ライフサイエンスコーパス: macular edema

1 measured by the incidence of POE and cystoid macular edema.

2 age-related macular degeneration or diabetic macular edema.

3 reated with Dexamethasone implant 0.7 mg for macular edema.

4 eration, retinal vein occlusion and diabetic macular edema.

5 of spreading capillary loss with associated macular edema.

6 macotherapy for treatment of CRVO-associated macular edema.

7 er factors is an important cause of diabetic macular edema.

8 to treatment in severely affected eyes with macular edema.

9 illary nonperfusion in eyes without diabetic macular edema.

10 71 (38) microm in the 7 exposed eyes without macular edema.

11 age-related macular degeneration or diabetic macular edema.

12 e largest increases at the time of recurrent macular edema.

13 ce of proliferative diabetic retinopathy and macular edema.

14 ce of proliferative diabetic retinopathy and macular edema.

15 graphs gradable for diabetic retinopathy and macular edema.

16 growth factor for the treatment of diabetic macular edema.

17 betic retinopathy in the absence of diabetic macular edema.

18 75%) had visual acuity of 20/70 or worse and macular edema.

19 cause ocular adverse effects such as cystoid macular edema.

20 possibly independent indicators of recurrent macular edema.

21 ns during 6 months in patients with diabetic macular edema.

22 apy, as initial treatment for RVO-associated macular edema.

23 with a greater likelihood of improvement in macular edema.

24 VO and HRVO patients receiving treatment for macular edema.

25 nable-to-determine result for retinopathy or macular edema.

26 y may prevent the postoperative worsening of macular edema.

27 ntral macula with or without typical cystoid macular edema.

28 r leakage observed in patients with diabetic macular edema.

29 l coherence tomography detection of diabetic macular edema.

30 retinopathy (DR) in the absence of diabetic macular edema.

31 age-related macular degeneration or diabetic macular edema.

32 increased vascular permeability in diabetic macular edema.

33 ly lower in the DRL of subjects with uveitic macular edema.

34 epiretinal membrane (0.16/EY), and recurrent macular edema (0.09/EY).

35 Primary outcome measure was resolution of macular edema 1 month after injection as measured by dec

36 and serum samples of patients with diabetic macular edema (1.6-fold) measured by Western blot and EL

37 retained cortical fragment (1 [4%]), cystoid macular edema (2 [8%]), and IOL subluxation (3 [13%]) ow

38 ncidence of proliferative retinopathy and of macular edema, 2 important causes of visual impairment i

39 ferative diabetic retinopathy (NPDR) without macular edema, 20 eyes had proliferative diabetic retino

40 309 (78) microm in the 6 eyes with diagnosed macular edema, 279 (23) microm in the fellow eyes, and 2

41 f 124 eyes analyzed, 60 (48.4%) had diabetic macular edema, 32 (25.8%) had neovascular age-related ma

42 d macular degeneration (12.9%), and diabetic macular edema (5.6%).

43 rticipants; 95% CI, 36.6%-39.4%) followed by macular edema (7% of participants; 95% CI, 6.3%-7.7%).

44 The major complications included macular edema (91%), cataract (93%), glaucoma (35%), and

45 retinal vascular permeability contributes to macular edema, a leading cause of vision loss in eye pat

46 tacle-corrected visual acuity, resolution of macular edema, adverse events, subgroup analysis by anat

47 Treatment-naive eyes with macular edema after BRVO were included in the study if t

48 han grid laser photocoagulation in eyes with macular edema after BRVO.

49 Cystoid macular edema after cataract surgery has a tendency to r

50 ased RR (RR, 1.80; 95% CI, 1.36-2.36) of new macular edema after surgery.

51 ields were obtained at the time of recurrent macular edema and analyzed retrospectively.

52 mized trial data on 660 adults with diabetic macular edema and decreased VA (Snellen equivalent, appr

53 of 9 mg/0.1 mL was associated with transient macular edema and diminished visual acuity in 6 of 13 ex

54 d doses of 15 mg or more twice daily reduced macular edema and improved vision in some patients.

55 ne acetonide (IVTA) is effective at reducing macular edema and improving visual acuity in participant

56 steroids, and procedures primarily targeting macular edema and neovascularization.

