ORCID Profile
0000-0003-4314-1877
Current Organisations
University of Tasmania
,
University of Sydney
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
DOI: 10.1016/J.JCRS.2014.06.025
Abstract: To compare the intraoperative complications and safety of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery. Single center. Prospective consecutive comparative cohort case series. Eyes had femtosecond laser-assisted cataract surgery (study group) or phacoemulsification (control group) by 1 of 5 surgeons. The technique comprised manual corneal incisions and capsulorhexis or laser-assisted anterior capsulotomy, lens fragmentation, corneal incisions, phacoemulsification, and intraocular lens implantation. The study group comprised 1852 eyes and the control group, 2228 eyes. Patient demographics were similar between groups. There was a significant improvement in vacuum/docking attempts, surface recognition adjustments, treatment, and vacuum time during the laser procedure in the study group. Anterior capsule tears occurred in 1.84% of eyes in the study group and 0.22% of eyes in the control group (P < .0001). There was no difference in the incidence of anterior capsule tears between the first half and second half of laser-assisted cases. Anterior capsulotomy tags occurred in 1.62% study group eyes. There was no significant difference in posterior capsule tears between the 2 groups (0.43% versus 0.18%). The incidence of significant intraoperative corneal haze and miosis was higher and the effective phacoemulsification time significantly lower in the study group (P < .001). Significant intraoperative complications likely to affect refractive outcomes and patient satisfaction were low overall. The 2 cataract surgery techniques appear to be equally safe. Although anterior capsule tears remain a concern, the safety of femtosecond-assisted cataract surgery in terms of posterior capsule complications was equal to that of phacoemulsification. No author has a financial or proprietary interest in any material or method mentioned.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.AJO.2022.01.013
Abstract: To review the literature on crystalline lens epithelial cell (LEC) removal in routine phacoemulsification and determine whether it should be incorporated as part of a surgeon's standard technique. Perspective. Expert commentary with video demonstrations on techniques of removal of LECs and associated potential complications. Discussion incorporates the importance of LEC removal, a review of techniques to prevent posterior capsular opacification (PCO), and the effects of intraocular lens design on LEC proliferation and PCO. The evidence suggests that LEC removal should be routinely performed as it can be carried out safely and with considerable short- and long-term benefits for patients. With effective cleanup, there is reduced anterior capsule opacification, fibrosis, and decentration of the capsular bag as well as reduced rates of posterior capsular opacification. Techniques for removal are easy to learn, with very low complication rates, and can reduce the risk of the long-term need for technically complex procedures such as intraocular lens explantation. LEC removal from both the anterior and posterior capsule is part of a continuous, incremental improvement of cataract surgery and should be introduced to ophthalmology trainees during their formative years as part of their regular cataract surgery armamentarium.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2015
Publisher: SAGE Publications
Date: 18-08-2021
DOI: 10.1177/11206721211039686
Abstract: As techniques for modern cataract surgery have expanded and premium intraocular lens (IOL) use is now widespread, patient expectations are high. The need for IOL explantation, whilst still low, remains an ongoing issue. Intraocular lens explantation can be challenging for a number of reasons and as such we have introduced an additional technique to add to the surgeon’s repertoire. Bimanual haptic stripping of fibrosis at the specific area where the haptic is adherent to the capsular bag is an effective strategy to aid in dissection of haptics without compromising the capsule or zonules. Given the challenges associated with IOL explantation, newly designed IOLs need to avoid these “sticking points” at which the IOLs interact with the fibrosed capsule. Techniques we have evolved and which are described below should assist anterior segment surgeons to facilitate IOL removal in an efficient and safe way.
