Alex C Day

Alex C Day
University College London | UCL · Institute of Ophthalmology

PhD, FRCOphth, CertLRS, PGDip CRS (Dist), MRCOphth, DRCOphth, MB BS, BSc Hons

About

89
Publications
14,116
Reads
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1,606
Citations
Introduction
Consultant Eye Surgeon at Moorfields Eye Hospital, specialising in cataract and refractive surgery. See www.alexday.co.uk for more information
Additional affiliations
April 2019 - present
University College London
Position
  • Professor (Associate)
August 2013 - present
University College London
Position
  • NIHR Academic Clinical Lecturer
May 2007 - present
Moorfields Eye Hospital NHS Foundation Trust
Position
  • SpR Ophthalmology, Lecturer Cataract Service.

Publications

Publications (89)
Article
Purpose: To evaluate the impact of surgery restrictions on cataract surgery performance. Setting: Moorfields Eye Hospital, NHS Foundation Trust, London, UK. Design: Retrospective, observational cross-sectional study. Methods: Single-centre, retrospective review of all patients that underwent phacoemulsification surgery at Moorfields Eye Hosp...
Article
Full-text available
p>Background: associations between microvascular variation and chronic kidney disease (CKD) have been reported previously. Non-invasive retinal fundus imaging enables evaluation of the microvascular network and may offer insight to systemic risk associated with CKD. Methods: retinal microvascular parameters (fractal dimension [FD] – a measure of t...
Article
Full-text available
Purpose To examine the association of alcohol consumption and type of alcoholic beverage with incident cataract surgery in two large cohorts. Design Longitudinal observational study Participants We included 469,387 participants of UK Biobank with a mean age of 56 years, and 23,162 participants of EPIC-Norfolk with a mean age of 59 years. Methods...
Article
Full-text available
Background Cataract surgery is one of the most common operations. Femtosecond laser-assisted cataract surgery (FLACS) is a technique that automates a number of operative steps. Objectives To compare FLACS with phacoemulsification cataract surgery (PCS). Design Multicentre, outcome-masked, randomised controlled non-inferiority trial. Setting Thre...
Article
p>The diagnosis of multiple sclerosis is based on a combination of clinical and paraclinical tests. The potential contribution of retinal optical coherence tomography (OCT) has been recognized. We tested the feasibility of OCT measures of retinal asymmetry as a diagnostic test for multiple sclerosis at the community level. In this community-based s...
Article
Purpose: To report the 1 year outcomes of a randomised trial comparing femtosecond laser assisted cataract surgery (FLACS) and phacoemulsification cataract surgery (PCS). Setting: Moorfields Eye Hospital, New Cross Hospital and Sussex Eye Hospital, UK DESIGN:: Multicentre, randomised controlled non inferiority trial. Methods: 311 of 392 (79%) par...
Article
Purpose To compare the clinical outcomes in femtosecond laser assisted deep anterior lamellar keratoplasty (F-DALK) to manual non-laser deep anterior lamellar keratoplasty (M-DALK) for keratoconus in a multi-surgeon public healthcare setting. Design Single-centre, comparative, retrospective interventional case series. Methods . Population Consec...
Article
Full-text available
Current estimates suggest 50% of glaucoma blindness worldwide is caused by primary angle-closure glaucoma (PACG) but the causative gene is not known. We used genetic linkage and whole genome sequencing to identify Spermatogenesis Associated Protein 13, SPATA13 (NM_001166271; NP_001159743, SPATA13 isoform I), also known as ASEF2 (Adenomatous polypos...
Article
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Purpose To report the 3 month results of a randomised trial (FACT) comparing femtosecond laser assisted cataract surgery (FLACS) and standard phacoemulsification cataract surgery (PCS). Design Multicentre, randomized controlled trial funded by the UK National Institute of Health Research (NIHR, HTA 13/04/46/) Methods This trial took place in thre...
Article
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IMPORTANCE: Myopia is a leading cause of untreatable visual impairment and is increasing in prevalence worldwide. Interventions for slowing childhood myopia progression have shown success in randomized clinical trials; hence, there is a need to identify which children would benefit most from treatment intervention. OBJECTIVES: To examine whether ge...
Article
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Spectral-domain OCT (SD-OCT) provides high resolution images enabling identification of individual retinal layers. We included 32,923 participants aged 40–69 years old from UK Biobank. Questionnaires, physical examination, and eye examination including SD-OCT imaging were performed. SD OCT measured photoreceptor layer thickness includes photorecept...
Article
Purpose Review scientific literature concerning femtosecond laser–assisted cataract surgery. Methods Following databases were searched: CENTRAL (Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 2 of 12, June 2019), Ovid MEDLINE ® without Revisions (1996 to June 2019), Ovid MEDLINE ® (1946 to June 2019), Ovid MEDLINE ® Daily Update...
