Reservations about the Malbran technique.
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Cataract Extraction↗
Biomedical subjects
R R Berger
Publications and source records attributed to R R Berger.
Ciliary sulcus fixation--still a shot in the dark.
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Adolescent↗
Incomplete posterior U.G.H. syndrome--different iatrogenic entity?
U.G.H. syndrome is a known complication of IOL implantation associated with the use of anterior and rarely, posterior chamber intraocular lenses. It is due to mechanical excoriation of the angle or iris by the haptics or optic of an IOL and consists of uveitis, glaucoma and hyphema (U.G.H.). The advised therapeutic approach is explantation of the IOL. Following implantation of a posterior chamber IOL, three patients presented with bleeding into the posterior chamber, one associated with glaucoma. No patient had signs of uveitis. We decided to address the symptoms and not to explant the IOL. We believe that this constitutes a variant of the 'classical' U.G.H. syndrome, namely an incomplete posterior U.G.H. (I.P.U.G.H.) syndrome, in which explanation of the I.O.L. is not compulsory.
Aged↗
Biochemical basis of phagocytosis. V. Effect of phagocytosis on cellular uptake of extracellular fluid, and on the intracellular pool of L-alpha-glycerophosphate.
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Animals↗
Procedures involving star-shaped capsulectomy for managing congenital cataracts in developing nations.
The management of congenital cataracts is still challenging, especially in developing nations, where surgical facilities are limited. Congenital cataracts were extracted from 22 patients (26 eyes): a procedure consisting of a star-shaped anterior capsulectomy and wash-out of lens material (STARWO) was performed in 16 of them (18 eyes) (group A); a procedure consisting of a star-shaped anterior capsulectomy, wash-out, anterior vitrectomy through the posterior capsulotomy, and repeated tearing of remnants of the anterior capsule (STARWAR) was performed in six patients (eight eyes) (group B). Intraocular lenses were implanted in both groups. In group A, secondary membranes (27.7%) developed in five eyes, postoperative uveitis in four (22.2%), and a late Elschnig pearl in 1 (5.5%). In group B, there was one case of secondary membrane formation (12.5%), and one of postoperative uveitis; neither required subsequent intervention. The inexpensive instrumentation used and the low rate of perioperative complications encountered in these patients make these two techniques attractive alternatives for managing congentital cataracts in developing nations.
Adolescent↗
Intraocular lens placement after removal of a subluxated lens.
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Anterior Chamber↗
The "anchor" anterior capsulectomy.
In recent years, continuous circular capsulorhexis (CCC) has become the preferred anterior capsulectomy in many ophthalmic centers. Yet, many ocular surgeons are still uncomfortable with it, especially when tearing the capsule on its lower semicircle, since this often results in corneal endothelial injury, and, thus, postoperative lower corneal edema. We present a modified anterior capsulectomy, which consists of a crescent capsulorhexis and a perpendicular discission, followed by circular tearing of the resulting capsular flaps. This "anchor" anterior capsulectomy (AAC) was used in 14 cases of elective extracapsular cataract extraction, followed by intraocular lens (IOL) implantation. The capsulectomy was successful in 12, and IOL implantation was successful in 12. The procedure was relatively easy to perform and resulted in good "in-the-bag" implantation, regardless of the IOL's overall length and the optic's size. AAC can serve as an intermediate step in learning CCC as well as a reliable alternative anterior capsulectomy.
Cataract Extraction↗
Vertical tripod fixation (VTF) simplifies transscleral approaches.
Transscleral fixation of intraocular lenses (IOL) is an accepted procedure today. Following Malbran's initial approach, new techniques have been developed in various ophthalmic centers; many, however, are time-consuming and difficult, as reflected by complications, most commonly hyphema and IOL tilt. We present here a simple method of transscleral fixation, which was performed in 24 patients in our department. It involves fixating the IOL vertically, on a three-point configuration, using standard 10-0 prolene stitches. Performing it is easy and time-saving. VTF ensures a stable transscleral fixation of an IOL.
Adolescent↗