RESUMEN
BACKGROUND: Modern day patients who undergo bilateral cataract surgery expect to be spectacles-independent after surgery. The options that are available to attain this goal are pseudophakic monovision, implanting multifocal IOLs or alternatively accommodative IOLs. The aim of this study is to establish the suitability in daily life when attaining minor monovision, named hereafter mini-monovision. MATERIAL/METHODS: In this clinical retrospective study 30 patients were examined. These subjects where bilaterally pseudophake and received either AcrySof®-IOL or Acreos® Adapt-IOL with a slight anisometropia of between 0.5 and 1.75 D and with a maximal astigmatism up to 1.5 D. Visual acuity (VA) for distance (ETDRS), intermediate (Jaeger 80 cm) and near (Jaeger 40 cm) as well as defocus curves were assessed. Furthermore were examined: the reading speed using the font size of the Radner reading chart, anisoconia (FA Oculus according to Esser), stereopsis (Titmus), subjective patient satisfaction (adapted VF-14-questionnaire) and the subjective dependence on having to wear spectacles. RESULTS: The median anisometropia was at 0.75 D; the age was between 61 and 80 (median being at 73 years). 12 patients were male and 18 female. When examined with binocular vision 100â% could attain distance VA of at least decimal 1.0 (LogMAR 0) and an intermediate VA of at least decimal 0.8 (LogMAR 0.1), up to 86.57â% a near VA of at least Jaeger 5, (LogMAR 0.4); up to 63.33â% even managed at least Jaeger 3 (LogMAR 0.3). The median average reading speed for binocular uncorrected reading under photopic conditions was 145 words/minute and under mesopic conditions 117 words/minute. The critical font size was LogRAD 0.60 (Jaeger 5-6), the anisoconia at 2â% and stereopsis at 80 arc seconds. The general dependence on glasses was reduced from 100â% preoperatively to 13â%, postoperatively. Simultaneously a high patient satisfaction score of 93.18 in the VF-14 questionnaire was attained. The result is comparable to those quoted in the literature on full monovision and mulitifocal IOLs. CONCLUSION: To attain spectacles independency, pseudophake mini-monovision is a cost efficient alternative to multifocal lenses for well selected patients. A relative reduction in near VA must be taken into account. To establish the refractive target further examinations are required. Establishing the accurate depth of vision will be helpful in attaining this.
Asunto(s)
Extracción de Catarata/efectos adversos , Lentes de Contacto Hidrofílicos , Anteojos , Implantación de Lentes Intraoculares , Seudofaquia/cirugía , Errores de Refracción/prevención & control , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Seudofaquia/diagnóstico , Seudofaquia/etiología , Errores de Refracción/diagnóstico , Errores de Refracción/etiología , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza VisualRESUMEN
This article describes the necessities, possibilities and limits of psycho-oncological treatment during the rehabilitation of patients with uro-oncologic malignancies. Studies verify the efficacy of educational and behavioral-medicine orientated interventions: improved coping, reduced burden affects, increased quality of life and a better compliance with the medical treatment.
Asunto(s)
Adaptación Psicológica , Terapia Conductista , Grupo de Atención al Paciente , Educación del Paciente como Asunto , Complicaciones Posoperatorias/psicología , Complicaciones Posoperatorias/rehabilitación , Calidad de Vida/psicología , Rol del Enfermo , Neoplasias Urogenitales/psicología , Neoplasias Urogenitales/rehabilitación , Trastorno Depresivo/psicología , Trastorno Depresivo/rehabilitación , Disfunción Eréctil/psicología , Disfunción Eréctil/rehabilitación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidad , Tasa de Supervivencia , Resultado del Tratamiento , Incontinencia Urinaria/psicología , Incontinencia Urinaria/rehabilitación , Neoplasias Urogenitales/mortalidadRESUMEN
Looking at the media one might believe there are no sexual taboos. On the contrary: People hardly discuss their own sexual experiences and behaviour. This applies in equal measure to day-to-day clinical and medical practice, although many studies definitely underline that patients do need information and counselling. The present contribution highlights a few fundamental aspects when treading on such delicate ground and provides helpful pointers.