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PubMed1988

Comparative efficacy of the beta-blockers for the prevention of increased intraocular pressure after cataract extraction.

We conducted a randomized, double-masked study of intraocular pressure in 80 patients treated with betaxolol, levobunolol, timolol, or placebo after extracapsular cataract extraction. Intraocular pressures were measured preoperatively and early (four to seven hours) and late (20 to 24 hours) postoperatively. There was a significant mean increase in pressure from the preoperative period to the early postoperative period for the placebo group (5.35 mm Hg), betaxolol group (6.73 mm Hg), and the timolol group (3.83 mm Hg). However, the levobunolol group had a mean decrease in pressure (0.43 mm Hg). There was no significant difference between preoperative and late postoperative pressures for any of the groups. One-way analysis of covariance of the changes in pressure from the preoperative to early postoperative period showed a significant increase for the placebo and betaxolol groups compared to the levobunolol group, without significant difference between the levobunolol and timolol groups. Overall, levobunolol proved most effective in preventing an increase in intraocular pressure after extracapsular cataract extraction; timolol was partially effective.

Adrenergic beta-Antagonists↗
PubMed1978

Lindner posterior vitreous fistula with senile cataract extraction for quick reformation of anterior chamber: indications, technique, and results.

Pars plana partial vitrectomy using Lindner posterior vitreous fistula was prophylactically used with senile cataract extraction in cases known to be liable for nonreformation of anterior chamber and gelly vitreous with perfect results as regards postoperative maintenance of anterior chamber aphakic depth. The combined operation is indicated in cases (1) if the other eye was lost through nonreformation of anterior chamber after a perfect senile cataract extraction; and (2) in very old patients with very shallow anterior chamber especially when there are other senile ocular changes such as flatter, thinner cornea, tendency for uveal vascular engorgement and exudations (after hypotony of operation), and bad wound healing. This is especially true in small hypermetropic eyes with small cornea. The technique of the combined operation is described.

Age Factors↗
PubMed1999

Panretinal photocoagulation during cataract extraction in eyes with active proliferative diabetic eye disease.

PURPOSE: Cataract surgery in the presence of active proliferative diabetic eye disease carries a high risk of progression of retinopathy and neovascular glaucoma. Lens opacities may prevent panretinal photocoagulation (PRP) before surgery, and applying PRP in the immediate post-operative period can be difficult. The purpose of this study is to report results of cataract extraction combined with per-operative indirect laser PRP in a group of these patients. METHODS: Nine eyes of 9 diabetic patients with active retinal or iris neovascularisation in which lens opacities prevented adequate pre-operative PRP underwent cataract surgery combined with indirect laser PRP after cortex aspiration and before intraocular lens implantation. RESULTS: Regression of neovascularisation with this combined procedure alone was achieved in 5 eyes, 3 responded to further PRP, and 1 developed neovascular glaucoma. Visual acuity improved in all eyes, 4 achieving > or = 6/12. Four patients developed increased post-operative uveitis. One developed clinically significant macular oedema. CONCLUSIONS: The method described has definite practical advantages over PRP attempted in the immediate post-operative period, when many factors can prevent its application or reduce its effectiveness, and when neovascularisation may be progressing rapidly. In addition, adjunctive per-operative indirect laser PRP appears to improve the outcome of cataract surgery in eyes with active proliferative diabetic eye disease.

Adult↗
PubMed1989

Intercapsular versus extracapsular cataract extraction.

Forty-five eyes that have undergone routine extracapsular cataract extraction with insertion of a posterior chamber intraocular lens were compared with a similar group of eyes that had undergone intercapsular extraction. Capsular fixation was more predictable following intercapsular (78%) than it was following extracapsular extraction (22%). Gonioscopy revealed prominence of the lens haptic in 22% of the intercapsular group, with peripheral anterior synechiae (PAS) in 18%; haptics were prominent in 78% of the extracapsular group, with synechiae in 55%. Lens eccentricity of 2 mm or more was seen in 2 patients (4%) following intercapsular and in 10 (22%) following extracapsular extraction. Pupil irregularities were noted in three of the intercapsular group (7%) and in eight of the extracapsular group, (13%) with peripheral iris tucking alone in three. These data strongly support the view that intercapsular is superior to extracapsular cataract surgery in terms of facilitating capsular fixation of posterior chamber intraocular lenses.

Aged↗
PubMed1987

Extracapsular cataract extraction with posterior chamber lens implantation in patients with glaucoma.