Article
Purpose To describe the distribution of corneal hysteresis (CH) in a large cohort and explore its associated factors and possible clinical applications. Design Cross-sectional study within the UK Biobank, a large cohort study in the United Kingdom. Participants We analyzed CH data from 93 345 eligible participants in the UK Biobank cohort, aged 40...
Article
Full-text available
Purpose To describe corneal astigmatism in the UK Biobank population and to look for associations with other biometric variables and socio-demographic factors. Methods This analysis included a subsample of 107,452 participants of the UK Biobank study who underwent an enhanced ophthalmic examination including autorefractor keratometry (Tomey RC 500...
Article
p>Purpose: To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell–inner plexiform layer (GCIPL) thicknesses in a large cohort. Design: Cross-sectional study. Participants: We included 42 044 participants in the UK Biobank. The mean age was 56 years. Methods: Spectral-domai...
Article
To determine whether socioeconomic status influenced the presenting visual acuity prior to first eye cataract surgery in the English National Health Service. Retrospective case series from The Royal College of Ophthalmologists’ National Ophthalmology Database Audit. In total 154,223 patients undergoing first eye cataract surgery at 68 centres in En...
Preprint
Full-text available
Purpose To describe corneal astigmatism in the UK Biobank population, to look for associations with other biometric variables and socio-demographic factors, and to report the proportion with abnormal keratometry and irregular astigmatism suggestive of pathological corneal ectasias such as keratoconus. Methods Cross-sectional data were obtained from...
Article
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p>A genetic contribution to refractive error has been confirmed by the discovery of more than 150 associated variants in genome-wide association studies (GWAS). Environmental factors such as education and time outdoors also demonstrate strong associations. Currently however, the extent of gene-environment or gene-gene interactions in myopia is unkn...
Article
p>Purpose To describe the rationale, methods and research potential of eye and vision measures available in UK Biobank. Participants UK Biobank is a large, multisite, prospective cohort study. Extensive lifestyle and health questionnaires, a range of physical measures and collection of biological specimens are collected. The scope of UK Biobank was...
Article
Purpose: To examine clinical outcomes in deep anterior lamellar keratoplasty (DALK) for keratoconus using contemporary techniques in a multisurgeon public healthcare setting. Design: Consecutive, retrospective case series. Methods: Setting: Moorfields Eye Hospital, London, United Kingdom. Study population: Consecutive cases of keratoconus tr...
Article
Purpose: To evaluate visual and refractive outcomes of small incision lenticule extraction (SMILE) for hyperopia. Methods: This prospective study of vertex-centered hyperopic SMILE used the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). Inclusion criteria were maximum attempted hyperopic meridian of between +1.00 and +7.00 diopte...
Article
Purpose: To report the outcomes of laser in situ keratomileusis (LASIK) for hyperopia using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany). Methods: This retrospective analysis included 1,383 eyes treated by LASIK for hyperopia using the Triple-A ablation profile with the MEL 90 at London Vision C...
Article
Purpose: To report the outcomes of LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany). Methods: This was a retrospective analysis of all eyes treated by LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 laser between July 2013 and October 2016....
Article
Full-text available
Purpose To assess the prevalence and severity of preoperative and postoperative astigmatism in patients with cataract in the UK. Setting Data from 8 UK National Health Service ophthalmology clinics using MediSoft electronic medical records (EMRs). Design Retrospective cohort study. Methods Eyes from patients aged ≥65 years undergoing cataract su...
Conference Paper
p>The morphometric characteristics of the retinal vascular network have been associated with risk markers of many systemic and vascular diseases. However, analysis of data from large population based studies is needed to help resolve uncertainties in these associations. QUARTZ (QUantitative Analysis of Retinal vessel Topology and siZe) is a fully a...
Article
Full-text available
Background: To describe the surgical technique and refractive outcomes following clear lens extraction (CLE) in the Effectiveness, in Angle-closure Glaucoma, of Lens Extraction trial. Methods: Review of prospectively collected data from a multicentre, randomised controlled trial comparing CLE and laser peripheral iridotomy. Eligible participants...
Article
Full-text available
Objectives To investigate differences in surgical time, the distance the surgical instrument travelled and number of movements required to complete manual phacoemulsification cataract surgery versus femtosecond laser cataract surgery. Design Non-randomised comparative case series. Setting Single surgery site, Moorfields Eye Hospital, UK. Partici...
Article
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Purpose: To describe the good outcome of implantable collamer lens (ICL) rotation to reduce post-operative vault. Methods: Retrospective analysis of case report. A 43-year-old woman had V4c EVO + myopic non-toric ICL implantation and post-operatively she presented with anisocoria and high vault. She underwent surgery to rotate the ICL 90 degrees...
