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PubMedDate not supplied

[Trabeculotomy ab interno combined with extracapsular cataract extraction and IOL implantation].

We made a total of 96 surgeries of extracapsular cataract extraction and IOL implantation combined with trabeculotomy ab interno during a period of 7 years. Patients with both open-angle and narrow-angle glaucoma of stages I and II and with the intraocular pressure (IOP) below or equal to 23 mm Hg according to Goldman under the conditions of hypotensive medicamental regimen were selected for surgery. After IOL was implanted into the lens bag, trabeculotomy ab interno was implemented as stage 2. A special mirror, introduced through the cataract incision, was used for direct gonioscopic monitoring. The trabecula was incised by the edge of a curved surgical knife under direct visual control. We regarded bleeding from the opened sinus as a favorable sign indicative of that the intrascleral collectors were intact. Only minor hyphemas were registered as postoperative complications; there was not a single case of ciliary-and-choroidal detachment. IOP was compensated for, in 6 months after surgery, in 94% of patients--69.8% of them did not use any hypotensive drops.

Cataract↗
PubMed1991

Posterior chamber intraocular lenses after extracapsular cataract extraction in patients with aniridia.

Visual rehabilitation of patients with aniridia and progressive cataract is a challenging clinical problem. Reduced corneal transparency, limitations of iris support, and decreased zonular integrity may make extracapsular cataract surgery difficult. Four patients with familial aniridia had substantial visual improvement after successful extracapsular cataract extraction (ECCE) with implantation of capsular-fixated posterior chamber intraocular lenses (PC IOLs). In one patient, it was combined with trabeculectomy to treat chronic open-angle glaucoma. Posterior chamber IOLs can be safely implanted in the aniridic eye normalities in the anterior segment.

Adult↗
PubMed1989

A review of extracapsular cataract extraction and intraocular lens implantation combined with trabeculectomy.

Six eyes underwent combined extracapsular cataract extraction with or without intraocular lens implantation and trabeculectomy in 1985 and 1986. Postoperatively, the intraocular pressure was acceptable without medication in all cases. Visual acuity also improved in every case. There was no greater incidence of postoperative complications than that expected when either procedure is done alone.

Aged↗
PubMed1996

Intraoperative complications of planned extracapsular cataract extraction versus manual nucleofragmentation.

PURPOSE: To compare the intraoperative complications of planned extracapsular cataract extraction (ECCE) with those of manual nucleofragmentation. SETTING: Hospital de la Esperanza, Universitat Autónoma de Barcelona, Spain. METHODS: This retrospective study comprised 567 eyes; 444 had planned ECCE and 123, manual nucleofragmentation through a scleral tunnel incision. RESULTS: No significant differences between techniques were found in terms of intraoperative complications (P < .05). Manual nucleofragmentation did not increase the risk of intraoperative complications (P < .05). CONCLUSIONS: Although phacoemulsification is the procedure of choice in many cases, manual nucleofragmentation is a safe and valid alternative that achieves the goals of small incision cataract surgery.

Aged↗
PubMed1987

[Expulsive hemorrhage in cataract extraction].

This article reports on six cases of massive expulsive hemorrhage during intracapsular cataract extraction (incidence = 0.17%). Some of the known risk factors are old age, hypertony, glaucoma, and an insufficient decrease in intraocular pressure following oculopression prior to surgery. Drainage of the suprachoroidal hemorrhage, closure of the wound and reformation of the anterior chamber are necessary surgical interventions. In one case the treated eye was saved and a visual acuity of 0.1 achieved.

Aged↗
PubMed1990

[Follow-up for posterior capsular opacification after extracapsular cataract extraction in 263 eyes].

263 eyes (252 patients) were followed up after extracapsular cataract extraction for posterior capsular opacifications. It was found that the incidence of this complication was higher after longer periods of follow-up, and also more frequent in younger patients. The etiology is due to migration and fibrosis of hyperplastic epithelial cells. Postoperative uveitis may be a contribution factor. Nd: YAG laser is the best means to perforate the posterior capsular opacification.

