Results of extracapsular cataract extraction with lens implant. A review of 1625 cases.
We studied the results and complications of extracapsular cataract extraction with lens implantation. A one year follow-up of 1625 cases is described.
Adult↗
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Risk factors of acute endophthalmitis after cataract extraction: a case-control study in Asian eyes.
AIM: To describe risk factors of acute endophthalmitis after cataract extraction in an Asian population. METHODS: A retrospective, case-control study. Cases (n = 34) were patients with acute endophthalmitis presenting within 6 weeks after cataract surgery. Three controls per case (n = 102) were randomly selected from the cataract surgery list matched on the date of operation of cases. RESULTS: Few risk factors were identified. In multivariable analysis, endophthalmitis was associated with silicone intraocular lens (odds ratio 5.1, 95% confidence intervals, 1.2 to 21.6, compared to poly(methylmethacrylate) lens) and posterior capsular rupture during surgery (odds ratio 20.9, 95% confidence intervals 2.3 to 187.9). CONCLUSION: Silicone intraocular lens and rupture of the posterior capsule are risk factors of acute endophthalmitis after cataract surgery.
Acute Disease↗
[Report on corneo-scleral ulceration after cataract extraction (author's transl)].
A case of corneo-scleral ulceration beginning 4 months after uncomplicated cataract-extraction is reported on. Neither conservative nor operative treatment was able to stop the ulceration, so that enucleation was necessary. The clinical picture and serological and ophthalmopathological findings are shown. The probably immunological aetiology is discussed.
Aged↗
The effect of indomethacin 0.5% ophthalmic suspension in preventing surgically induced miosis during planned extracapsular cataract extraction.
The effect of topical Indomethacin 0.5% ophthalmic suspension in preventing surgically induced miosis during planned extracapsular cataract extraction is examined. Eighteen patients received Indomethacin per-operatively while 16 did not and served as controls. Our study failed to show any difference in per-operative pupil size between either group.
Administration, Topical↗
One-step extracapsular cataract extraction and silicone oil-injection in the management of proliferative vitreoretinopathy.
A combined technique of extracapsular cataract extraction and silicone oil injection is described. The anterior capsule is preserved to prevent movement of the silicone oil from the vitreous cavity to the anterior chamber. An anterior chamber tap ensures that the vitreous cavity is completely filled with silicone oil, while a peripheral iridectomy prevents postoperative pupillary block glaucoma.
Adult↗
Management of persistent filtering cicatrix following cataract extraction.
We used a safe and simple surgical technique in the management of persistent filtering cicatrices after cataract extraction. The edematous, friable filtering cicatrix was excised entirely and a healthy fornix-based conjunctival flap was sutured over the fistula. Invariably, the fistula was very small, usually only large enough to admit a 27-gauge needle. Of the 27 eyes treated with this technique, there were two failures, but no other complications.
Aged↗
[Results of cataract extraction and lens implantation].
98 patients were invited for a follow-up examination 2 years after cataract extraction. They then completed a questionnaire dealing with their daily functioning, comparing the situations prior to and 2 years after the operation, and were asked as to their satisfaction with the results of the operation. Statistically significant improvement was found in measurements of both near and distance vision and in performance of most aspects of daily functioning. Most patients were pleased with results of the operation.
Cataract Extraction↗
Visual outcome of cataract extraction and lens implantation complicated by vitreous loss.
A retrospective study of 62 cases of planned extracapsular cataract extraction with intraocular lens implantation complicated by vitreous loss revealed a visual outcome of 20/20 to 20/40 in 34 eyes (54.8%), 20/50 to 20/80 in 16 eyes (25.8%), 20/100 to 20/400 in six eyes (9.7%), and worse than 20/400 in six eyes (9.7%). If preexisting ocular diseases such as glaucoma and macular degeneration are eliminated, 77.3% achieved a visual acuity of 20/40 or better.
Adult↗
Phacoanaphylactic endophthalmitis associated with extracapsular cataract extraction and posterior chamber intraocular lens.
We describe the clinicopathologic findings in a patient who underwent extracapsular cataract extraction (ECCE) with insertion of a posterior chamber intraocular lens (IOL). The patient had a sterile hypopyon and anterior uveitis that temporarily subsided but recurred. The inflammation actually worsened after removal of the IOL, and the eye was enucleated. Histopathologic examination showed a pattern consistent with phacoanaphylactic endophthalmitis. We therefore postulate that the patient's complications were due to hypersensitivity to her own lens protein, which remained after the ECCE, rather than to the IOL itself.