57 participants) with center-involved diabetic macular edema and no preexisting open-angle glaucoma, 26

58 In eyes with center-involved diabetic macular edema and no prior open-angle glaucoma, repeated

59 tion significantly declined for treatment of macular edema and proliferative retinopathy.

60 The median interval between onset of macular edema and proton beam therapy was 1.7 months (ra

61 ing the search terms diabetic retinopathy OR macular edema AND stroke OR cerebrovascular disease OR c

62 having diabetic retinopathy without diabetic macular edema and underwent fluorescein angiography and

63 jections every 8 weeks maintained control of macular edema and visual benefits through week 52.

64 ibercept Injection in Patients With Diabetic Macular Edema) and VIVID (Intravitreal Aflibercept Injec

65 ibercept Injection in Patients With Diabetic Macular Edema) and VIVID (Intravitreal Aflibercept Injec

66 iferative diabetic retinopathy (PDR) without macular edema, and 27 eyes had diabetic macular edema (D

67 retinal disease, including uveitis, diabetic macular edema, and age-related macular degeneration.

68 ties, such as angle closure glaucoma, cystic macular edema, and exudative retinal detachment.

69 o 7 times for diabetic retinopathy, diabetic macular edema, and image gradability by a panel of 54 US

70 The improvement in VA, anatomic reduction of macular edema, and improvement in DR severity score with

71 change, proportion of patients with resolved macular edema, and leakage on fluorescein angiography.

72 diabetic retinopathy, clinically significant macular edema, and the need for intervention (photocoagu

73 Eyes with early subclinical macular edema are at significantly higher risk for futur

74 and ranibizumab in the treatment of diabetic macular edema are unknown.

75 ative diabetic retinopathy, and incidence of macular edema as assessed via grading of color stereo fi

76 f nonproliferative DR, proliferative DR, and macular edema, as well as stereoscopic fundus photograph

77 reatment of decreased vision attributable to macular edema associated with central retinal vein occlu

78 degradable implant approved for treatment of macular edema associated with retinal vein occlusion (RV

79 lateral synechiae, bilateral papilledema and macular edema associated with serous retinal detachment

80 Eyes with subclinical macular edema at baseline (and at 4 months after plaque

81 50%) compared with eyes without subclinical macular edema at baseline (n = 39; 30%) (P = 0.005; haza

82 nalysis, factors associated with subclinical macular edema at baseline were increasing tumor diameter

83 affected by uveitis, even in the presence of macular edema, at least in the early stage of the inflam

84 xudative age-related macular degeneration or macular edema attributable to retinal vein occlusion.

85 -VEGF treatment, but longer mean duration of macular edema before randomization (18 months vs. 1 mont

86 rative retinopathy or clinically significant macular edema, both of which require timely intervention

87 vision in eyes with center-involved diabetic macular edema, but the relative effect depended on basel

88 Diabetic macular edema causes impairment of vision in patients wi

89 trast to the rapid effects of ranibizumab on macular edema, changes in HE area were more gradual.

90 for uveal melanoma demonstrated OCT-evident macular edema, clinically evident radiation maculopathy,

91 Current treatments for cystoid macular edema (CME) in retinitis pigmentosa (RP) are not

92 Cystoid macular edema (CME) in retinitis pigmentosa (RP) has bee

93 Cystoid macular edema (CME) occurred in 5 eyes (0.87%): 3 in gro

94 a vitreous haze score of >/=1.5+ or cystoid macular edema (CME) of >300 mum were enrolled.

95 y (VA), complications, resolution of cystoid macular edema (CME), and anterior chamber and vitreous i

96 ersistent fetal foveal architecture, cystoid macular edema (CME), intraretinal exudates and subretina

97 ual acuity (VA) in eyes with uveitic cystoid macular edema (CME).

98 ar pressure (IOP) increase (n = 12), cystoid macular edema (CME; n = 3), and nonarteritic anterior is

99 ETDRS] of 55 letters or better); (2) cystoid macular edema (CMO), foveal thickness, and macular volum

100 o macular ischemia, and has a higher risk of macular edema compared to eyes with no vasculitis.

101 Retinal vasculitis had twice the risk of macular edema compared to the non-vasculitis group.

102 ved over time such that the proportions with macular edema converged in the 2 groups by 36 months and

103 nce of DME, including clinically significant macular edema (CSME), on monocular fundus photographs us

104 proliferative DR, or clinically significant macular edema (CSME).

