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PubMed1990

[Detachment of the choroid after cataract extraction].

Injections of air into the anterior chamber were applied by the authors in choroidal detachment and flat anterior chamber after 22 cataract extractions and 4 fistulizing operations in glaucoma (together 26 cases) after an ineffective conservative treatment. The deepening of the anterior chamber and reapposition of the choroid was achieved in all the cases. Special attention in applying this method was called to the deepening of the anterior chamber and to supply a considerable amount of air into the eye, so as to raise the intraocular pressure up to the normal values or even more. The air remained in the eye even for 7 days. In 12 cases there was a need to inject the air a second time because of an insufficient reapposition of the choroid after the resorption of the air finished or because of the recurrence of the detachment.

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PubMed1984

Influence of cataract extraction on cornea and conjunctiva, assessed by vital staining.

A study of the post-operative course in 100 patients subjected to cataract extraction revealed fairly pronounced dehydration of the corneal epithelium and the generally non-exposed segment of the conjunctiva, estimated by Rose Bengal stainability. This dehydration was to become appreciably reduced from the first to the third post-operative day, reaching normal levels of Rose Bengal stainability. The exposed conjunctival segment showed a surprisingly low Rose Bengal stainability on the first post-operative day, in 10% declining until the third day. Disinfection with polyvinylpyrrolidine iodide was found not to alter the stainability of cornea and conjunctiva, compared with the commonly employed method of disinfection with tincture of iodine. In 34% 'bulla'-like formations localized in the superior half of the cornea were noticed on the first post-operative day. These were supposed to represent oedema. The percentage had declined to 20 on the third day.

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PubMed2003

Infective endophthalmitis caused by Bacillus cereus after cataract extraction surgery.

We describe a 72-year-old Chinese man who developed fulminant Bacillus cereus endophthalmitis 36 h after an uneventful surgery for cataract extraction. Clinical progression of disease was extremely rapid, in spite of early vitrectomy and intravitreal injection of antibiotics. Results of Gram staining showed gram-positive bacilli, and the culture was positive for B. cereus. Endophthalmitis is rare after cataract surgery (cumulative probability within 1 year, approximately 0.08%), and cases caused by B. cereus are even less common. The prognosis and plan of treatment are discussed.

Bacillaceae Infections↗
PubMed1996

Phacoemulsification versus endocapsular cataract extraction in a unique cohort of patients.

The visual recovery and refractive results of 33 consecutive patients (66 eyes) undergoing standard endocapsular cataract extraction in one eye and simultaneous phacoemulsification in the fellow eye are reported. One surgeon performed all the operations. Surgically induced astigmatism was evaluated for the two techniques in terms of: (1) the proportion of eyes with a refractive cylinder of 1.5 dioptres (D) or less; (2) the interocular difference in post-operative astigmatism. Eyes undergoing phacoemulsification had a significantly lower mean induced cylinder (paired Student's t-test: t = 3.729; p < 0.001) and were more likely to exhibit a cylinder of 1.5 D or less (chi-squared test with Yates' correction: chi 2 = 7.88; p < 0.01) than the nuclear expression group. For paired eyes less post-operative astigmatism (Wilcoxon's signed rank test: T = 92; p < 0.01) was seen in the phacoemulsification eye. At the time of the last post-operative assessment a significantly higher proportion of phacoemulsified eyes achieved a corrected Snellen visual acuity of 6/6 or better than their fellow eyes (McNemar's test: p < 0.01). The results of this unique cohort of patients confirm the beneficial effects of phacoemulsification on astigmatism and visual outcome in the early post-operative period.

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PubMedDate not supplied

[Corneal endothelium in patients with diabetes after extracapsular cataract extraction with intraocular lens implantation in the posterior chamber].

We have examined endothelial cell density before and 3, 6, 12 months after extracapsular cataract extraction with intraocular lens implantation (posterior chamber) in diabetic patients and in non-diabetics. We have not found statistically significant differences between the mean loss of endothelial cells due to surgery in diabetic and non-diabetic patients.

