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Study of the Prevalence of Glaucoma in Kazakhstan.

Klin Monbl Augenheilkd 2021 Apr 14. Epub 2021 Apr 14.

Ophthalmology, Kazakh Scientific Research Institute of Eye Diseases, Almaty, Kazakhstan.

Background: Glaucoma is one of the leading causes of permanent visual disability around the world. However, the available literature lacks data on the prevalence of glaucoma in Central Asia, particularly in the Republic of Kazakhstan.

Objective: The study was aimed at assessing the prevalence of glaucoma in the population of the Republic of Kazakhstan over 40 years old in 2019. Read More

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Large-Diameter Penetrating Keratoplasties are Mostly Due to Very Severe Infectious Keratitis and Cannot Always Prevent Secondary Enucleation.

Klin Monbl Augenheilkd 2021 Apr 14. Epub 2021 Apr 14.

Augenheilkunde, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg (Saar), Germany.

Purpose: To report the indications and outcomes of penetrating keratoplasties with a graft diameter > 8.5 mm in severe corneal diseases at the Department of Ophthalmology at Saarland University Medical Centre.

Study Design: Retrospective (6 years), descriptive, and observational. Read More

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Robotic-Assisted Unicompartmental Knee Arthroplasty Reduces Components' Positioning Differences among High- and Low-Volume Surgeons.

J Knee Surg 2021 Apr 14. Epub 2021 Apr 14.

Orthopaedic Clinic CTO, University of Florence, Florence, Italy.

Robotic-assisted medial unicompartmental knee arthroplasty (mUKA) has been introduced to improve accuracy in implant positioning and limb alignment, overcoming the reported high failure rates of conventional UKA. Indeed, mUKA is a technically challenging procedure strongly related to surgeons' skills and expertise. The purpose of this study was to evaluate the likelihood of robotic-assisted surgery in reducing the variability of coronal and sagittal component positioning between high- and low-volume surgeons. Read More

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Outcomes of Total Knee Arthroplasty in Patients with Prior Hardware: A Case-Control Study Using Handheld Navigation.

J Knee Surg 2021 Apr 14. Epub 2021 Apr 14.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Presence of hardware in juxta-articular location poses challenge during total knee arthroplasty (TKA). When present in distal femur, it precludes the use of an intramedullary femoral jig during TKA often necessitating removal of hardware leading to prolonged surgery, higher risk of complications, and inferior results. We conducted a case-control study to assess the outcome of TKA among patients with post-traumatic arthritis using a handheld navigation system to perform bone cuts allowing retention of hardware in situ. Read More

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Efficacy of Adductor Canal Blocks in Total Knee Arthroplasty.

J Knee Surg 2021 Apr 14. Epub 2021 Apr 14.

Department of Orthopaedics, Toowoomba Hospital, Toowoomba, Queensland, Australia.

Total knee arthroplasty (TKA) is associated with significant postoperative pain. The population receiving TKA is generally elderly and often have multiple comorbidities that can present a challenge to postoperative management. Safe and effective multimodal pain management has led to improved outcomes while minimizing complications and side effects. Read More

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Comparison of High CPAP versus NIPPV in Preterm Neonates: A Retrospective Cohort Study.

Am J Perinatol 2021 Apr 14. Epub 2021 Apr 14.

Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

Objective:  The aim of this study was to compare outcomes following receipt of high continuous positive airway pressure (CPAP) versus nasal intermittent positive pressure ventilation (NIPPV) in extremely preterm neonates.

Study Design:  We retrospectively compared outcomes of preterm neonates (22-28 weeks' gestation) following their first episode of either high CPAP (≥ 9 cmHO) or NIPPV. Primary outcome was failure of high CPAP or NIPPV within 7 days, as determined by either need for intubation or use of an alternate noninvasive mode. Read More

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Bioabsorbable Implant for Treatment of Nasal Valve Collapse with or without Concomitant Procedures.

Facial Plast Surg 2021 Apr 14. Epub 2021 Apr 14.

Madison ENT and Facial Plastic Surgery, New York, New York.