Adolescent↗
PubMed1994

Delirium after cataract extraction: a prospective study.

A prospective study of 350 consecutive in-patients undergoing cataract extraction revealed the incidence of postcataract extraction delirium to be 1.7%. While in one case the delirium was due to anticholinergic toxicity, in the remaining 5 cases no organic cause was evident. Sensory deprivation was present in 3 patients. In addition to organic causes sensory deprivation was found to be an important cause of postcataract extraction delirium.

Adolescent↗
PubMed1981

Extracapsular cataract extraction and pseudophakos implantation in primates: a clinico-pathologic study.

Eighteen rhesus monkeys underwent lens implantation with Choyce Mark VIII, Binkhorst iridocapsular, or Shearing posterior chamber lenses. They were sacrificed 4-28 months postoperative. The eyes were compared clinically and histologically. Controls included unoperated eyes and eyes with lens extraction without implantation. Several histologic findings pertained equally to cataract extraction with or without lens implantation. Late opacification of the posterior capsule was caused by migrations and fibrous metaplasia of the lens epithelial cells. These cells appeared to undergo such metaplasia only when exposed directly to aqueous, never when they were in firm apposition to another tissue such as another layer of capsular epithelium, lens cortex, or iris. All implants were well tolerated clinically. Histologically the eyes with Binkhorst lenses showed a tendency to focal loss of iris pigment epithelium and some pigmented macrophages in the iris stroma an trabecular mesh. The Choyce lenses frequently displayed marked displacement and thinning of the iris root, and occasionally showed a few chronic inflammatory cells and thin fibrous encapsulation around the implant feet. The Shearing lenses had no effect on the adjacent ciliary body when the loops were well seated in the lens capsule, but when a loop was anterior to the capsule, it eroded into the ciliary body. The loops developed a thin fibrous capsule within the ciliary body with very little chronic inflammatory reaction. The long-term effect of such loops lying in the ciliary body is undetermined, however. At present it is recommended that, if such a lens is implanted, every effort be made to ensure both loops lie in the capsular envelope. On the basis of this study, it is also recommended that in removing such a lens, one must assume that a loop might lie embedded in the ciliary body and cut the lens free from the loops before removing it.

Animals↗
PubMed1980

Extracapsular cataract extraction and pseudophakos implantation in primates: a clinico-pathologic study.

Eighteen Rhesus monkeys underwent lens implantation with Choyce Mark VIII, Binkhorst iridocapsular, and Shearing posterior chamber lenses. They were sacrificed 4 to 28 months following surgery. The eyes were compared clinically and histologically. Controls included unoperated eyes and eyes with lens extraction without implantation. Several histologic findings pertained equally to cataract extraction with or without lens implantation. Late opacification of the posterior capsule was caused by migration and fibrous metaplasia of the lens epithelial cells. These cells appeared to undergo such metaplasia only when exposed directly to aqueous, never when they were in firm apposition to another tissue such as another layer of capsular epithelium, lens cortex, or iris. Also strong fibrous posterior synechiae between the iris and lens remnants occurred only where the anterior lens capsule was missing. All implants were well tolerated clinically. Histologically they showed remarkably little inflammation. The eyes with Binkhorst lenses had a mild tendency to focal loss of iris pigment epithelium and some showed pigmented macrophages in the iris stroma and trabecular mesh. The Choyce lenses frequently displayed marked displacement and thinning of the iris root, and occasionally showed a few chronic inflammatory cells and thin fibrous encapsulation around the implant feet. The Shearing lenses had no effect on the adjacent ciliary body when the loops were well seated in the lens capsule, but when a loop was anterior to the capsule, it eroded into the ciliary body. The loops developed a thin fibrous capsule within the ciliary body with very little chronic inflammatory reaction, but the long term effect of such loops lying in the ciliary body is undetermined. At present it is recommended that, if such a lens is implanted, every effort be made to ensure both loops lie in the capsular envelope. On the basis of this study, it is also recommended that in removing such a lens, one must assume that a loop might lie embedded in the ciliary body and cut the lens free from the loops before removing it.