Aged↗
Bilateral acute postoperative retinal detachment after cataract extraction: case report and review of the literature.
A 57-year-old white man had extracapsular cataract extraction complicated by vitreous loss. On postoperative day 1, he was noted to have a total retinal detachment (RD) with vitreous hemorrhage. No predisposing anatomic risk factors were present except for the vitreous loss. During the RD repair, 2 small superior tears were discovered. Eleven months later, the patient had uneventful phacoemulsification in the fellow eye. On postoperative day 1, he again had a total RD with a superior retinal tear. Meticulous retinal evaluation had been performed preoperatively, and no holes or tears were discovered. The RD was repaired, and the best corrected visual acuity at the last examination was 20/40 in both eyes.
Acute Disease↗
[Pupillary blockage after intracapsular cataract extraction in the adult apropos of 4 cases].
Intra capsular extraction is the most employed surgical technics for the treatment of senile cataract in developing countries. Nevertheless complications are usual, among them the pupillary block. The authors notified in 365 intra capsular cataract extractions, executed during 8 months, 4 cases of pupillary block occurred after operation without incident. The 3 cases had favorable evolution after an average of 4 days with medical treatment. 1 case had unfavorable evolution to aphakic glaucoma in spite of medical and surgical treatment. They point out in the necessity of strict post operative supervision and early treatment.
Adult↗
Combined trabeculectomy and cataract extraction. Advantages of a modified technique and review of current literature.
The management of eyes with both cataract and glaucoma is reviewed. An argument is made for the use of combined cataract and glaucoma surgery as the initial procedure in eyes that have glaucoma, regardless of preoperative control, with cataract which requires removal. The combined operation is also recommended in eyes that require glaucoma surgery and have significant cataract (i.e. visual acuity of 6/12 or reading 6 pt print). A comparison of the results of a modified combined procedure with those of an initial cataract or glaucoma procedure followed by a second procedure at a later date and with those of previous combined procedures demonstrates the advantages of the former. The combined trabeculectomy and cataract extraction is modified by the use of a fornix-based conjunctival flap and by tightly suturing the lamellar trabeculectomy scleral flap to its base. The advantage of this technique is that a 3 1/2-year follow-up demonstrates a lower risk of postoperative complications compared with combined trabeculectomy with a loosely-sutured or unsutured scleral flap which has the same risk of postoperative complications, including shallow or flat anterior chamber, as do combined classical filtering procedures (thermal sclerostomy, trephination, sclerectomy, iridencleisis). We have reviewed 46 eyes operated by this technique and followed them for an average of 3 1/2 years. In 44 eyes the postoperative intraocular pressure is well controlled and the visual fields remain stable.
Cataract↗
Extracapsular cataract extraction and implantation of a low power lens for high myopia.
A comparative study of two groups of patients with cataracts and high myopia was made. The percentage of patients with a visual acuity equal to or better than 20/40 (P less than .01) and normocorrections +/- 1 diopter (P less than .01) was significantly greater in the group with extracapsular cataract extraction and intraocular lens implantation.
Cataract↗
Astigmatism after a large scleral pocket incision in extracapsular cataract extraction.
In this four-month prospective study, we measured astigmatism in 116 patients who had extracapsular cataract extraction through a 13 mm scleral pocket incision. In one group, the wound was closed with five radial 10-0 polypropylene sutures. Early and late postoperative astigmatism in this group was approximately 2 diopters (D), but a significant shift to against-the-rule astigmatism occurred. In a second group, an additional 10-0 polypropylene horizontal suture was placed anteriorly to the radial suture at the 12 o'clock meridian. This reduced the against-the-rule astigmatic decay. Moreover, this group had less postoperative astigmatism. Mean corneal astigmatism was 2.27 D at one week, 1.76 D at one month, 1.37 D at two months, and 1.70 D at four months. In neither group was cutting the sutures necessary.
Aged↗
Corneal toxic changes after cataract extraction.
