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PubMed1981

Combined penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber lens implantation.

A retrospective chart review of 18 consecutive unselected cases of combined penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber lens implantation was performed. Overall, 89% of the grafts remained clear with follow-up between six and 54 months (average 21 months). Visual acuities were 20/50 or better in 61% of the cases and 20/80 or better in 83%. Postoperative complications included two graft failures, two cases of secondary glaucoma, one case of cystoid macular edema, and one case of pupil capture. No patients to date have required a secondary discission.

Aged↗
PubMedDate not supplied

[Postoperative astigmatism after extracapsular cataract extraction].

The authors analysed the occurrence and changes of postoperative astigmatism in three groups of patients after the performed extracapsular cataract extraction, regarding the type of the applied sutures: single, continuous double row and combined suture. One hundred and fifty-eight eyes were followed up over the period of 6 months. The quickest decreasing of astigmatism and its lowest values were recorded in the application of the combined suture. A statistically significant decrease of astigmatism values (p < 0.01) was already found after 1 month, and after 6 months 98.7% of the operated eyes had the postoperative astigmatism lower than 0.9 D.

Adult↗
PubMed1984

Combined trabeculectomy, intracapsular cataract extraction, and lens implantation: a clinical series.

Twenty-two eyes from 17 patients underwent a combined surgical approach for cataracts and glaucoma, involving an intracapsular cataract extraction, trabeculectomy, and anterior chamber intraocular lens implantation with an average follow-up of one year. The surgical technique is described. The average intraocular pressure fell from 24.9 mm Hg to 16.7 mm Hg. Seventy-three percent of the patients required no medication postoperatively for control of their glaucoma. Ninety-six percent of the patients showed an improvement in visual acuity improvement. Complications of flat peripheral anterior chambers and hyphema formation did not affect post-operative pressures or visual acuity results. The results encourage further investigation of this procedure.

Aged↗
PubMed1990

[Changes in refraction after cataract extraction and IOL implantation].

The refraction changes were followed up in 61 eyes 1 week to 3 years after extracapsular cataract extraction and posterior chamber IOL implantation. The variation in spherical power during follow-up was not significant, while the changes in astigmatism were very significant at end of the first week, when the mean value of cylinder power was 4.21 D and the axis in 82% of the eyes was with-the-rule. After 3 months, the astigmatism became reduced and relatively stable, when the mean power was 1.90 D and the axis in 65.6% of the eyes against-the-rule. The astigmatism continued to change afterwards, especially in the position of axis.

Aged↗
PubMed1999

[Dolasetron, droperidol and a combination of both in prevention of postoperative nausea and vomiting after extracapsular cataract extraction under general anesthesia].

BACKGROUND: Both, droperidol and the new 5-HT3-antagonist (e.g. dolasetron) are effective drugs in the prevention of postoperative nausea and vomiting (PONV). It was the aim of this prospective double blind placebo controlled study to determine the efficacy of low-dose droperidol, dolasetron, and a combination of both drugs in the prevention of PONV after extracapsular cataract extraction. METHODS: 148 inpatients undergoing cataract surgery were stratified according to gender and then randomised to receive one of four antiemetic regimens: placebo, droperiodol (10 micrograms x kg-1), dolasetron (12.5 mg), or the combination of both drugs (10 micrograms x kg-1 + 12.5 mg). The drugs were administered intravenously 5-10 minutes before the end of anaesthesia. General anaesthesia and the perioperative management of the patients were standardised: benzodiazepine premedication, induction with etomidate, alfentanil and mivacurium. Maintenance using desflurane in N2O/O2, and a continuous infusion of mivacurium was used. Postoperative analgesia (diclofenac or paracetamol) and antiemetic rescue medication (dimenhydrinate and metoclopramide) was standardised. Nausea, episodes of vomiting, retching and the need for additional antiemetics were recorded for 24-hours. The severity of PONV was categorised using a standardised scoring algorithm. The main aim of the study was the number of patients who stayed completely free from PONV. RESULTS: There were no differences between the two groups with regard to biometric data, type of surgery, and distribution of risk factors for developing PONV. In all three treatment groups significantly less patients suffered from PONV (placebo: 66%; droperidol: 89%, dolasetron: 92%, combination: 89%; p = 0.011). Furthermore, the severity of PONV was reduced (p = 0.012). CONCLUSION: Low-dose droperidol and dolasetron are equally effective to reduce the incidence of PONV after cataract surgery under general anaesthesia. The combination of both drugs revealed no additional effect.

Aged↗
PubMed1982

Outer retinal ischemic infarction--a newly recognized complication of cataract extraction and closed vitrectomy. Part 1. A case report.