Animals↗
PubMed1990

Extracapsular cataract extraction, posterior chamber lens insertion, and pars plana vitrectomy in one operation.

Extracapsular cataract extraction (ECCE), placement of a posterior chamber intraocular lens (PC IOL), and pars plana vitrectomy were combined in a single operation in 24 patients. Sixteen of these, 11 of whom are diabetic, have had 6 months or more of follow-up. In all cases, excellent visualization of the posterior segment was obtained, and the surgical objectives were achieved. No diabetic patient without preoperative neovascularization of the iris had this complication later. The advantages and disadvantages of alternative techniques are discussed.

Adult↗
PubMed1995

[The relationship between diabetic retinopathy and cataract extraction with intraocular lens implantation in diabetics].

47 diabetics (71 eyes) having undergone cataract extraction with intraocular lens (IOL) implantation were examined and followed up. The results show that there is significant difference in the last post-operative visual acuities between the diabetic group and non-diabetic group (P < 0.01). The main cause affecting the post-operative visual acuities of the diabetics is diabetic proliferative retinopathy (P < 0.001). There is no significant difference in the post-operative visual acuities between diabetic group with or without simple diabetic retinopathy and non-diabetic group (P > 0.05). The intra- and post-operative complications in the diabetic and non-diabetic group were also investigated and there was no significant difference. IOL implantation should be guarded for diabetics with proliferative retinopathy especially when complicated with maculopathy.

Aged↗
PubMed1988

The efficacy and safety of combined trabeculectomy, cataract extraction, and intraocular lens implantation.

The safety and efficacy of combined trabeculectomy, extracapsular cataract extraction (ECCE), and posterior chamber intraocular lens (PC IOL) implantation were evaluated by retrospectively analyzing 108 consecutive operations. Postoperatively, 89% of eyes achieved 20/40 or better visual acuity when preoperative macular and optic nerve diseases were excluded. Mean follow-up was 16.8 months. Intraocular pressure (IOP) control (less than or equal to 21 mmHg) was achieved in 92% of eyes; 57% required no medications. Capsulotomy (20%) and transient hyphema (15%) occurred significantly more often (P less than 0.001) than in a comparison group. These results suggest that the combined procedure gives excellent visual rehabilitation and IOP control in the majority of patients included in this analysis.

Aged↗
PubMed1998

Late removal of releasable sutures after trabeculectomy or combined trabeculectomy with cataract extraction supplemented with antifibrotics.

PURPOSE: Releasable scleral flap sutures have been effectively used in trabeculectomy. The suggested time for suture removal is within the first two postoperative weeks. The authors wished to determine whether the use of intraoperative antifibrotics alters the time of suture removal and the results of surgery. METHODS: The charts of 324 patients (388 eyes) undergoing trabeculectomy and 141 patients (174 eyes) undergoing combined trabeculectomy with cataract extraction with a minimum follow-up of 12 months were retrospectively reviewed. All eyes received intraoperative antifibrotics; mitomycin C in 534 eyes and 5-fluorouracil in 29 eyes. Two releasable scleral flap sutures were used in all of the eyes. RESULTS: The removal time of at least one of the two releasable sutures was later than 21 days postoperatively in 89 eyes of 83 patients with trabeculectomy (22.9%) and in 58 eyes of 55 patients with combined surgery (33.3%). The suture removal was deferred in 39 eyes because of an early complication such as hypotony (intraocular pressure (IOP) < or = 5 mm Hg), bleb leak, or shallow or flat anterior chamber. There was no complication in the other 108 eyes, but suture removal was delayed until the IOP was more than 10 mm Hg. Immediate IOP reduction was (mean +/- standard deviation) 6.3 +/- 2.8 mm Hg when suture removal was performed beyond 3 weeks. There was a decreased response as the postoperative time until suture removal increases (r = -0.57). No serious complication associated with late suture removal was noted during the follow-up period (mean +/- standard deviation, 19.8 +/- 10.1 months). CONCLUSION: Intraoperative pharmacologic modulation of wound healing in trabeculectomy and combined trabeculectomy with cataract extraction extends the period that releasable suture removal is clinically effective. However the response decreases with a longer interval to releasable suture removal.