The aim of the study is to report outcomes after treatment of nasal valve collapse with a bioabsorbable nasal implant. It involves two prospective, multicenter, post-market studies evaluating long-term effectiveness of the LATERA implant for severe to extreme nasal obstruction. Participants underwent implant alone or with concomitant inferior turbinate reduction (ITR) and/or septoplasty. Read More

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Caudal Extension Graft of the Lower Lateral Cartilage: Technique and Aesthetic and Functional Results.

Facial Plast Surg 2021 Apr 14. Epub 2021 Apr 14.

Pontificia Universidade Catolica de Minas Gerais, Medical School, Belo Horizonte, Minas Gerais, Brazil.

Here we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. Read More

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A Comparison of Patient-Reported Outcomes in Bipedicled Total Abdominal versus Unipedicled Hemiabdominal Free Flaps for Unilateral Breast Reconstruction.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina.

Background:  While bipedicled free flaps enable increased soft tissue volume and potential for contralateral symmetry in unilateral breast reconstruction, the influence of bipedicled flap reconstruction on patient-reported outcomes remains unclear.

Methods:  Patients undergoing unilateral free flap breast reconstruction at a single institution from 2014 to 2019 were retrospectively reviewed and sent the BREAST-Q and Decision Regret Scale. Complication rates and the BREAST-Q and Decisional Regret Scale scores (0-100) were compared between patients receiving bipedicled total abdominal and unipedicled hemiabdominal free flaps. Read More

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Use of Single Chimeric Free Flaps or Double Free Flaps for Complex Head and Neck Reconstruction.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.

Background:  Free flaps have become the preferred reconstructive approach to restore form and function for patients presenting with complex head and neck defects. For composite, complex defects for which a regular free flap might not meet all reconstructive demands, adequate coverage can be achieved with either a single chimeric free flap or a double free flap.

Methods:  We performed a single-center retrospective chart review of patients who underwent either single chimeric free flap or double free flap reconstruction. Read More

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Free Flap Reconstruction of Traumatic Pediatric Foot and Ankle Defects: An Analysis of Clinical and Functional Outcomes.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri.

Background:  Traumatic lower extremity injuries involving the foot and ankle can have devastating consequences and represent a complex reconstructive challenge. To date, there are limited reports on microsurgical reconstruction for foot and ankle defects in children. This study aims to evaluate clinical and functional outcomes of free flaps for pediatric foot and ankle injuries. Read More

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A Novel Technique for Radiographic Diagnosis of Sarcopenia that Accurately Predicts Postoperative Complications in Lower Extremity Free Flap Patients.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center New Orleans, New Orleans, Louisiana.

Introduction:  Sarcopenia is linked to poor outcomes throughout the surgical literature and can be assessed on preoperative imaging to potentially aid in risk stratification. This study examined the effects of sarcopenia on surgical morbidity following lower extremity (LE) reconstruction, and also compared two methods of assessment, one of which is novel ("ellipse method").

Methods:  A retrospective cohort study of 50 patients receiving free flap-based reconstruction of the LE was performed. Read More

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The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital; Washington, District of Columbia.

Introduction:  Research in lower extremity (LE) wound management involving flap reconstruction has primarily focused on surgeon-driven metrics. There has been a paucity in research that evaluates patient-centered outcomes (PCO). This systematic review and meta-analysis examines articles published between 2012 and 2020 to assess whether reporting of functional and quality of life (QOL) outcomes have increased in frequency and cohesiveness, compared with the previous two decades. Read More

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Redefining the Reconstructive Ladder in Vulvoperineal Reconstruction: The Role of Pedicled Perforator Flaps.

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.

Background:  Gynecological reconstruction is difficult, particularly in cases with recurrence and received previous surgeries and/or radiotherapy and necessitate secondary reconstruction. Perforator flaps can preserve other donor sites for potential later reconstruction, and they also can be better tailored to the defect. We hypothesized that the use of perforator-based flaps can better restore the defect with less complications. Read More

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Do Patient Expectations of Discharge Affect Length of Stay after Deep Inferior Epigastric Perforator Flap for Breast Reconstruction?

