CME associated with ECCE and ICCE.
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Cataract Extraction↗
Biomedical subjects
M A Galin
Publications and source records attributed to M A Galin.
Laser trabeculoplasty and cataract surgery.
We have compared long-term intraocular pressure control in patients with open angle glaucoma, cupping and atrophy of the optic nerve head and visual field loss as well as cataract after: trabeculectomy posterior to the scleral spur and cataract extraction without implantation in 108 patients. guarded posterior lip sclerectomy, cataract extraction and Mark VIII or Mark IX anterior chamber implantation in 28 patients. argon laser trabeculoplasty followed by lens extraction and implantation in 27 patients. Approximately 75 per cent of patients achieve intraocular pressures of 18 mm Hg or less without medication after (a), and approximately 40 per cent of patients achieve similar control without medication after (b). Approximately 25 per cent of these glaucoma patients have intraocular pressure levels of less than or equal to 18 mm Hg on topical medication three months after ALT, and none achieve this control without medication. Cataract surgery with anterior or posterior chamber implantation caused loss of topical control in four of the seven patients benefiting from ALT. These data imply that combined surgery with or without implantation produces better and more significant intraocular pressure control than the presently utilized techniques of ALT subsequently followed by lens extraction and implantation.
Anterior Chamber↗
Trabeculectomy, cataract extraction and intra-ocular lens implantation.
Seventeen cases of open-angle glaucoma requiring cataract extraction underwent intracapsular cataract extraction, trabeculectomy posterior to the scleral spur, and MK9 intraocular lens insertion. Approximately 50 per cent of the patients achieved intraocular pressures of 18 mm Hg or less without medication two years later. Though implantation reduces the surgical success of the combined operation, it is safe, easy to perform and does not worsen pre-operative levels of intraocular pressure and/or control.
Cataract Extraction↗
Cataract extraction in glaucoma.
Cyclodialysis lens extraction or cyclodialysis canalicular trabeculectomy lens extraction in one eye and cataract extraction in the fellow eye were performed in 24 glaucoma patients. The combined procedure follow-up was from five to 12 years in the first group, two to four years in the second group, and from three to ten years in the control group. The 50% success rate of cyclodialysis lens extraction can be enhanced with no significant increase in surgical morbidity or postoperative complications by performing a cyclodialysis canalicular trabeculectomy where the disinsertion of the scleral spur is carried out under direct visualization.
Aged↗
The effects of timolol on cataract extraction and intraocular pressure.
We studied the effect of timolol on post-operative intraocular pressures (IOPs) in a control and experimental group of 30 eyes, each in patients who had uncomplicated intracapsular cataract extractions, most with iris clip lenses. Closure of the eye in each case was with three 6-0 silk sutures preplaced in a morticed incision. Six control eyes had IOP increases of 6 mm Hg or more within 24 hours of surgery. One patient treated with timolol had an IOP increase of 6 mm Hg or more. The differences in IOP between the control and experimental groups were statistically significant at the .01 level. The pressure lowering ability of timolol appears to be prophylactic as well as therapeutic. It is well suited for pseudophakic eyes as pressure reduction is not associated with pupillary alterations.
Cataract Extraction↗
Sodium hydroxide sterilzation of intraocular lenses.
Intraocular lenses of polymethylmethacrylate contaminated with various inocula of bacteria, spores, and fungi were sterilized by modifications of the Ridley method using sodium hydroxide. Positive cultures were obtained from iris-supported lenses contaminated with concentrations of approximately 1 x 10(6) organisms per milliliter after one hour in 10% NaOH. No positive cultures were obtained when lenses remained in 10% NaOH for three hours, a time corresponding to a 1 x 10(-6) probability of surviving organism. The NaOH method, when appropriately used, is an effective sterilization process for intraocular lenses.
Aspergillus niger↗
Retinal detachment in pseudophakia.
In a series of cataract patients excluding myopic individuals, under age 60 years, and cases in which vitreous loss occurred, retinal detachment was no less frequent after intracapsular cataract extraction and Sputnik iris supported lenses than in controls. Both groups were followed up for a minimum of two years. The detachments predominantly occurred from retinal breaks in areas of the retina that looked normal preoperatively.
Age Factors↗
Time analysis of corneal endothelial cell density after cataract extraction.
Serial endothelial photographs were taken preoperatively and postoperatively in 200 eyes; 111 eyes contained a Rayner iris clip lens, 54 eyes contained a Fyodorov Sputnik lens, and 35 eyes had no lens. Central endothelial cell density was changed in all instances, with counts in implanted eyes declining 25 to 30%, and in nonimplanted eyes 10 to 15%. In both instances, the decline essentially ceased at about three months. The cause of the greater decline in implanted eyes appeared to be mechanical and subsequent cell loss after the 90-day period was virtually equal for the two groups. Methods that may be used to alter the difference in cell density occurring with implantation are best analyzed by using the 90-day period data for comparison.