This report describes a peculiar syndrome occurring as a complication of cataract extraction. The syndrome is characterized initially by (1) acute loss of central and paracentral vision discovered usually on the first postoperative day; (2) diffuse and patchy whitening of the outer retinal layers in the posterior fundus; (3) normal angiographic retinal and choroidal appearance and circulation time; (4) a peculiar polygonal pattern of fluorescein staining of the pigment epithelium and outer retina in the area of retinal whitening, and followed later by (5) clearing of the retinal whitening and mottled changes in the pigment epithelium; (6) partial recovery of the central visual field; and (7) preservation of normal optic disc and retinal vessel caliber. Prolonged elevation of the intraocular pressure sufficient to obstruct choroidal blood flow occurring during the use of intraocular volume-reducing devices before surgery, during phakoemulsification or closed vitrectomy is postulated as the major cause of this complication.

Adolescent↗
PubMed1992

Intraocular pressure and anterior chamber depth before and after extracapsular cataract extraction with posterior chamber lens implantation.

Long-term intraocular pressure (IOP) was evaluated in 41 glaucoma patients after extracapsular cataract extraction (ECCE) with posterior chamber lens (PC-IOL) implantation. All patients were initially monitored for a mean of 19 days. Eight failed to return for reexamination, but follow up of the other 33 continued for a mean of 12 months. IOP dropped significantly and the need for medication was reduced in all patients (particularly in those with open-angle glaucoma and prior iridotomy and iris suturing). The reduction in pressure remained significant in patients with simple or exfoliation glaucoma even after long-term observation. Pressure also significantly dropped in patients who had undergone previous ophthalmic surgery. The pressure drop was possibly due to a surgical deepening of the chamber angle. (Using the laser tomographic scanner, we found the same phenomenon in 50 patients without glaucoma: following ECCE/PC-IOL, the anterior chamber angle widened 9.3 +/- 4.3 degrees.)

Aged↗
PubMed2003

[Comparing patients' quality of life after phacoemulsification with intraocular lens implantation with that after extracapsular cataract extraction with intraocular lens implantation].

OBJECTIVE: To Compare the effects of phacoemulsification with intraocular lens implantation (PHACO + IOL) to extracapsular cataract extraction with intraocular lens implantation (ECCE + IOL) on quality of life. METHODS: The study population consisted of 116 patients receiving PHACO + IOL and 93 patients receiving ECCE + IOL. They were interviewed using the quality of life questionnaire, and the clinical outcomes were obtained before surgery and in 1 week, 1 month, 3 months after surgery respectively. RESULTS: Patients receiving PHACO + IOL reported larger benefit in quality of life and all sub-scales than did those receiving ECCE + IOL in 1 week after surgery. Subjects underwent PHACO + IOL showed better improvement in quality of life and two sub-scales (social and mental) than did those underwent ECCE + IOL in 1 month and 3 months after surgery. However, the improvement in other two sub-scales (self-care and mobility) was similar between two surgical groups in 1 month and 3 months after surgery. CONCLUSION: The patients receiving PHACO + IOL reported better and more rapid improvement in quality of life within 3 months after surgery. PHACO + IOL and ECCE + IOL have the same effects on improvement in self-care and mobility. So quality of life in patients receiving PHACO + IOL are better than those of ECCE + IOL.

Aged↗
PubMed1994

Long-term natural and modified course of surgically induced astigmatism after extracapsular cataract extraction.

A prospective study was carried out to investigate the long-term course of surgically induced astigmatism after extracapsular cataract extraction. Sixty-one eyes were followed for 36 months. In 27 eyes with post-operative astigmatism > 4D with-the-rule, one or two sutures were cut in the steeper meridian after 3 months. In another group of 34 eyes with only minor or no postoperative astigmatism with-the-rule, no suture was cut. We found that 1) postoperative astigmatism was significantly increased in all eyes after 1 week and 3 months, but decreased in time approaching preoperative values after 3 years, 2) surgically induced astigmatism was with-the-rule at 1 week and 3 months but turned against-the-rule in time in both groups. Astigmatism decay rate was significantly steeper in eyes with suture cutting, 3) the keratometric axis was exclusively with-the-rule after 1 week, but turned against-the-rule in both groups, approaching the preoperative distribution of axis after 3 years. We concluded that surgically induced astigmatism is a dynamic feature showing changes in size and axis even in the period 1-3 years postoperatively. Suture cutting seems to intensify the decrease in the induced astigmatism and accelerate the shift in astigmatic axis, turning astigmatism against-the-rule compared to eyes with intact sutures.

Adult↗
PubMed1997

Phacoemulsification versus extracapsular cataract extraction: a comparative study of cell survival and growth on the human capsular bag in vitro.