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.

Introduction:  Deep inferior epigastric artery perforator (DIEP) flap is a common method of breast reconstruction. Enhanced recovery after surgery (ERAS) postoperative protocols have been used to optimize patient outcomes and facilitate shorter hospital stays. The effect of patient expectations on length of stay (LOS) after DIEP has not been evaluated. Read More

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Transition Services for Paediatric Inflammatory Bowel Disease; A Multicentre Study of Practice in the United Kingdom.

J Pediatr Gastroenterol Nutr 2021 Apr 12. Epub 2021 Apr 12.

Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK Department of Paediatric Gastroenterology, Sheffield Children's NHS Foundation Trust, Sheffield, UK Department of Paediatric Gastroenterology, Great Ormond Street Hospital, London, UK Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Bristol, UK Department of Paediatric Gastroenterology, The Royal Hospital for Sick Children, 9 Sciennes Rd, Edinburgh, UK Department of Paediatric Gastroenterology, Royal Hospital for Children Glasgow, 1345 Govan Road, Glasgow, UK Department of Paediatric Gastroenterology, Oxford University Hospitals, Oxford, UK Department of Paediatric Gastroenterology, Addenbrooke's Hospital, Cambridge, UK Department of Paediatric Gastroenterology, The Royal London Hospital, Barts Health NHS Trust, London, UK Department of Paediatric Gastroenterology, Alderhey Children's Hospital NHS Foundation Trust, West Derby, Eaton road, Liverpool L12 2AP,UK Department of Paediatric Gastroenterology, Birmingham Children's Hospital, Birmingham, UK Department of Paediatric Gastroenterology, St. Georges University Hospital NHS Foundation Trust, London, UK Department of Paediatric Gastroenterology, Chelsea and Westminster Hospital, 369 Fulham Road, London, UK Department of Paediatric Gastroenterology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK Department of Paediatric Gastroenterology, University Hospitals of North Staffordshire NHS Trust, Stoke-On-Trent, UK Department of Paediatric Gastroenterology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS trust, Leeds, UK Department of Paediatric Gastroenterology, Manchester Children's Hospital, Manchester, UK Department of Paediatric Gastroenterology, Nottingham Children's Hospital, Queens Medical Centre, Nottingham, UK Department of Paediatric Gastroenterology, University Hospitals of Leicester NHS Trust, Leicester, UK Department of Paediatric Gastroenterology, Evelina London Children's Hospital, UK.

Objectives: Patients with paediatric inflammatory bowel disease (IBD) constitute one of the largest cohorts requiring transition from paediatric to adult services. Standardised transition care improves short and long-term patient outcomes. This study aimed to detail the current state of transition services for IBD in the United Kingdom (UK). Read More

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Favorable Outcomes From an In-person and Online Feasibility Mindful Moment Pilot Study.

Holist Nurs Pract 2021 May-Jun 01;35(3):158-166

Rush-Copley Medical Center Aurora, Illinois (Ms Patronis); and College of Nursing (Dr Staffileno) and Center for Clinical Research and Scholarship (Dr Staffileno), Rush University Medical Center, Chicago, Illinois.

Long hours, inadequate staff, and increasingly complicated patients make nurses more vulnerable to increased levels of stress and burnout. Nurses skilled in exercising self-care practices are better equipped to manage complex clinical situations. The purpose of this pilot study was to evaluate the feasibility of short mindfulness sessions (Mindful Moment) practiced prior to a shift, available in person and online, on nurse burnout and perceived levels of stress. Read More

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Enhanced Recovery after Surgery: Benefits for the Fetal Surgery Patient.

Fetal Diagn Ther 2021 Apr 14:1-8. Epub 2021 Apr 14.

Department of Anesthesiology, Perioperative and Pain Medicine,Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.