105 for the detection of clinically significant macular edema (CSME).

106 oliferative DR [PDR], clinically significant macular edema [CSME], or both who had evidence of retina

107 Patients with neovascular AMD and persistent macular edema despite fixed-interval intravitreous anti-

108 We identified incident macular edema diagnoses that had been recorded 5 to 120

109 d hyperemia and swelling of the optic nerve, macular edema, diffuse intraretinal hemorrhages, and dil

110 tinopathy (n = 9) and patients with diabetic macular edema (DME) (n = 31) were compared with healthy

111 0.7) was approved for treatment of diabetic macular edema (DME) after demonstration of its efficacy

112 The prevalence of persistent diabetic macular edema (DME) after months of anti-vascular endoth

113 Patients with diabetic macular edema (DME) are at high risk of vascular complic

114 d characterization of patients with diabetic macular edema (DME) are important for individualizing tr

115 (VA 20/32 or worse) center-involved diabetic macular edema (DME) at baseline were required to receive

116 a shorter duration of diabetes and diabetic macular edema (DME) at baseline, were less likely to hav

117 l aflibercept injections (IAIs) for diabetic macular edema (DME) during the phase III VISTA DME trial

118 owth factor (anti-VEGF) therapy for diabetic macular edema (DME) favorably affects diabetic retinopat

119 Diagnosing diabetic macular edema (DME) from monocular fundus photography vs

120 nibizumab (0.3 mg) for treatment of diabetic macular edema (DME) involving the center of the retina a

121 al dexamethasone implant therapy in diabetic macular edema (DME) is associated with long-term outcome

122 Diabetic macular edema (DME) is the major cause of vision loss in

123 t, bevacizumab, and ranibizumab for diabetic macular edema (DME) might influence interpretation of st

124 potential effect of treatments for diabetic macular edema (DME) on driving should be of value to pat

125 pro-permeability factors (PPFs) in diabetic macular edema (DME) patients before and after injection

126 ic fundus photographs, we evaluated diabetic macular edema (DME) progression and DR progression.

127 thly dosing period) (2q8) and other diabetic macular edema (DME) therapies at doses licensed outside

128 sham in the first-line treatment of diabetic macular edema (DME) to inform technology assessments suc

129 erity score (DRSS) in patients with diabetic macular edema (DME) treated with intravitreal ranibizuma

130 VEGF) medicines have revolutionized diabetic macular edema (DME) treatment.

131 Patients with diabetic macular edema (DME) who received sham control or FAc 0.2

132 hout macular edema, and 27 eyes had diabetic macular edema (DME) with either NPDR or PDR.

133 tional characteristics in eyes with diabetic macular edema (DME) with subfoveal neuroretinal detachme

134 growth factor therapy in eyes with diabetic macular edema (DME) with vision loss after macular laser

135 growth factor therapy in eyes with diabetic macular edema (DME) with vision loss after macular laser

136 erative DR (NPDR), 51 with NPDR and diabetic macular edema (DME), and 18 with proliferative DR (PDR)-

137 Retinal hypoxia also contributes to diabetic macular edema (DME), and because of the absence of good

138 related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) we

139 related macular degeneration (AMD), diabetic macular edema (DME), central and branch retinal vein occ

140 kening of the center of the retina, diabetic macular edema (DME), is the most common cause of visual

141 herapeutic target for patients with diabetic macular edema (DME), perhaps in combination with current

142 elated macular degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusion, choroidal n

143 f varying severity, with or without diabetic macular edema (DME), using en face Doppler OCT.

144 Diabetic retinopathy, diabetic macular edema (DME), vision-threatening diabetic retinop

145 peripheral vision loss or worsening diabetic macular edema (DME).

146 tivity of AKB-9778 in patients with diabetic macular edema (DME).

147 d meta-analysis of dyslipidemia and diabetic macular edema (DME).

148 current or resolved center-involved diabetic macular edema (DME).

149 t changes in treatment paradigm for diabetic macular edema (DME).

150 ith or without concomitant baseline diabetic macular edema (DME).

151 f 456 patients with center-involved diabetic macular edema (DME).

152 e study of diabetic retinopathy and diabetic macular edema (DME).