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PubMedDate not supplied

[Intracapsular implantation of the Saturn-type intraocular lens during simultaneous cataract extraction and trabeculectomy].

The authors have developed a method for implantation of the Saturn-type intraocular lens (IOL), designed by Krasnov and Pivovarov, during a simultaneous cataract extraction with trabeculectomy. Such combined operations have been carried out in one of the eyes of 15 patients suffering from senile cataracts and open-angle glaucomas, the vision acuity of the other eye being at least 0.4. The patients have been followed up for 1 to 3 yrs postoperation. The suggested variant of surgery involves but little complications and yields good immediate and late hypotensive effect. Intracapsular implantation of this IOL design provides a better intactness of the posterior epithelium of the cornea than other implantation techniques with other IOL designs. Normal ophthalmic tone has been recorded in late periods after surgery in all the cases; in one patient additional drug therapy has been necessary. The vision acuity in 14 eyes has reached 0.4 and higher, in 9 of these it has been 0.7 and higher as compared to the immediate results. Thirteen patients have recovered binocular vision; the visual field has widened in 5 eyes and has not essentially changed in 10. The authors consider that further clinical studies of the suggested technique hold good promise as regards medical and social rehabilitation of patients with senile cataracts and open-angle glaucomas.

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PubMedDate not supplied

Comparison of intraocular pressure profiles during cataract surgery by phacoemulsification and extracapsular cataract extraction.

BACKGROUND AND OBJECTIVE: In view of reports of fluctuations in intraocular pressure (IOP) during phacoemulsification, real-time IOP during small-incision, manual extracapsular cataract extraction (ECCE) and phacoemulsification was measured to determine the effect of anterior chamber maintainer infusion on intraoperative IOP dynamics. PATIENTS AND METHODS: A comparative study of IOP during cataract surgery was conducted by these two methods in 29 patients. An anterior chamber maintainer infused balanced salt solution continuously into the eye throughout ECCE. The anterior chamber maintainer was open in 7 cases throughout phacoemulsification and switched off during phacoemulsification in 7 cases. RESULTS: IOP measurements during small-incision ECCE were physiologic (range, 5 to 20 mm Hg) during most of the operation and coincided with the value of hydrostatic pressure established by the height of the anterior chamber maintainer infusion bottle. During phacoemulsification without concomitant anterior chamber maintainer, IOP was positive (> 2 to 3 mm Hg) as long as the phacoemulsification infusion line was activated (position 1). Moving to position 0 caused hypotony. Occlusion breaks occasionally caused wide fluctuations in IOP. Concomitant anterior chamber maintainer and phacoemulsification infusion did not prevent surges, but may account for the lower range of fluctuation. The anterior chamber maintainer also maintained a positive IOP at position 0 during phacoemulsification. CONCLUSIONS: An anterior chamber maintainer in conjunction with a self-sealing incision can maintain stable physiologic IOP during small-incision ECCE. The IOP fluctuations during phacoemulsification, especially during occlusion breaks, can be attenuated by an anterior chamber maintainer.

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PubMed1981

Incidence of retinal detachments following extracapsular cataract extractions. A prospective study.

This is a preliminary report on a prospective study designed to determine the incidence of retinal detachment following planned extracapsular cataract extractions. The population consists of 454 eyes with a mean follow-up period of 23 months. The incidence of detachment is much lower than that reported for intracapsular extractions. The most significant finding to date is the importance of maintaining the posterior capsule and the vitreous face intact. The incidence of detachment when this is accomplished in normal eyes is 0.9%. The overall incidence of this complication in the entire series is 1.50%. The reported disadvantage of maintaining the posterior capsule is the 40% to 50% incidence of a secondary cataract. In this series, the incidence is 11%. The factors responsible for this low figure are enumerated.