Background: The fetoscopic approach to the prenatal closure of a neural tube defect (NTD) may offer similar advantages to the newborn compared to prenatal open closure of a NTD, with a reduction in maternal risks. Enhanced recovery after surgery (ERAS) protocols have been applied to different surgical procedures with documented advantages. We modified the perioperative care of patients undergoing in utero repair of myelomeningocele with the goal of enhancing the recovery. Read More

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COVID-19: Clinical Presentation and Prognostic Factors of Severe Disease and Mortality in the Oldest-Old Population: A Cohort Study.

Gerontology 2021 Apr 14:1-14. Epub 2021 Apr 14.

Research Area, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Sant Pere de Ribes, Barcelona, Spain.

Introduction: The oldest-old population (80 years or older) has the highest lethality from COVID-19. There is little information on the clinical presentation and specific prognostic factors for this group. This trial evaluated the clinical presentation and prognostic factors of severe disease and mortality in the oldest-old population. Read More

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Right Ventricular Dysfunction and Adverse Outcomes after Renal Transplantation.

Cardiorenal Med 2021 Apr 14:1-10. Epub 2021 Apr 14.

Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Medical School and Michigan Medicine, Ann Arbor, Michigan, USA.

Introduction: Pulmonary hypertension is common among patients with end-stage renal disease, although data regarding the impact of right ventricular (RV) failure on postoperative outcomes remain limited. We hypothesized that echocardiographic findings of RV dilation and dysfunction are associated with adverse clinical outcomes after renal transplant.

Methods: A retrospective review of adult renal transplant recipients at a single institution from January 2008 to June 2010 was conducted. Read More

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Rectal cancer: Watch-and-wait and continuing the rectal-preserving strategy with local excision for incomplete response or limited regrowth.

Surg Oncol 2021 Apr 3;37:101574. Epub 2021 Apr 3.

Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, UK.

Background: Deferral of conventional surgery for rectal cancer after neo-adjuvant chemo-radiotherapy is gaining increasing interest, particularly for patients who are too frail to undergo major surgery but also those who wish to avoid the adverse effects of major surgery. We elected to undertake a pragmatic approach to include all comers in a cohort with the aim of reflecting the clinical outcomes for patients on a deferral from conventional rectal surgery pathway, treated with neo-adjuvant chemo-radiation (CRT) with or without selective local excision (LE) offered to those who failed to demonstrate a complete clinical response (cCR).

Methods: Rectal cancer patients treated with neo-adjuvant CRT were stratified to a group of complete responders to CRT on a "watch and wait" (WW) pathway and a group who were treated with an additional local excision for persistent tumour. Read More

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Tacrolimus as a therapeutic option in patients with acquired neuromyotonia.

J Neuroimmunol 2021 Apr 7;355:577569. Epub 2021 Apr 7.

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

Objective: To analyze the clinical characteristics and outcomes of patients diagnosed with acquired neuromyotonia and who were treated with tacrolimus.

Methods: A single center, retrospective study was performed on patients with acquired meuromyotonia whose treatment included tacrolimus. The clinical information, antibody tests, and electromyography results were reviewed. Read More

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Psychological training to improve psychosocial function in patients with major depressive disorder: A randomised clinical trial.

Psychiatry Res 2021 Apr 3;300:113906. Epub 2021 Apr 3.

Department of Psychiatry and Psychotherapy, University Hospital Münster, University of Münster, Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The Universit y of Melbourne, Parkville, VIC, Australia. Electronic address:

Cognitive and emotional remediation training for depression (CERT-D): a randomised controlled trial to improve cognitive, emotional and functional outcomes in depression The aim of the current study was to evaluate an experimental treatment designed to improve psychosocial function in patients with Major Depressive Disorder (MDD) by reinforcing cognitive, emotional, and social-cognitive abilities. Participants (N = 112) with current or lifetime MDD were recruited to participate in a randomised, blinded, controlled trial. Exclusion criteria included diagnosis of a substance abuse disorder, bipolar disorder organic, eating disorders, or illness which affect cognitive function. Read More

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Economic Burden of Urinary Tract Infections From Antibiotic-Resistant Escherichia coli Among Hospitalized Adult Patients in Lebanon: A Prospective Cohort Study.