153 iabetic retinopathy (DR), including diabetic macular edema (DME).

154 otocoagulation for center-involving diabetic macular edema (DME).

155 ated macular degeneration (AMD) and diabetic macular edema (DME).All patients were operated at a smal

156 acular degeneration (AMD, n = 400), diabetic macular edema (DME, n = 400), or retinal vein occlusion

157 2 diabetes and severe stages of DR (diabetic macular edema [DME] and proliferative diabetic retinopat

158 [NPDR], proliferative DR [PDR], or diabetic macular edema [DME]) or "any DR" (further subclassified

159 age-related macular degeneration or diabetic macular edema does not respond to an initial anti-vascul

160 age-related macular degeneration or diabetic macular edema does not respond to an initial anti-vascul

161 nited States, and included 362 patients with macular edema due to central retinal or hemiretinal vein

162 Among patients with macular edema due to central retinal or hemiretinal vein

163 d safety of aflibercept for the treatment of macular edema due to central retinal vein occlusion.

164 injectable suspension (CLS-TA), in eyes with macular edema due to retinal vein occlusion (RVO).

165 th Intravitreal Aflibercept in Subjects with Macular Edema Due to Retinal Vein Occlusion (TANZANITE)

166 s not alter choroidal thickness in eyes with macular edema due to RVO, but may result in expansion of

167 38 eyes of 38 treatment-naive patients with macular edema due to RVO, enrolled in the prospective Su

168 e detected in aqueous in untreated eyes with macular edema due to RVO.

169 5 pregnant women who presented with diabetic macular edema during pregnancy in the period from 2011 t

170 e processes, including postoperative cystoid macular edema, epiretinal membrane formation, macular fo

171 uring the Fluocinolone Acetonide in Diabetic Macular Edema (FAME) A and B Phase III clinical trials.

172 ts with vision loss in 1 eye attributable to macular edema following BRVO were recruited from 5 insti

173 of ranibizumab in the treatment of diabetic macular edema has been proven with large clinical trials

174 nterval {CI}, 2.15-4.35], P < .001), cystoid macular edema (HR = 2.87 [95% CI, 1.41-5.82], P = .004),

175 % CI, 0.99-3.17], P = .06), the incidence of macular edema (HR, 1.04 [95% CI, 0.83-1.29], P = .74; OR

176 Macular edema improved equally with longer follow-up.

177 By 2-years' follow-up, macular edema improved in 71% of eyes and resolved in 60

178 Although macular edema improved significantly more often with imp

179 ty, central subfield thickness, and rates of macular edema improvement (>20% reduction in central sub

180 atment groups in the proportion of eyes with macular edema improving (systemic therapy vs. implant, 6

181 occlusive vasculitis in 59 eyes (25.4%), and macular edema in 42 eyes (18.1%).

182 429 episodes of recurrent macular edema in 80 eyes were examined.

183 age-related macular degeneration or diabetic macular edema in a 9-member retinal specialty private pr

184 ctious and nontumoral uveitis complicated by macular edema in at least 1 eye.

185 ly on central subfield thickness to quantify macular edema in central and branch retinal vein occlusi

186 A cut-off CFT value for treatment of macular edema in IU, in the presence of other relevant m

187 gnosis of cystoid macular edema or new-onset macular edema in patients with diabetes, recorded by a h

188 abetic retinopathy or clinically significant macular edema in patients with various initial retinopat

189 tection of diabetic retinopathy and diabetic macular edema in retinal fundus photographs.

190 ying pathophysiologic foundation for cystoid macular edema in retinal vascular diseases.

191 Cystoid macular edema in retinal vein occlusion occurred in rela

192 e early detection and treatment of recurrent macular edema in retinal vein occlusion.

193 nges that were hyperautofluorescent, cystoid macular edema in the inner nuclear layer, no light rise

194 baseline, 164 patients (54%) had subclinical macular edema in the involved eye.