Article
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Objective To investigate changes in the patterns of cumulative surgical experience for ophthalmologists in the UK following the introduction of a new national training scheme. Design Retrospective review of all surgical training records submitted to the UK Royal College of Ophthalmologists by trainees for the award of Certificate of Completion of...
Article
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Purpose To estimate the incidence, and describe the clinical features and short-term clinical outcomes of acute angle closure (AAC). Methods Patients with newly diagnosed AAC were identified prospectively over a 12-month period (November 2011 to October 2012) by active surveillance through the Scottish Ophthalmic Surveillance Unit reporting system...
Article
Full-text available
Background: Cataract is the leading cause of blindness in the world, and cataract surgery is one of the most commonly performed operations in the Western world. Preferred surgical techniques have changed dramatically over the past half century with associated improvements in outcomes and safety. Femtosecond laser platforms that can accurately and...
Article
Full-text available
Objectives To describe the initial outcomes following installation of a cataract surgery laser system. Setting National Health Service cataract surgery day care unit in North London, UK. Participants 158 eyes of 150 patients undergoing laser-assisted cataract surgery. Interventions Laser cataract surgery using the AMO Catalys femtosecond laser p...
Article
Purpose: To investigate time to pseudophakic retinal detachment (RD) after cataract surgery with posterior capsule rupture (PCR) to provide an evidence-based guide for postoperative management. Design: Retrospective case series. Participants: A total of 61 907 eyes of 46 824 patients undergoing cataract surgery. Methods: Subanalysis of the U...
Article
Full-text available
Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease...
Article
Purpose: To investigate if previous intravitreal therapy is a predictor of posterior capsule rupture (PCR) during cataract surgery. Design: Multicenter, national electronic medical record (EMR) database study with univariate and multivariate regression modeling. Participants: A total of 65 836 eyes of 44 635 patients undergoing cataract surger...
Article
Purpose: To investigate the stability of keratometric astigmatism after femtosecond laser intrastromal astigmatic keratotomy (ISAK) performed during laser cataract surgery. Methods: In this prospective comparative case series, data were collected from patients during follow-up 1 and 6 months after laser-assisted cataract surgery. Corneal keratom...
Article
Purpose: To evaluate the factors associated with the efficacy of femtosecond laser intrastromal astigmatic keratotomy (AK). Setting: Moorfields Eye Hospital, London, United Kingdom. Design: Prospective case series. Methods: Eyes having intrastromal AK for corneal cylinder correction were analyzed. Preoperative biometric parameters included a...
Article
Full-text available
Purpose: To describe the effect of femtosecond laser intrastromal astigmatic keratotomy (AK) performed during cataract surgery. Setting: Moorfields Eye Hospital, London, United Kingdom. Design: Prospective case series. Methods: This study comprised patients having laser cataract surgery with concurrent astigmatism management by intrastromal...
Article
Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.
Article
To describe the associations of physical and demographic factors with Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) in a British cohort. Cross-sectional study within the UK Biobank, a large-scale multisite cohort study in the United Kingdom. We included 110 573 participants from the UK Biobank...
Chapter
PACG is a more visually destructive form of disease than primary open-angle glaucoma. Primary angle-closure glaucoma is responsible for half of all glaucoma blindness worldwide. Most angle closure is asymptomatic. Primary angle-closure glaucoma is more common than historically thought in European-derived populations and all new primary glaucoma cas...
Article
To derive macular thickness measures and their associations by performing rapid, automated segmentation of spectral-domain optical coherence tomography (SD OCT) images collected and stored as part of the UK Biobank (UKBB) study. Large, multisite cohort study in the United Kingdom. Analysis of cross-sectional data. Adults from the United Kingdom age...
Article
Purpose: Abnormalities of lacrimal punctum size and morphology probably contribute to excess tearing, with significant effects on quality-of-life for affected individuals. Our current understanding of normal punctal morphology originates from ex vivo studies, which are unlikely to capture the true nature of the living punctum. This study used enha...
Article
Full-text available
Introduction: Cataract is one of the leading causes of low vision in the westernised world, and cataract surgery is one of the most commonly performed operations. Laser platforms for cataract surgery are now available, the anticipated advantages of which are broad and may include better visual outcomes through greater precision and reproducibility...
Article
Full-text available
PurposeTo describe the relationships of axial length with ocular copathology, preoperative visual acuity, and posterior capsule rupture rates in patients undergoing cataract surgery.DesignThe Royal College of Ophthalmologists' National Ophthalmology Database (NOD) study.Methods Anonymised data on 180 114 eyes from 127 685 patients undergoing catara...
Article
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To report the methodology and findings of a large scale investigation of burden and distribution of refractive error, from a contemporary and ethnically diverse study of health and disease in adults, in the UK. U K Biobank, a unique contemporary resource for the study of health and disease, recruited more than half a million people aged 40-69 years...