AIMS/BACKGROUND: Phacoemulsification is rapidly replacing conventional extracapsular cataract extraction (ECCE) as the method of choice for cataract surgery in the Western world. However, posterior capsule opacification (PCO) still remains the major postoperative complication, affecting 20-50% of patients, and results from persistent cell growth of epithelial cells remaining after surgery. This study aimed to compare cell survival and growth on capsular bags following ECCE and phacoemulsification surgery using an established human capsular bag culture system. METHODS: Sham ECCE and phacoemulsification cataract operations were performed on pairs of human donor eyes. Capsular bags were dissected free, pinned flat on a petri dish, and incubated with Eagle's minimum essential medium (EMEM) alone or EMEM supplemented with 10% fetal calf serum (FCS). Ongoing observations were made using phase contrast microscopy. RESULTS: Cell growth was observed across the posterior capsule of all preparations studied. It was found that there was no significant difference in the rate of cell growth on the posterior capsule with the two extraction methods, such that 50% confluency was achieved in 7.0 (SD 1.8) (n = 7) days for ECCE and 7.43 (2.1) (n = 7) days for phacoemulsification surgery. The physical changes to the capsule as a result of cell growth, such as wrinkling and capsular tensioning, were also seen in both groups. CONCLUSIONS: Cell survival and growth is dependent on the donor, rather than the surgical technique performed. There is no significant difference between phacoemulsification and ECCE surgery on the rate and nature of cell growth on the posterior capsule in vitro.

Cataract Extraction↗
PubMed1975

Fundus changes immediately after cataract extraction.

The effect of acute ocular hypotony as a factor in the formation of serous choridal detachments was investigated in 45 eyes undergoing cataract extraction. A fundus examination was made with binocular indirect ophthalmoscopy immediately after lens removal and in the early postoperative period. No choroidal detachments occurred, either early or late. Full-thickness infoldings of the eye wall in the posterior segment were seen in 80 per cent of the eyes immediately after lens extraction. The orientation of these folds is described, and factors leading to their formation are discussed.

Cataract Extraction↗
PubMed1986

Combined intracapsular cataract extraction and trabeculectomy with Severin five-loop posterior chamber intraocular lens.

The efficacy and safety of a combined operation for cataract and glaucoma is established. This procedure of combined cataract extraction and trabeculectomy is taken one step further by the simultaneous insertion of the Severin intraocular posterior chamber lens implant. The results of treating 24 eyes in terms of control of glaucoma are discussed. Postoperative miotics may be required to improve stability of the implant, especially after delivery of the lens through a pupil rendered tight by long term preoperative miotic administration.

Aged↗
PubMed1976

Lamellar macular hole: a complication of cystoid macular edema after cataract extraction.

A woman developed an inner lamellar macular hole and cellophane maculopathy as a complication of chronic cystoid macular edema following cataract extraction. Fluorescein angiography revealed a cystoid pattern of fluorescence in the paracentral area but no evidence of staining in the region of the hole. Following death, histopathologic examination of both eyes confirmed the clinical observations. Biomicroscopic examination and fluorescein angiography are of value in differentiating an inner lamellar macular hole from a full-thickness macular hole and from a pseudomacular hole caused by spontaneous contraction of an epiretinal membrane.

Cataract Extraction↗
PubMed2006

Risk of retinal detachment after cataract extraction, 1980-2004: a population-based study.

PURPOSE: To estimate the long-term cumulative risk of retinal detachment (RD) after cataract extraction (CE). DESIGN: Retrospective cohort study and nested case-control study. PARTICIPANTS: All residents of Olmsted County, Minnesota who had CE from 1980 through 2004 (10 256 CEs in 7137 residents) and were diagnosed subsequently with RD in the same period. Two controls chosen from the primary cataract surgery cohort were matched to each RD case by age, gender, and duration of follow-up. METHODS: Cases were identified through the Rochester Epidemiology Project databases. Records were reviewed to confirm case status and ascertain risk factor information. The observed probability of RD after CE was estimated using the Kaplan-Meier method. A cumulative probability ratio of RD after CE was determined by comparing the observed probability of RD and the expected probability of RD in residents without CE. Logistic regression models assessed differences between cases and controls. MAIN OUTCOME MEASURES: Probability of and risk factors associated with RD after CE. RESULTS: Eighty-two cases of RD were identified. The cumulative probability of RD increased in a nearly linear manner over the 25-year study period. At 1, 5, 10, 15, and 20 years after extracapsular CE (ECCE) and phacoemulsification, cumulative probabilities of RD were 0.27%, 0.71%, 1.23%, 1.58%, and 1.79%, respectively. There was no significant difference in the probability of RD after ECCE when compared with phacoemulsification (P = 0.13). The cumulative probability ratio of RD at 20 years after ECCE and phacoemulsification remained 4.0-fold (95% confidence interval, 2.6-5.4) higher than would be expected in a similar group of residents not undergoing CE (P<0.001). Male gender, younger age, myopia, increased axial length, and posterior capsular tear were associated significantly with RD (P<0.01). CONCLUSIONS: The cumulative risk of RD after ECCE and phacoemulsification is increased for up to 20 years after surgery.

Adolescent↗