Cataract Extraction↗
PubMed1993

Analysis of the short-term effect of two viscoelastic agents on the intraocular pressure after extracapsular cataract extraction. Sodium hyaluronate 1% vs hydroxypropyl methylcellulose 2%.

We conducted a study to evaluate the shortterm effect on intraocular pressure (IOP) following extracapsular cataract extraction using either sodium hyaluronate 1% or hydroxypropyl methylcellulose 2%. In both groups a non-significant rise in IOP at day 1 was followed by a significant decline in IOP at day 3 to values below the pre-operative level (p < 0.05). At day 7 both groups had returned to pre-operative values. Post-operatively, spikes in intraocular pressure (> 25 mmHg) were seen equally in both groups. Patients with pre-operatively diagnosed open-angle glaucoma, high myopia and diabetic retinopathy are considered to be at high risk concerning post-operatively elevated IOP, but with small variation these patients followed the main trend.

Adult↗
PubMed1992

Peripheral corneal oedema following cataract extraction (Brown-McLean syndrome).

We describe the clinical features of 21 eyes of 15 patients who developed peripheral bullous corneal oedema following cataract extraction. The peripheral oedema was asymptomatic in all cases and was only noted at a review examination. Although the onset of the peripheral oedema was probably delayed for several years after surgery, it was not documented to progress in any patient or to involve the central cornea. Endothelial specular microscopy did not reveal any endothelial features that are specific for this condition, but confirmed that the central endothelial cell density can be as high as 2150 cells/mm2 in the presence of peripheral corneal decompensation. Despite the surface irregularity resulting from the peripheral corneal oedema 12 patients (18 eyes) continued to wear contact lenses to correct their aphakia.

Adult↗
PubMed1988

Long-term changes of the corneal endothelium following intracapsular cataract extraction with implantation of open-loop anterior chamber lenses.

The central corneal endothelium of a consecutive group of 158 patients with senile cataract was examined before intracapsular cataract extraction with implantation of an open-loop anterior chamber lens and 6, 12 and 48 months after surgery. Corneal endothelial morphometry was performed using an automated digital image analysis system. After 6 months of follow-up, there was an average loss of 10.8% in central corneal endothelial cell density, which increased to 14.8% after 12 months and 18.8% after 48 months. The early post-operative endothelial cell loss was correlated significantly with a decrease of cell pattern stability and polymegathism (P less than 0.0001). There was also a significant correlation between the continuous post-operative cell loss and the simultaneous changes of pattern stability and polymegathism and the age at the time of surgery (P less than 0.05).

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PubMed2003

Posterior capsule dehiscence during phacoemulsification and manual extracapsular cataract extraction: comparison of outcomes.

PURPOSE: To compare the intraoperative behavior and postoperative outcomes of posterior capsule dehiscence during phacoemulsification and during manual extracapsular cataract extraction (ECCE). SETTING: L.V. Prasad Eye Institute, Hyderabad, India. METHODS: This study was a retrospective chart review of consecutive cases of posterior capsule dehiscence over 2 years in patients having phacoemulsification or manual ECCE. A chi-square test was used for statistical comparison of the results in the 2 groups. RESULTS: In the 127 eyes with posterior capsule dehiscence, the incidence of vitreous prolapse was comparable between the 2 groups (phacoemulsification, 61.6%; ECCE, 62.7%). In the phacoemulsification group, vitreous prolapse occurred more frequently if nuclear fragments were present at the time of posterior capsule dehiscence than if they were present during cortex removal (P =.05). Posterior dislocation of nuclear fragments occurred in 4 eyes in the phacoemulsification group. Increased anterior uveitis in the early postoperative period occurred more frequently in the ECCE group (P =.02). The visual outcomes were similar between the 2 groups. CONCLUSIONS: Even though differences existed between the intraoperative factors influencing the management of posterior capsule dehiscence during phacoemulsification and ECCE, the final anatomic and visual outcomes were comparable.