195 te key clinical observations of ischemia and macular edema in the posterior pole and ischemia in the

196 he initial DEX implant, the mean duration of macular edema in treatment-naive patients was 4.9 months

197 wn to prevent the recurrence or worsening of macular edema in uveitic patients with a history of CME

198 Diabetic macular edema involving the foveal center that presented

199 Diabetic macular edema involving the foveal center was observed b

200 ults (mean age, 61+/-10 years) with diabetic macular edema involving the macular center to receive in

201 Macular edema is a common cause of visual loss at uveiti

202 Pseudophakic cystoid macular edema is an important cause of visual decline af

203 Pseudophakic cystoid macular edema is common after phacoemulsification catara

204 Subclinical macular edema is common in eyes with uveal melanoma befo

205 Diabetic macular edema is one of the leading causes of vision los

206 Macular edema is the leading cause of vision loss in bil

207 litis and low-grade vitritis with or without macular edema may have birdshot chorioretinopathy eviden

208 vitreoretinal traction (57.1%), and chronic macular edema (ME) (71.4%).

209 fficacy variables were: patients (%) in whom macular edema (ME) developed (>/=30% increase from preop

210 Macular edema (ME) is the leading cause of decreased vis

211 Macular edema (ME) prognosis and treatment response vary

212 erapeutic alternatives for the management of macular edema (ME) secondary to branch retinal vein occl

213 cteristic retinal vascular lesions including macular edema (ME), a leading cause of vision loss in DR

214 retinal vein occlusion (BRVO) complicated by macular edema (ME).

215 d frequent topical steroids for postsurgical macular edema (ME).

216 luid in the retina [i.e., the development of macular edema, (ME)].

217 phthalmoscopic examination features included macular edema, mild intraretinal pigment migration, and

218 inal neovascularization (n = 1), and cystoid macular edema (n = 1).

219 53 and/or presence of clinically significant macular edema; n = 95) using the modified Airlie House c

220 cident proliferative diabetic retinopathy or macular edema, nor of statin use with decreased incidenc

221 e not associated with clinically significant macular edema (NPA, P = 0.99; NPI, P = 0.67), nor correl

222 Cystoid macular edema observed on SD OCT in very preterm infants

223 Pseudophakic macular edema occurs commonly after phacoemulsification

224 al coherence tomography (OCT) showed cystoid macular edema on both eyes.

225 A (88.9% vs 62.5%, P = .05), and presence of macular edema on OCT (33.3% vs 6.2%, P = .04).

226 presence of morphologic features of diabetic macular edema on Spectralis optical coherence tomography

227 sociated with a high prevalence of cataract, macular edema, optic disc atrophy, and glaucoma.

228 Patients with a history of retinopathy and macular edema or a current diagnosis indicating ophthalm

229 x implant whenever there was a recurrence of macular edema or a decrease in best-corrected visual acu

230 ical susceptibility to postoperative cystoid macular edema or exacerbation of choroidal neovasculariz

231 Diagnosis of cystoid macular edema or new-onset macular edema in patients wit

232 low-density lipoprotein and the incidence of macular edema or the worsening of diabetic retinopathy i

233 Black race was associated with a risk of macular edema (OR, 2.86; 95% CI, 1.41-5.79).

234 A literature search for "diabetic macular edema" or "diabetic maculopathy" was performed u

235 abetic retinopathy or worse, the presence of macular edema, or an unable-to-determine result for reti

236 rse diabetic retinopathy, referable diabetic macular edema, or both, were generated based on the refe

237 Overall, on resolution of macular edema, our study suggests that in both major and

238 reatment of decreased vision attributable to macular edema owing to CRVO or HRVO.

239 y significantly reduced rates of OCT-evident macular edema (P = 0.045) and clinically evident radiati

240 15), retinal detachments (P = 0.76), cystoid macular edema (P = 0.83), or timing of complications bet

241 Diabetic macular edema patients with VMA have a greater potential

242 n for the prevention of pseudophakic cystoid macular edema (PCME) using a prospective, randomized, do

243 s (NSAIDs) on the incidence of postoperative macular edema (PME) after cataract surgery.

244 e best-corrected visual acuity, incidence of macular edema, posterior capsular opacification, epireti

245 Diabetic macular edema required the greatest number of ophthalmol

246 rovement can continue in some patients after macular edema resolves and CFT decreases stabilize.

247 changes in BCVA from baseline at 2 years by macular edema response status were: resolution, +10 lett

248 nstrated that VEGF is a major contributor to macular edema resulting from retinal vein occlusion, als

249 In patients with macular edema resulting from RVO, there was no short-ter

250 control, worsening of visual acuity, cystoid macular edema, retroprosthetic membrane formation, persi

251 sual acuity (BCVA) in retinal vein occlusion macular edema (RVO-ME).