Forty-six patients with medically controlled open angle glaucoma were scheduled to undergo extracapsular cataract extraction with implantation of a posterior chamber intraocular lens. Surgery was performed in 43 eyes; three eyes had an intraoperative complication that prevented a posterior chamber lens implantation. The mean preoperative intraocular pressure was 17.6 mm Hg with the patients receiving a mean of 1.9 medications. The mean intraocular pressure (16.2 mm Hg) and the number of medications (1.4) administered to the 43 eyes having the planned surgery were significantly decreased an average of 23.4 months following cataract surgery. Seventy-two percent of the eyes had a postoperative visual acuity of 20/40 or better. Operative complications were similar to those reported for the same type of cataract surgery in nonglaucomatous eyes. However, there seemed to be an increased incidence of postoperative cystoid maculopathy (11.6%) in these glaucomatous eyes compared with previous reports in the literature and with the incidence in nonglaucomatous eyes that we treated. Our study shows that extracapsular cataract extraction with a posterior chamber lens can be effective in restoring vision without compromising intraocular pressure control in eyes with preexisting open angle glaucoma.

Aged↗
PubMedDate not supplied

[The efficacy of using enzymes in treating toxic-allergic reactions after cataract extraction with intraocular lens implantation].

Physiotherapy was administered to 84 patients aged 59-78 years with toxic allergic reaction in the eye after extracapsular cataract extraction with implantation of intraocular lenses (IOL). The patients were divided into 4 groups. Group 1 (n = 15) were treated by fibrinolysin magnetophoresis, group 2 (n = 17) lidase magnetophoresis, group 3 (n = 28) lecozyme magnetophoresis, and group 4 (n = 24) collalysin magnetophoresis. Treatment started on days 3-5 after surgery. Magnetophoresis was carried out using Russian Gradient-1 device, generating a low-frequency magnetic field of 10-12 mT, 10-12 min exposure. For patients with pronounced iridocyclitis and uveitis, enzyme magnetophoresis was supplemented with atropine, adrenalin, and calcium chloride electrophoresis (with monitoring the pupil size). Comprehensive treatment resulted in complete resolution of exudation in the anterior and posterior segments of the eye, hypopyon, loosening and resorption of anterior and posterior synechiae, the vitreous body grew more transparent, visual acuity improved in 91.1% patients (coarse dystrophic changes in the central zone of the fundus oculi were detected in 8.9%). Magnetophoresis with fibrinolysin and lidase is most effective in patients with toxic allergic reaction during the early periods after cataract extraction with IOL implantation, while in later periods magnetophoresis with lecozyme and collalysin should be preferred. The efficacy of collalysin is not inferior to that of lecozyme, but its effect is more mild and the drug causes no allergic reactions. Magnetophoresis with mydriatics (with monitoring the pupil size) and calcium chloride is recommended for all cases.

Aged↗
PubMed1999

[Evaluation of endothelial cells after the usage of gentamycin in irrigation-aspiration fluid during extracapsular cataract extraction].

PURPOSE: Assessment of the density of endothelial cells after usage of gentamicin in irrigation-aspiration fluid. MATERIAL AND METHODS: 60 patients subjected to extracapsular cataract extraction with intraocular lens implantation. In 30 eyes irrigation was performed with Ringer fluid (group I) and in 30 eyes Ringer fluid with gentamicin (group II) 4 mg gentamicin were added to 500 ml of Ringer fluid obtaining the concentration 8 micrograms/ml. Evaluation of endothelial cells density was carried before operation, 1 month and 6 months after. RESULTS: Percentage endothelial cells loss in group I was 7.8% 1 month postoperatively and 14.5% 6 months after operation and in group II 8.5% and 14.87%, respectively. CONCLUSION: Gentamicin added to irrigation-aspiration fluid doesn't cause enhanced endothelial cells loss during extracapsular cataract extraction.

Aged↗
PubMed2003

[The effect of brimonidine on postoperative hypertonia after an extracapsular cataract extraction].