Animals↗
Binkhorst Lecture (Part 1). Experimental cataract surgery.
The use of intraocular lenses in cataract surgery leads to a greater corneal complication rate than surgical treatment without such devices. It has been assumed that the predominant reason for this is surgical trauma at the time of lens insertion. A laboratory study to verify and analyze this difference has been carried out, the cat being used as an experimental model. This first report evaluates the effect of the usual steps of cataract extraction on the density of corneal endothelial cells.
Animals↗
Glaucoma, cataract surgery, and the intraocular lens.
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Cataract↗
Cystoid macular oedema and ocular inflammation. The corneo-retinal inflammatory syndrome.
Intraocular lens implantation may be associated with an inflammatory syndrome which leads to corneal decompensation and cystoid macular oedema. The inflammatory aspects often do not appear striking but manifest as mild ciliary flush, mild flare, moderate cells in the anterior chamber, and moderate vitritis. The cornea will decompensate in the presence of endothelial cell counts which are sufficient to maintain corneal clarity in the non-inflamed eye. Metal-looped lenses and poorly polished lenses cause iris chafing and capillary leakage which increase the severity of this syndrome. It is postulated that intraocular surgery initiates an inflammatory response which is augmented by certain components of intraocular lenses. The mediation for this increased inflammatory response may be inhibited by both steroidal and non-steroidal anti-inflammatory agents. The presence of white blood cells and their products, such as lysosomal enzymes, may be sufficient to perpetuate the inflammatory response and cause damage to abnormal and normal cells. The presence of protein and its immune components, as well as complement, may be involved in this syndrome.
Aged↗
Binkhorst Lecture. (Part 2). Experimental cataract surgery--electron microscopy.
Scanning and transmission electron microscopic examinations were performed on cat corneas after the steps usually taken to perform cataract extraction were completed. The endothelium did not replicate, but showed nuclear division or segmentation occasionally. In each case, the anterior segment was free from any evidence of inflammation one year after surgical treatment--unless a pseudophakos had been inserted: in some of these cases, significant numbers of white cells were present, a condition that may contribute to anterior segment complications from implants.
Animals↗
Stereoscopic acuity measurement in aphakia.
We performed a variety of tests to assess binocular function on monocular aphakic patients wearing contact lenses, monocular pseudophakic patients, bilateral spectacle-wearing aphakic patients, bilateral aphakic contact lens wearers, and bilateral pseudophakic patients. Stereoscopic acuity levels at distance and near when visual acuity was at least 6/12 (20/40) provided the most useful data. Pseudophakic patients and contact lens wearers performed equally well and outperformed spectacle wearers. Implant patients did not have superior stereoscopic acuity.
Aphakia, Postcataract↗
Endothelial cell loss from intraocular lens insertion.
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Aged↗
Cataract extraction and intraocular pressure.
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Aged↗
Trimolol: effect on intraocular pressure in chronic open-angle glaucoma.
Timolol maleate is an effective agent of reducing intraocular pressure in patients with chronic open-angle glaucoma. To date, there are no adverse side effects demonstrable with use of this medication. Its mechanism of action is not clearly delineated but preliminary data suggest an effect on outflow facility.
Adrenergic beta-Antagonists↗
Argon laser photocoagulation of the posterior segment in pseudophakia.
A series of in vitro, in vivo, and clinical studies was performed to explore the safety and efficacy of argon laser and xenon arc photocoagulation in pseudophakia. The polymethylmethacrylate intracameral lens (Fyodorov) proved resistant to photothermal decomposition and allowed transmission of therapeutically effective energy levels to the retina. The argon laser delivered through a slit lamp and contact lens optical system appears to be the preferred method for posterior segment photocoagulation in pseudophakia. On the basis of five-day tissue culture studies and clinical experience of two years, the intracameral lens does not appear to be a toxic or transmission barrier to careful argon laser photocoagulation.
Animals↗
Surgical repair of leaking blebs.
To repair a ruptured filtering bleb, we used the conjunctiva alone, or combined with its undissected Tenon's fascia, to cover the sclerostomy site. We used mattress sutures to thread the new flap into a vertical corneal groove anterior to the sclerostomy, creating a firm, nonretracting but still sufficiently "porous" cover that maintained filtration and resisted infection and perforation. Seven of eight cases of ruptured filtering blebs have been successfully repaired in this manner with the maintenance of adequate filtration.
Adult↗