252 f DEX implant treatment in 289 patients with macular edema secondary to branch or central RVO (BRVO,

253 ia in patients with visual impairment due to macular edema secondary to branch retinal vein occlusion

254 inferior to aflibercept for the treatment of macular edema secondary to central retinal or hemiretina

255 led observational case study of 30 eyes with macular edema secondary to central retinal vein occlusio

256 Questionnaire (NEI VFQ-25), in patients with macular edema secondary to central retinal vein occlusio

257 gain in a broad population of patients with macular edema secondary to CRVO, including those with ma

258 cutive case study of patients with recurrent macular edema secondary to either central or branch reti

259 nd safety of DEX implant in the treatment of macular edema secondary to retinal vein occlusion (RVO)

260 Six hundred eighty-two patients with macular edema secondary to retinal vein occlusion were e

261 11 consecutive treatment-naive patients with macular edema secondary to RVO.

262 Cystoid macular edema seems to be a marker for poorer visual out

263 ing DR was defined as clinically significant macular edema, severe nonproliferative DR, or proliferat

264 ired blood-retinal barrier function leads to macular edema that is closely associated with the deteri

265 monstrated modest improvements in vision and macular edema that warrant additional investigation of t

266 the prognostic significance of postoperative macular edema, the role of prophylaxis, the risk among b

267 ome an interesting novel target for diabetic macular edema therapy.

268 and mean number of months from diagnosis of macular edema to randomization was 6 (range, 0-104 month

269 The Diabetic Macular Edema Treated with Ozurdex (DMEO) Trial measured

270 Sixteen patients with NPDR without macular edema underwent SDOCT and OCTA.

271 raded centrally for retinopathy severity and macular edema using the Early Treatment Diabetic Retinop

272 elial growth factor agents to treat diabetic macular edema warrant further assessment.

273 abetic retinopathy or clinically significant macular edema was 1.0% over 5 years among patients with

274 The mean (SD) time to resolution of macular edema was 5.2 (1.3) days; the final central subf

275 Macular edema was defined as thickening of the retina (c

276 oth central and branch occlusions, recurrent macular edema was detected in non-central macular fields

277 Macular edema was less likely to resolve in eyes that re

278 abetic retinopathy or clinically significant macular edema was limited to approximately 5% between re

279 Resolution of macular edema was more common in patients with DRSS impr

280 Diabetic macular edema was not associated with depressive symptom

281 .001]), whereas an increased risk of cystoid macular edema was not identified for those who received

282 % CI, 3.0%-6.4%), and clinically significant macular edema was observed among 2.0% (95% CI, 1.1%-3.3%

283 Macular edema was observed among 4.5% of people with dia

284 Macular edema was observed in 224 eyes (40.7%) and was a

285 One case of post-operative macular edema was observed without post-operative increa

286 which is increased in patients with diabetic macular edema, was capable of cleaving netrin-1 into the

287 sed by multiadjusted odds of retinal cystoid macular edema, was not increased for patients receiving

288 for the detection of clinically significant macular edema were 81% and 98%, respectively.

289 Individual episodes of recurrent macular edema were also examined to ascertain the freque

290 undred four eyes of 77 patients with uveitic macular edema were identified at a tertiary care center.

291 About two thirds of eyes with uveitic macular edema were observed to experience improvement in

292 raphs of 30 eyes (20 patients) with diabetic macular edema were obtained.

293 nce of proliferative diabetic retinopathy or macular edema, were identified.

294 20/40(+2), except in 1 patient with cystoid macular edema whose vision was 20/60(-) and 20/70(+1).

295 Treatment of RVO-associated macular edema with at least 2 sequential DEX implants wa

296 ith PA alone, the OR for the relationship of macular edema with PA+NSAID was 0.45 (95% CI, 0.21-0.95)

297 plexus were analyzed in relation to cystoid macular edema with retention of depth information.

298 and efficacy of treatment of RVO-associated macular edema with sequential DEX implants in clinical p

299 atment was associated with a reduced risk of macular edema with visual acuity of 20/40 or worse.

300 he main outcome measure was the diagnosis of macular edema within 90 days of cataract surgery.