PURPOSE: We conducted a prospective study to determine the effect of topical administration of brimonidine tartrate 0.2% on postoperative intraocular pressure (IOP) spikes during the first 24 hours after an extracapsular cataract extraction. MATERIAL AND METHODS: In a placebo-controlled study, we randomized 40 consecutive normotensive eyes undergoing extracapsular cataract surgery into two treatment modalities. Twenty eyes (group A) received placebo and 20 eyes (group B) were given brimonidine tartate 0.2% drops twice the day before and twice on the day of the operation. IOP was measured at baseline (prior to surgery) and then 4, 6, 12 and 24 hours postoperatively. RESULTS: Mean postoperative IOP was higher in the placebo group than in the brimonidine group at every time point studied. In both groups, peak elevation of mean IOP was recorded 6 hours after surgery. At that time, mean IOP was significantly higher in the placebo group (36.2+/-4.0 mmHg) than in the brimonidine group (24.7+/-3.8 mmHg) (p<0.001). A gradual reduction in IOP followed, yet with significantly higher values than those found preoperatively, even 12 hours after surgery (p<0.001). It was only the brimonidine group that achieved a near-to-normal mean IOP 24 hours after surgery (p>0.05). Four of the placebo group patients compared to 1 of the brimonidine group patients had an IOP higher than 40 mmHg 6 hours after surgery and therefore received additional therapy. CONCLUSION: Prophylactic treatment with brimonidine tartrate 0.2% drops twice a day for 2 days is effective in reducing IOP spikes throughout the first 24 hours after an extracapsular cataract extraction.

Adrenergic alpha-Agonists↗
PubMed1991

Extracapsular cataract extraction with intraocular lens implantation after scleral buckling surgery.

We reviewed the records of 28 patients who had undergone successful scleral buckling surgery followed by extracapsular cataract extraction with implantation of an intraocular lens. Posterior chamber intraocular lenses were inserted in 27 eyes, and anterior chamber intraocular lenses were inserted in two eyes with posterior capsule rupture at the time of surgery. The mean follow-up period was 44 months. Final visual acuity was 20/40 or better in 15 of 29 eyes (52%). One eye (3.4%) developed a recurrent retinal detachment 15 months after cataract surgery. Two eyes (6.9%) developed angiographically proven cystoid macular edema. The outcome for extracapsular cataract extraction with intraocular lens implantation in eyes that had previously undergone successful scleral buckling for retinal detachment is favorable.

Adult↗
PubMed1986

Combined cataract extraction and guarded sclerectomy. Reevaluation in the extracapsular era.

Thirty-four eyes of 25 patients underwent a guarded sclerectomy in combination with either an intracapsular or extracapsular cataract extraction. The intraocular pressure was well-controlled in the early postoperative period in all but one case, and only one eye developed a flat anterior chamber that required surgical reformation. However, there was a high incidence of intraoperative and postoperative complications in both the intracapsular and extracapsular groups. These observations, as well as experience with extracapsular cataract extraction and posterior chamber lens implantation alone in glaucomatous eyes, have led to a reevaluation of the criteria for combined cataract and glaucoma surgery.

Adult↗
PubMed1976

Senile cataract extraction and diabetes.

A study of hospital discharge diagnoses from both national data and data from a local medical centre indicates that diabetes substantially increases the probability of cataract extraction at age 40-49, about doubles or triples the probability for age 50-69, and has little effect on risk at age 70 and over. Strengths and weaknesses of the data are discussed. Other reports, generally estimating a much stronger association between diabetes and probability of cataract extraction, at least at age 50 and above, are critically evaluated.

Adult↗
PubMedDate not supplied

[Effects of the duration of cataract extraction and eyeglass wear in patients with aphakia on the development of changes in the macular area].

Forty-eight patients with aphakia were examined to elucidate the effect of cataract extraction duration on subsequent development of Irwin-Hass syndrome. A total of 229 patients were examined 6 months and more after cataract extraction to find out whether sun light could induce development of dystrophic changes in the central retina in aphakia. The results indicate that operation duration of more than an hour increased the risk of subsequent development of Irwin-Hass syndrome. Aphakia patients wearing no eyeglasses or contact lenses or intraocular lenses may develop maculodystrophies, probably due to the injurious effect of sun rays on the retina.

Aged↗
PubMed2006

[Unintentional staining of lens posterior capsule with trypan blue during extracapsular cataract extraction: case report].

Report of a complication related to the use of 0.1% trypan blue during capsular staining of the anterior crystalline lens capsule in an extracapsular cataract extraction with intraocular lens implantation. The capsular dye was injected using an air-bubble technique, inadvertently, it was done using high pressure dispersing the dye through the zonules leading to a complete lost of red reflex, the following steps of the procedure becoming more difficult after the cataract extraction and causing a temporary disturbance of visual acuity in the postoperative period. In order to avoid this complication, the authors also describe the use of "Modified air-bubble technique" where dispersive viscoelastic is placed into the iridolenticular space 360 degrees to create a protection barrier.

Adult↗
PubMed1987

Endophthalmitis following cataract extraction.

We describe a case of bacterial endophthalmitis complicating routine cataract extraction and intraocular lens implantation in a 91-year-old woman. The ocular and systemic factors that may have predisposed to intraocular infection in this case, and the possibility of predicting these pre-operatively, are discussed.

Adenocarcinoma↗