Over an 18-month period 10 patients (12 eyes) presented with severe corneal toxic changes after cataract extraction. Defined stages in the keratopathy included punctate epithelial keratopathy, pseudodendrite, central epithelial ulcer and central stromal ulcer. Periods of up to 13 months were required for resolution of the defects. Axial scarring and nonhealing epithelial defects resulted in a final visual acuity of counting fingers and hand movement in two patients. We believe that exposure during the postoperative period to benzalkonium chloride contained in ophthalmic medications represents the most likely cause of the toxic changes and that no single ophthalmic medication can be held responsible. The past ocular histories of the patients included chronic open-angle glaucoma, dry eye syndrome and anterior membrane dystrophy. Prior exposure to benzalkonium-containing antiglaucoma medications, tear film deficiencies or abnormalities of epithelial adhesion may have predisposed the corneas in these patients to the development of benzalkonium-related toxic changes.
Benzalkonium Compounds↗
Intraocular dapiprazole for the reversal of mydriasis after extracapsular cataract extraction with intraocular lens implantation. Part II: Comparison with acetylcholine.
Intraocular dapiprazole for reversing mydriasis during extracapsular cataract extraction with intraocular lens (IOL) implantation has been compared to intraocular acetylcholine. Ninety patients were enrolled in a double-blind study and divided into three groups of 30 eyes; each group received balanced salt solution (control), 0.25% dapiprazole, or 1% acetylcholine. Pupillary diameter recordings were performed immediately before and a few minutes after drug injection, and two, four and eight hours after surgery. Goldmann tonometry was performed the day before and 6 and 24 hours after surgery. Contact endothelial cell count was performed before and one and four months after surgery. The results indicated a slower starting but longer lasting effect with dapiprazole than with acetylcholine and a significant reduction of the postoperative intraoperative pressure rise with both drugs. No significant difference in reduction in the endothelial cell count was seen between dapiprazole and acetylcholine groups and the control group.
Acetylcholine↗
Risk factors for posterior capsular pearling after uncomplicated extracapsular cataract extraction and plano-convex posterior chamber lens implantation.
We retrospectively reviewed 542 consecutive cases of extracapsular cataract extraction with implantation of a plano-convex laser ridge posterior chamber intraocular lens. We were interested in the incidence and probability of the development of postcapsular epithelial pearling that required laser capsulotomy and the risk factors associated with it. After four years of follow-up, 21% of all cases had developed pearling. Over the same period, the probability of pearling, as determined by the Kaplan-Meier curves, was 29% with a 95% confidence interval between 22% and 36%. After one year of follow-up, the probability of pearling was 5%; after two years, 15%; after three years, 24%. Younger age (50 years or less), larger optic, and smaller IOL were identified as significant risk factors when each of these factors was analyzed separately. When all risk factors were studied together, and after applying confounding statistics, only younger age was identified as a significant risk factor (P = .003).
Adult↗
Results of extracapsular cataract extraction with intraocular lens implantation in eyes with uveitis and Fuchs' heterochromic iridocyclitis.
A total of 63 cataractous eyes of 48 patients (group 1) with uveitis and 12 eyes of 12 patients (group 2) with Fuchs' heterochromic iridocyclitis underwent extracapsular cataract extraction (ECCE) with capsular bag fixation of a posterior-chamber intraocular lens (PC OIL). A perioperative regimen of systemic dexamethasone (0.8-1.5 mg/kg) was initiated. This dose was tapered by 20 mg/day, reaching zero within 4-8 days. Intraoperatively, synechiolysis was required in 51 of 63 eyes in group 1 and a sector iridectomy was necessary in 42 eyes. A fibrinous reaction occurred in 7 eyes. During a mean follow-up period of 2 years, 7 eyes developed uveitis recurrences that were successfully treated with topical and systemic steroids in 4 eyes; the other 3 eyes developed cystoid macular edema. Overall, mean visual acuity improved from 20/120 to 20/50. Intraoperatively, 3 patients in group 2 developed a transient hemorrhage from atypical anterior-chamber-angle vessels. Postoperatively, 3 eyes showed a transient fibrinous reaction. The mean visual acuity improved from 20/240 to 20/30. In patients with Fuchs' heterochromic iridocyclitis, ECCE with PC IOL implantation renders good intermediate results. In other selected patients with uveitis, in-the-bag IOL implantation may be performed with an acceptable risk. As judged from their improved visual acuity, 57 of 63 eyes (90.5%) benefited from the procedure.
Adult↗