Publisher: Informa UK Limited
Date: 13-09-2017
DOI: 10.1080/09286586.2017.1336562
Abstract: To determine the incidence and clinical phenotype of ocular tuberculosis in Australia based on the mandatory jurisdictional health notification records for TB. A whole population retrospective case series (Australia). Patients diagnosed with ocular tuberculosis were identified over the past 10 years (1 January 2006 to 31 December 2015) as recorded by in idual Health Department jurisdictions per mandatory health notifications. The incidence rates were calculated based on the available Australian census data. Incidence rates were age and sex standardized. A total of 162 cases of ocular tuberculosis were identified across Australia over a 10-year time period. Of these, 156 participants were overseas born. The 10-year Australian incidence of ocular tuberculosis was 0.77 per 100,000 people. While there has been a downward trend in overall TB annual incidence rates from 2010 to 2015, over the same period the annual incidence of ocular TB has increased compared to the 4 previous years. Descriptive clinical data regarding the ocular manifestations of TB was available in 73/157 patients. In these 73 patients the commonest manifestations of ocular TB were unspecified uveitis (50.1%), focal, multifocal or serpiginous choroiditis or chorioretinitis (12.3%) and retinal vasculitis (11.0%). Of patients with ocular TB, 4/162 (2.47%) had associated pulmonary TB and 8/162 (4.94%) had associated systemic (non-pulmonary) TB. Systemic anti-TB therapy was administered to 161 patients. The annual Australian incidence of ocular tuberculosis was 0.077 per 100,000 people. Increasing notifications in the past 6 years may demonstrate increased awareness and changing diagnostic criteria of the disease in the Australian population.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.JOCA.2012.07.019
Abstract: To assess the efficacy of thrice daily topical 4Jointz utilizing Acteev technology (a combination of a standardized comfrey extract and a pharmaceutical grade tannic acid, 3.5 g/day) on osteoarthritic knee pain, markers of inflammation and cartilage breakdown over 12 weeks. Adults aged 50-80 years (n = 133) with clinical knee OA were randomised to receive 4Jointz or placebo in addition to existing medications. Pain and function were measured using a visual analogue scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) scale at baseline, 4, 8 and 12 weeks. Inflammation was measured analysing IL-6 expression and CTX-2 presence as representative for cartilage breakdown using ELISA, at baseline and 12 weeks. Pain scores significantly reduced in the group who received 4Jointz compared to the group who received placebo after 12 weeks using both the VAS (-9.9 mm, P = 0.034) and the KOOS pain scale (+5.7, P = 0.047). Changes in IL-6 and CTX-2 were not significant (-0.04, P = 0.5 -0.01, P = 0.68). Post-hoc analyses suggested that treatment may be most effective in women (VAS -16.8 mm, P = 0.008) and those with milder radiographic osteoarthritis (OA) (VAS -16.1 mm, P = 0.009). Rates of adverse events were similar in both groups, excepting local rash that was more common amongst participants receiving 4Jointz (21% vs 1.6%, IRR 13.2, P = 0.013), but only 26% (n = 4) of participants with rashes discontinued treatment. There were no changes in systemic blood results. Topical treatment using 4Jointz reduced pain but had no effect on inflammation or cartilage breakdown over 12 weeks of treatment. Australia and New Zealand Clinical Trials registry ACTRN12610000877088.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2023
DOI: 10.1097/J.JCRS.0000000000001098
Abstract: The purpose of this article was to look at the pathophysiology behind and devise a classification system for the causes of zonular apparatus–capsular bag (ZACB) insufficiency. Also discussed is dystrophic bag syndrome, including clinical cases and addressing where it lies on the ZACB spectrum. There has been interest in the emergence of in-the-bag intraocular lens (IOL) subluxation, the prevalence of which is increasing. There has also been a recent report of dead bag syndrome, which the authors believe is part of the same disease spectrum. The authors put these phenomena into perspective and provide a classification system based on the possible causes of what they have termed ZACB insufficiency. The basic aspects of capsular bag–IOL ocular pathophysiology are summarized with a focus on functional aspects and the consequences for IOL fastening. Within this framework, dystrophic bag syndrome is a form of primary capsular ZACB insufficiency. The contribution of factors such as intraocular drugs may suggest a reconsideration of agents used and their mode of application.
Publisher: Wiley
Date: 03-08-2016
DOI: 10.1111/CEO.12801
Abstract: To determine the incidence of full thickness macular hole in the Tasmanian population. A whole population retrospective case series in Tasmania, Australia. Patients diagnosed with full thickness macular hole (confirmed by optical coherence tomography (OCT) imaging) of both idiopathic and secondary causes were identified from April 2005 to April 2011 by a sole vitreoretinal surgeon servicing Tasmania. Baseline characteristics were recorded. The six-year incidence rate was calculated, based on the 2006 and 2011 Tasmanian census data. Incidence rates were age and sex standardized. One hundred forty-seven eyes of 136 patients. To determine the incidence (age and sex standardized) of full thickness macular holes in Tasmania, Australia. Idiopathic macular holes comprised 128 (87.1%). There were 116 cases of idiopathic Full Thickness Macular Hole in one or both eyes between 1 April 2005 and 31 April 2011. The six-year incidence of idiopathic full-thickness macular holes was 24.3 per 100 000 people, 4.05 per 100 000 per year, with the highest six-year incidence observed among women aged 70-79 years. This is the first global study to report OCT confirmed incidence rates of full thickness macular holes in a relatively static Australian population sub-group.