Value Health Reg Issues 2021 Apr 11;25:90-98. Epub 2021 Apr 11.

Quality and Safety Department, Nabatieh Governmental Hospital, Nabatieh, Lebanon.

Objectives: The rising incidence of urinary tract infections (UTIs) attributable to Escherichia coli resistant isolates is becoming a serious public health concern. Although global rates of infection vary considerably by region, the growing prevalence of this uropathogen has been associated with a high economic burden and health strain. This study aims: (1) to estimate the differences in clinical and economic outcomes between 2 groups of adult hospitalized patients with UTIs from E. Read More

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Non-invasive Monitoring of Uterine Electrical Activity Among Obese Patients: A New External Monitoring Device.

Am J Obstet Gynecol MFM 2021 Apr 11:100375. Epub 2021 Apr 11.

Albert Einstein College of Medicine / Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY 10461.

Background: Tocodynamometry is a common noninvasive tool used to measure contraction frequency; however, its utility is often limited in obese patients. Intrauterine pressure catheter is a more accurate measurement of uterine contractions but requires ruptured membranes, limiting its utility in early latent labor. Electrical uterine myography has shown promise as a noninvasive contraction monitor with efficacy similar to that of the intrauterine pressure catheter; however, its efficacy has not been widely studied in the obese population. Read More

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Stress urinary incontinence after urethral diverticulum repair without concomitant anti-incontinence procedure.

Urology 2021 Apr 11. Epub 2021 Apr 11.

Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110. Electronic address:

Objective: To review the rates of persistent and de novo stress urinary incontinence (SUI) following urethral diverticulum (UD) repairs performed without concomitant SUI surgical procedures.

Methods: Following IRB approval, charts of women who underwent UD excision by three FPMRS surgeons were reviewed. Data collected from the electronic medical record included demographic information, preoperative symptoms and evaluation (validated questionnaires [UDI-6, QoL]), imaging studies, operative details, post-operative symptoms, and subsequent surgical interventions. Read More

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A randomized trial of Mycobacterium w in severe presumed Gram-negative sepsis (MIST).

Chest 2021 Apr 11. Epub 2021 Apr 11.

Professor, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:

Background: Mycobacterium w (Mw), an immunomodulator, has been shown to resolve early organ failure in severe sepsis.

Research Question: Does Mw improve survival in subjects with severe presumed Gram-negative sepsis?

Study Design: and methods: This was a randomized, double-blind, placebo-controlled, parallel-group study conducted in intensive care units (ICUs) of five tertiary care centers in India. We included consecutive subjects (aged ≥18 years) with presumed Gram-negative sepsis in the study within 48 hours of the first organ dysfunction. Read More

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Vision-Targeted Health-Related Quality-of-life Survey for Evaluating Minimally Invasive Glaucoma Surgery: Minimally invasive glaucoma surgery qualify-of-life survey.

Am J Ophthalmol 2021 Apr 11. Epub 2021 Apr 11.

Stanford University School of Medicine, Stanford, CA, USA.

Purpose: To develop a vision-targeted health-related quality-of-life (HRQoL) instrument for patients with glaucoma who are candidates for minimally invasive glaucoma surgery (MIGS).

Design: Development of a health-related quality-of-life instrument.

Participants: Twelve practicing ophthalmologists and 41 glaucoma patients. Read More

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Outcomes of patients with active diabetic macular edema at the time of cataract surgery managed with intravitreal anti-VEGF injections: Outcomes of cataract surgery in active DME patients.

Am J Ophthalmol 2021 Apr 11. Epub 2021 Apr 11.

Mayo Clinic Department of Ophthalmology, Rochester, MN. Electronic address:

Purpose: To investigate the outcomes of cataract surgery in patients with active diabetic macular edema (DME) who are receiving active treatment with intravitreal anti-vascular endothelial growth factor (VEGF) injections in the perioperative period.

Design: Retrospective clinical cohort study.

Methods: All patients who underwent cataract surgery and were receiving intravitreal anti-VEGF injections from January 1, 2012 through December 31, 2017. Read More

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