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An instrument for maintaining a deep anterior chamber during extracapsular cataract extraction is described. This anterior chamber maintainer makes the different stages of extracapsular technique safer and easier to perform.
PURPOSE: To evaluate the effect of trabeculectomy combined with extacapsular cataract extraction and posterior chamber intraocular lens implantation (triple surgeries) on the patients of coexisting cataract and glaucoma. METHODS: 18 cases (19 eyes) of coexisting cataract and glaucoma treated by the triple surgeries were reviewed. Mean follow-up was 14.7 months (rangs from 2 to 20 months). RESULTS: Intraocular pressure was controlled satisfyingly in all cases except one case required additional treatment of the anti-glaucoma drug. 78.9% of patients achieved 0.3 or better visual acuity. The operation complications consist of anterior uveitis and hyphaema. However, all of them were controlled within 14 days. CONCLUSION: The triple surgeries are safe and have definite effect on controlling the IOP and improving visual acuity.
Myopic patients, in particular, should be carefully observed by contactglass examination prior to and after cataract surgery, in order to be able to perform prophylactic photocoagulation. In cases of vitreous loss, the risk of having an aphakic retinal detachment will be 20 times as high; that is to say, in one of every five cases cataract extraction with vitreous loss can be expected to produce a retinal detachment. It can be said, therefore, that the best cataract procedure- as far as aphakic retinal detachment is concerned-will be that in which we can expect the lowest rate of vitreous loss. Whether an extensive anterior vitrectomy will reduce the number of aphakic detachments, we cannot yet say defintely, because in these cases we have only routinely performed vitrectomy during the past 2 years.
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We prospectively evaluated the change in trabecular pigmentation following extracapsular cataract extraction and posterior-chamber intraocular lens implantation in 70 patients (94 eyes) with senile cataracts. Using the Boys-Smith pigment gradation lens to measure semiquantitatively the amount of pigment visible in the angle, we estimated the mean trabecular pigmentation preoperatively and at 3-month intervals postoperatively. Both the mean pigmentation and the number of eyes with heavy pigmentation rose after the operation and then gradually returned to preoperative levels. There was no correlation between the amount of trabecular pigmentation and intraocular pressure.
PURPOSE: To compare the effect of latanoprost 0.005% with that of a placebo (balanced salt solution [BSS]) applied after phacoemulsification on intraocular pressure (IOP). SETTING: Pasco Eye Institute, New Port Richey, Florida, USA. METHODS: A group of patients having cataract extraction by phacoemulsification was randomized following surgery to receive one drop of latanoprost 0.005% (1.5 micrograms) or a placebo (BSS). Exclusion criteria included ocular diagnosis in addition to cataract, previous eye surgery, history of glaucoma, previous use of glaucoma medications, or vitreous loss during surgery. Standard phacoemulsification was performed through a scleral tunnel approach and a one-piece, poly(methyl methacrylate) intraocular lens implanted in the capsular bag. Approximately 24 hours after surgery, IOP was measured with a Goldmann applanation tonometer by the surgeon. The anterior chamber reaction was qualitatively graded from 1+ to 4+. RESULTS: The study included 103 eyes (latanoprost = 53; control = 50). Latanoprost treatment resulted in significantly lower postoperative (IOP) (16.4 mm Hg +/- 3.7 [SD]) than preoperative IOP (17.9 +/- 3.0 mm Hg) (P < .025). There was no decrease in postoperative IOP in the control group (18.2 +/- 3.5 mm Hg) compared with preoperative IOP (18.3 +/- 2.6 mm Hg). When two groups were compared, postoperative IOP after treatment with latanoprost was significantly less than control IOP (P < .01). Preoperative IOP was not significantly different in the placebo and latanoprost groups. Anterior chamber reaction was not increased by latanoprost; it averaged 1+ in both groups. CONCLUSIONS: Latanoprost may pharmacologically enhance uveoscleral outflow immediately after cataract extraction. In this study, latanoprost was a safe, effective method of reducing postoperative IOP.
This paper presents an evaluation of the astigmatism induced in two groups of consecutive surgeries for cataract. At risk is the hypothesis that phacoemulsification (Group 2) induces less astigmatism than extracapsular cataract extraction (Group 1) in a series.
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Our results of anterior vitrectomy in 12 patients with vitreo-corneal touch following cataract extraction, and in three patients with ghost-cell glaucoma due to vitreous hemorrhage were reported. The Machemer vitreous infusion suction cutter was used for pars plana and trans-corneal approaches. Anterior vitrectomy was effective in treating both disorders.
The authors report monofilament Polyglatin 910 running suture's experience in cataract extraction surgery. The security of this method is procured by:--an adequate wound closure with a complete absorption within eight weeks;--the running suture assured excellent imperviousness;--the physicochemical excellent tolerance of the monofilament.
PURPOSE: To compare the efficacy of a topical nonsteroidal anti-inflammatory agent (ketorolac tromethamine 0.5%) with that of a topical steroid (rimexolone 1%) to control inflammation after cataract surgery. SETTING: Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Thirty-six patients were prospectively and randomly assigned to receive topical treatment with either ketorolac tromethamine 0.5% or rimexolone 1% starting the day after routine cataract extraction. Treatment was masked to both patient and investigator. Each patient had uneventful small incision phacoemulsification with placement of a foldable posterior chamber intraocular lens. Patients used 1 of the 2 antiinflammatory agents 4 times each day starting 24 hours after surgery. No antiinflammatory medications were used preoperatively, intraoperatively, or for 24 hours postoperatively. Signs and symptoms of inflammation, intraocular pressure (IOP), and Kowa cell and flare measurements were evaluated 1, 4, 7, and 30 days postoperatively. RESULTS: There was no statistically significant difference in any measurement of postoperative inflammation between the 2 groups. There was no difference in objective or subjective cell and flare measurements. In addition, there was no difference in IOP measurements between groups. CONCLUSIONS: Ketorolac tromethamine 0.5% was as effective as rimexolone 1% in reducing inflammation after cataract surgery. These results suggest that ketorolac tromethamine 0.5% is a safe and effective antiinflammatory alternative to steroids after cataract extraction.