Capsulorhexis↗
PubMed1986

Morphological changes after extracapsular cataract extraction with implantation of posterior chamber lenses. A prospective clinical study.

Morphological changes and lens position were examined in 66 patients 3 to 5.5 (mean 4) months after extracapsular cataract extraction with intended implantation of posterior chamber lenses in the ciliary sulcus. Important findings were: capsulotomy-requiring secondary cataract (3%), iris-lens synecchiae (18%), iris-capsule synecchiae (14%), pupillar capture (2%) and haptic-malposition (17%). The lens optic was slightly decentered in 33%. The internal anterior chamber depth was measured with optical pachymetry and averaged 3.5 mm (range 2.3-4.5 mm). The central distance between the posterior lens surface and the posterior capsule (LPCD) was measured pachymetrically and averaged 0.14 mm (range 0-0.6 mm).

Anterior Chamber↗
PubMed2001

Posterior ischemic optic neuropathy after uncomplicated cataract extraction.

PURPOSE: We report a case of posterior ischemic optic neuropathy after uncomplicated cataract extraction. DESIGN: Observational case report. METHODS: Retrospective description of the natural course of posterior ischemic optic neuropathy in one patient seen at an academic institution. RESULTS: The patient had sudden vision loss after uncomplicated cataract surgery with the features of an optic neuropathy, no acute disk swelling, and delayed optic nerve head perfusion on fluorescein angiography. CONCLUSIONS: Posterior ischemic optic neuropathy rarely occurs after uncomplicated cataract surgery, and should be considered in the setting of postoperative vision loss.

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PubMed1996

Effect of surgical technique on the increase in intraocular pressure after cataract extraction.

BACKGROUND AND OBJECTIVE: A prospective study was performed to determine the influence of surgical technique on the increase in intraocular pressure (IOP) after cataract surgery. PATIENTS AND METHODS: Three groups of 30 patients each underwent either extracapsular cataract extraction with sclerocorneal suture (ECCE), phacoemulsification with sclerocorneal suture (PS), or phacoemulsification with a sutureless scleral tunnel (PT). RESULTS: Each group experienced a significant increase in IOP 5 to 7 hours after surgery: 20.2 +/- 7.9 mm Hg for ECCE, 11.2 +/- 8.3 mm Hg for PS, and 4.7 +/- 8.7 mm Hg for PT. The differences in the increases among the three groups were significant. CONCLUSION: PT [corrected] produces the lowest postoperative increase in IOP and should be considered for patients with glaucomatous damage.

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PubMedDate not supplied

Extracapsular cataract extraction and intraocular lens implantation in leprosy patients: visual outcome and complications.

In Belo Horizonte, Brazil, 70 eyes of 53 leprosy patients had extracapsular cataract extraction and intraocular lens implantation done during a period of four years. The authors analyzed the outcome regarding restoration of vision and complications after this procedure. The visual acuity improved in 92.9% of the eyes and in 65.7% the acuity had improved by four lines or more on the Snellen chart. The post-operative complications could not be associated only to leprosy infiltration; in any case, they were not too serious and could be controlled.

Adult↗
PubMed1988

Cystoid macular edema following extracapsular cataract extraction and posterior chamber intraocular lens implantation.

The outcome of clinical cystoid macular edema (CME) was studied in 20 symptomatic eyes in which extracapsular cataract extraction and posterior chamber intraocular lens implantation had been performed. Resolution of symptoms and apparent resolution of the macular edema were observed in 18 (90%) of the 20 cases. Clearing occurred within one year in 14 (78%) of these 18 eyes and in 17 (94%) within two years. In all eyes in which macular edema resolved, visual acuity returned to 20/40 or better. This study suggests that clinical cystoid macular edema occurring in association with a posterior chamber intraocular lens has a relatively favorable course.

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