Aged↗
PubMed1993

[Capsular sack suture PMMA intraocular lens. Comparative study of centering behavior after phacoemulsification and planned extracapsular cataract extraction].

The position of bag-fixated intraocular lenses after phacoemulsification or extracapsular cataract extraction (ECCE) was compared in order to determine the relationship to the method of operation and the type of capsular opening. Photographs were taken from 71 eyes 6 months after in-the-bag implantation of a one-piece posterior chamber lens. Centering was determined with respect to the pupillary center. Forty-six eyes were operated on by phacoemulsification after continuous circular capsulorhexis with closed edges and 25 eyes by ECCE after capsulorhexis with a radial incision of the capsular rim at the 12 o'clock position. Ninety-four percent of the intraocular lenses implanted after phacoemulsification and 92% of the intraocular lenses implanted after ECCE were decentered less than 0.5 mm. The centering of bag-fixated intraocular lenses is related to the technique of opening the anterior capsule. Phacoemulsification with continuous capsulorhexis offers conditions similar to that in ECCE with capsulorhexis and radial capsular rim incision for good centering of one-piece posterior chamber lenses.

Adult↗
PubMed1988

Control of intraocular pressure in glaucomatous eyes after extracapsular cataract extraction with intraocular lens implantation.

Two hundred sixty eyes of 195 patients having extracapsular cataract extraction (ECCE) with insertion of a posterior chamber intraocular lens were studied retrospectively. Of these cases, 160 eyes had preexisting glaucoma while 100 had no ocular pathology except for cataract. Intraocular pressure decreased significantly after ECCE in both groups and slowly returned to baseline within two years. The average postoperative visual acuity was better in the control group than in the glaucoma group. Patients with glaucoma were controlled with less medication after surgery. We believe that ECCE with insertion of a posterior chamber intraocular lens can be safely performed in glaucoma patients and has a beneficial effect on the control of glaucoma.

Aged↗
PubMed2000

[Postoperative ptosis after cataract extraction: own material].

PURPOSE: To determine the incidence of postoperative ptosis in patients after cataract extraction and whether the type of local anaesthesia has any influence on the occurrence of this complication. MATERIAL AND METHODS: This study comprised 72 patients who had phakoemulsification of cataract. In group I 36 patients received 2-point peribulbar anaesthesia and in group II 36 patients received retrobulbar anaesthesia and the lid block. No bridle suture was used in both groups. To evaluate the ptosis the distance between the upper lid margin and central corneal reflex was measured before and 3 days after the operation. RESULTS: The ptosis of 2 mm occurred in one patient. There was no statistical difference between two groups referring to the incidence of ptosis. CONCLUSION: This relatively low incidence may be due to not using bridle suture. The technique of anaesthesia seemed to have no influence on the incidence of postoperative ptosis in our study.

Adult↗
PubMed1986

Inappropriate antidiuretic hormone secretion after cataract extraction under local anesthesia.

We report a case of a patient who underwent bilateral cataract extractions under local anesthesia. In both operations, the patient developed signs, symptoms, and laboratory data consistent with the syndrome of inappropriate secretion of antidiuretic hormone. In this era of outpatient cataract surgery, we believe this diagnosis should be entertained postoperatively in the proper clinical setting.

Aged↗