determine the incidence of glaucoma following cataract surgery in children and to identify surgically modifiable risk factors that may influence the development of glaucoma in these eyes.

Methods: All lensectomies performed in patients 18 years old or younger over a 7-year period (1995 through 2001) were identified by conducting a database search. A retrospective chart review was performed for every patient identified. Data extraction included patient's age at surgery, intraocular lens implantation at cataract extraction, date of glaucoma onset, and length of follow-up. Statistical methods included risk ratio calculations and Kaplan-Meier analyses for the "time to glaucoma" for eyes undergoing lensectomy.

Results: We identified 116 eyes of 79 children in whom lensectomy was performed. The median age at cataract surgery was 178 days (approval 6 months). Mean follow-up time was 2.7 years. The overall incidence of glaucoma was 11%. Kaplan-Meier analysis demonstrated that eyes operated on at less than 30 days of age were statistically more likely to develop glaucoma than eyes operated on at age 30 days or older (P < .001). For those operated on at less than 30 days of age, the risk ratio was 11.8 for subsequent glaucoma development compared with those operated on at 30 days of age or older. Forty-nine eyes (42%) had primary intraocular lens implantation, and none of these developed glaucoma (P = .001).

Conclusions: Timing of surgery at less than 30 days of age and lack of implantation of an intraocular lens at lensectomy were both associated with an increased risk of subsequent glaucoma. Knowledge of modifiable risk factors is essential to allow ophthalmic surgeons to make cogent decisions regarding the care of children with cataracts.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447558PMC
December 2006

The accuracy of digital-video retinal imaging to screen for diabetic retinopathy: an analysis of two digital-video retinal imaging systems using standard stereoscopic seven-field photography and dilated clinical examination as reference standards.

Trans Am Ophthalmol Soc 2004 ;102:321-40

Department of Ophthalmology, University of Minnesota, and Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.

Purpose: To evaluate the accuracy of two digital-video retinal imaging (DVRI) systems to detect diabetic retinopathy.

Methods: A prospective, masked, technology assessment was conducted for two DVRI systems at a tertiary care Veterans Affairs Medical Center. Group A (n = 151 patients) was imaged with a 640x480 resolution system and group B (n = 103 patients) with an 800x600 resolution system. Four retinal evaluations were performed on each patient: DVRI with undilated pupils using one imaging field (U-DVRI), DVRI with dilated pupils using three imaging fields (D-DVRI), dilated clinical examination, and Early Treatment Diabetic Retinopathy Study stereoscopic seven-field photography (ETDRS-P). Two analyses of accuracy were conducted, one using ETDRS-P as a "gold standard" (ETDRS-GS) and one using dilated clinical examination as a "gold standard" (C-GS).

Results: For group A, using the ETDRS-GS, sensitivities of U-DVRI and D-DVRI were 0.66 and 0.66; specificities of U-DVRI and D-DVRI were 0.66 and 0.86. Using the C-GS, sensitivities of U-DVRI and D-DVRI were 0.79 and 0.80; specificities of U-DVRI and D-DVRI were 0.68 and 0.85. For group B, using the ETDRS-GS, sensitivities of U-DVRI and D-DVRI were 0.76 and 0.85; specificities of U-DVRI and D-DVRI were 0.45 and 0.80. Using the C-GS, sensitivities of U-DVRI and D-DVRI were 0.81 and 0.87; specificities of U-DVRI and D-DVRI were 0.45 and 0.69. For both groups, dilation significantly improved specificities.

Conclusions: The 800x600 resolution DVRI system offers an accurate method of detecting diabetic retinopathy, provided there is adequate pupillary dilation and three retinal images are taken. DVRI technology may help facilitate retinal screenings of growing diabetic populations.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1280108PMC
April 2005
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