Publisher: Wiley
Date: 07-12-2016
DOI: 10.1111/CEO.12640
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2020
DOI: 10.1097/J.JCRS.0000000000000044
Abstract: To examine the 6-month outcomes of visual performance and positional stability of a capsule-fixated intraocular lens (IOL), FEMTIS Comfort MF15, extended depth-focus (EDOF) version, after cataract surgery performed using femtosecond laser-assisted cataract surgery capsulotomy. Vision Eye Institute, Sydney, Australia. Prospective open-label postregistration data collection. Three-month and 6-month outcomes were measured including visual function, stability of IOL position, and quantitative measurement of glare and halo. Subjective patient satisfaction and spectacle independence rates were documented with a subjective questionnaire. A computer simulator was used to quantify the incidence and severity of unwanted visual phenomena allowing comparison with other EDOF and multifocal IOLs. Forty-four eyes of 25 patients were included in the study. There were 19 bilateral cases. The median shift in IOL position over 6 months (from surgery to 6 months) was 0.095 ± 0.09 mm. There was a marked improvement in uncorrected and corrected distance visual acuity from the preoperative to the 6-month mark. Patient satisfaction and spectacle independence levels were high. There was no IOL enclevation, negative dysphotopsia, decentration, or capsular phimosis. To the authors' knowledge, this is the first study to report outcomes after insertion of the FEMTIS capsulorhexis-fixated EDOF IOL. This IOL offers excellent refractive predictability, functional range of vision, and minimal unwanted visual phenomena. The attachment to the anterior capsulorhexis is shown to be stable over time with no significant shift in the position or capsular phimosis. There was high patient satisfaction with spectacle independence.
Publisher: Wiley
Date: 08-05-2014
DOI: 10.1111/CEO.12345
Publisher: Wiley
Date: 04-04-2014
DOI: 10.1111/CEO.12323
Publisher: Elsevier BV
Date: 12-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2015
DOI: 10.1016/J.JCRS.2014.10.026
Abstract: To compare changes in intraocular pressure (IOP) during femtosecond laser pretreatment of cataract between glaucomatous eyes and nonglaucomatous eyes. Launceston Eye Institute and Launceston Eye Hospital, Launceston, Australia. Nonrandomized interventional prospective case series. Patients with clinically stable primary open-angle glaucoma (POAG) having femtosecond laser pretreatment were compared with a concurrent cohort of patients with healthy eyes having the same procedure. Pretreatment was performed using a fluid-filled optical docking system (Liquid Optics Interface). With the patient supine, the IOP was measured at 4 time points using a rebound tonometer (Icare Pro). The study comprised 143 eyes of 97 patients. Forty-three eyes (30.1%) had documented glaucoma. The mean baseline IOP was 20.2 mm Hg ± 4.2 (SD) in glaucomatous eyes and 18.9 ± 4.0 mm Hg in nonglaucomatous eyes (P = .06). The mean change in IOP values between each time frame and baseline was as follows: vacuum-on, 13.8 ± 9.9 mm Hg and 11.1 ± 6.9 mm Hg, respectively (P = .06) after treatment, 17.4 ± 7.4 mm Hg and 14.1 ± 7.2 mm Hg, respectively (P = .014) after undocking of vacuum, 9.9 ± 5.4 mm Hg and 8.7 ± 5.7 mm Hg, respectively (P = .24). Femtosecond pretreatment caused a greater transient rise in IOP after treatment and a higher residual IOP after vacuum undocking in glaucomatous eyes than in nonglaucomatous eyes. This is well tolerated short term however, long-term implications for eyes with glaucoma are unknown at present. No author has a financial or proprietary interest in any material or method mentioned.
Publisher: Informa UK Limited
Date: 07-2012
DOI: 10.2147/BTT.S20659
No related grants have been discovered for Erica Darian-Smith.