Article
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To assess the suitability of retinal images held in the UK Biobank--the largest retinal data repository in a prospective population-based cohort--for computer assisted vascular morphometry, generating measures that are commonly investigated as candidate biomarkers of systemic disease. Non-mydriatic fundus images from both eyes of 2,690 participants...
Article
Full-text available
AimsTo describe the outcomes of cataract surgery in the United Kingdom.Methods Anonymised data on 180 114 eyes from 127 685 patients undergoing cataract surgery between August 2006 and November 2010 were collected prospectively from 28 sites. Outcome measures included intraoperative and postoperative complication rates, and preoperative and postope...
Article
Visual impairment due to myopia is an important public health issue. A prior analysis of population-based cohorts aged 15 to 22 years recruited from the United Kingdom and Israel suggested myopia and high myopia were approximately 10% more common in first-born compared with later-born children. To examine whether myopia was associated with birth or...
Article
Purpose To report the rate of complete capsulotomies without adhesions and anterior capsule tears using the Catalys femtosecond laser. Setting Moorfields Eye Hospital, London, United Kingdom. Design Prospective consecutive case series. Methods This study evaluated femtosecond laser–assisted cataract cases performed between January 2013 and March...
Thesis
Aims: To describe the epidemiology, biometric characteristics and risk factors for primary angle closure disease (PAC & PACG) in European people. Methods: 1.Systematic reviews of PACG prevalence and acute angle closure (AAC) incidence studies; with prevalence modelling, and incidence trend analysis. 2.Analyses of EAGLE study data to investigate for...
Chapter
Full-text available
This is the protocol for a review and there is no abstract. The objectives are as follows: To compare the safety and effectiveness of femtosecond laser assisted lens surgery with conventional manual phacoemulsification lens surgery.
Article
Full-text available
To describe the prevalence and phenotypic characteristics of small eyes in the European Prospective Investigation of Cancer (EPIC)-Norfolk Eye Study. Community cross-sectional study. East England population (Norwich, Norfolk and surrounding area). 8033 participants aged 48-92 years old from the EPIC-Norfolk Eye Study, Norfolk, UK with axial length...
Article
Purpose: To describe small hyperreflective areas using spectral-domain optical coherence tomography (SD-OCT) imaging in eyes that have had silicone oil tamponade. Methods: Retrospective case series of 11 eyes of 11 patients. The authors retrospectively identified patients who underwent vitrectomy and silicone oil tamponade secondary to a rhegmat...
Article
Full-text available
Aims: To investigate if the single nucleotide polymorphisms rs3753841, rs1015213 and rs11024102, recently implicated in the development of acute primary angle closure or primary angle closure glaucoma, are associated with ocular biometric characteristics of British adults in the European Prospective Investigation of Cancer-Norfolk eye study. Meth...
Article
PURPOSE: To evaluate the outcomes of phacoemulsification and intraocular lens (IOL) implantation in microphthalmos and nanophthalmos. SETTING: Moorfields Eye Hospital, London, United Kingdom. DESIGN: Retrospective case series. METHODS: Eyes with an axial length (AL) less than 21.0 mm had elective phacoemulsification and IOL implantation. RESULTS: O...
Article
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Purpose To measure the dimensions of aqueous outflow structures and to investigate associations with intraocular pressure (IOP) and ocular biometry parameters in an older British population. Method Fifty-two participants from the European Prospective Investigation of Cancer-Norfolk eye study underwent imaging using the Heidelberg Spectralis optical...
Article
Full-text available
To estimate the prevalence of primary angle closure glaucoma (PACG) in European derived populations. Systematic review and modelling of PACG prevalence data from population studies. PACG was defined according to the ISGEO definition requiring structural and/or functional evidence of glaucomatous optic neuropathy. Prevalence estimates were applied t...
Article
Background: To assess the accuracy of Haigis, Holladay 1, Hoffer Q and SRK/T formulae in eyes with axial length of <22.00 mm. Design: Retrospective comparative analysis. Participants: 163 eyes of 97 patients undergoing phacoemulsification and intraocular lens (IOL) implantation. Methods: Ocular biometry was performed using IOLMaster laser in...
Article
Background: Necrotizing fasciitis is a rare, life-threatening subcutaneous soft tissue infection that causes massive tissue destruction. Objectives: To illustrate the warning signs of this condition by reporting a rare case of eyelid necrotizing fasciitis. Case report: A previously healthy 22-year-old man presented with a preseptal eyelid infe...
Article
Full-text available
A 34-year-old Caucasian female with advanced primary angle closure glaucoma developed acute angle closure following administration of g.pilocarpine 2% given as preparation for laser peripheral iridotomies. Subsequent investigations supported an underlying diagnosis of spherophakia with no systemic associations. She required peripheral iridotomies,...
Article
Full-text available
Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.