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PubMed1976

Corticosteroid therapy for the reduction of postoperative inflammation after cataract extraction.

In an random, double-masked multicentric clinical trial, topical betamethasone phosphate 0.1% or placebo eyedrops were used five times daily for the first two weeks after uncomplicated intracapsular cataract extraction in 107 patients who had moderate to severe postoperative inflammation on the first postoperative day. Topical corticosteroid solution was significantly more effective than placebo in the reduction of postoperative ocular inflammation. There were no ocular complications of corticosteroid treatment.

Adrenal Cortex Hormones↗
PubMed1995

[An investigation on therapeutic results of extracapsular cataract extraction and intraocular lens implantation in diabetics].

44 cases (50 eyes) with diabetes and cataract were followed up for 6-30 months after extracapsular cataract extraction (ECCE) with intraocular lens implantation (IOL). No severe intra- and post-operative complications were found and 84% of eyes obtained post-operative corrected visual acuities > or = 0.5. The results suggest that the pre-operative hyperglycemia alone be not a contraindication of the operation. Pre-operatively, if the diabetes of patients with cataract can be controlled by diet or hypoglycemic agent, their glucose level in the blood remains normal and stable for a period of time and there are no other systemic and ocular complications, ECCE with IOL can be performed on such patients and the therapeutic results of the operation can be safe and reliable.

Adult↗
PubMed1990

Prospective study of posterior capsule-zonular disruption during extracapsular cataract extraction: eliminating iatrogenic disruption.

We modified our surgical techniques after analyzing the mechanisms responsible for posterior capsule-zonular disruption with or without vitreous loss in 250 consecutive extracapsular cataract extraction cases. We applied the derived principles and prospectively studied the subsequent 1,500 cases. Modifications in our surgical protocol included the use of a Honan balloon for a longer interval (at least 60 minutes preoperatively) and more aggressive surgical expansion of poorly dilating pupils. Furthermore, complete YAG anterior capsulotomy performed after the retrobulbar block appeared to minimize zonular stress associated with mechanical anterior capsulotomy. We reduced the risk of posterior capsule-zonular disruption from 4.8% (2.4% vitreous loss) to zero, eliminating this complication completely in our last 1,000 cases.

Cataract Extraction↗
PubMed1982

Prostaglandin inhibition and central corneal thickness after cataract extraction.

The effect of systemically given naproxen (a qprostaglandin inhibitor) on central corneal thickness was studied in vivo, in the normal cornea, and in the cornea made artificially oedematous by cataract surgery. Only after cataract extraction could an effect be demonstrated. The post-surgical oedema was in this case reduced statistically significant corresponding to approximately 50% of control. Further the secondary rise in CCT on the third post-operative day as seen with non-medicated guttata corneas was absent after naproxen.

Adult↗
PubMed1998

Retinal detachment following intracapsular cataract extraction. A 10-year follow-up study.

PURPOSE: To examine the incidence of and risk factors for retinal detachment during a 10-year follow-up on intracapsular cataract extraction (ICCE). METHODS: Retrospective analysis of medical records of 1041 eyes operated on with ICCE in the years 1984-86. A complete follow-up was achieved, and actuarial methods were used in the risk assessment. The risk time averaged 82 months. RESULTS: Twenty-two (2.1%) eyes developed retinal detachment; half of the cases occurred during the first postoperative year, but new cases emerged throughout the period. The cumulative incidence of RD amounted to 2.8%; 95% confidence interval: 1.5-4.2%. Multivariate Cox regression analysis identified younger age at surgery (relative risk for each 10-year increase in age=0.6; 95% confidence interval: 0.39-0.95) and male gender (relative risk=2.5; 95% confidence interval 1.04-6.04) as significant risk factors for RD. Eleven eyes, 50% of eyes with RD and 1% of the total number of eyes, lost useful vision in spite of retinal surgery. CONCLUSION: Even though the risk for both RD and an unfavourable result following retinal surgery may be smaller using contemporary surgical techniques, the present study indicates a substantial morbidity following cataract surgery, when a sufficiently long observation period is considered.

Age Distribution↗
PubMed1996

The course after cataract extraction, intraocular lens implantation, and trabeculectomy for patients with diabetes.

BACKGROUND AND OBJECTIVE: To evaluate the postoperative recovery of the anterior segment and the course of diabetic retinopathy following a combined procedure of an extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy in diabetic patients with glaucoma. PATIENTS AND METHODS: The records of diabetic patients with uncontrolled glaucoma and cataract, who underwent a combined procedure in one eye, were retrospectively reviewed. RESULTS: Eleven patients were included. The mean intraocular pressure and the amount of antiglaucomatous medications required to control it were both reduced postoperatively. Anterior segment complications included hyphema in 4 eyes (37%), fibrin formation in 4 eyes (37%), and posterior synechia in 3 eyes (27%). The hyphema resolved spontaneously and the fibrin disappeared following increased administration of steroids. Development of diabetic retinopathy occurred in 1 eye (9%). Cystoid macular edema without other evidence of diabetic retinopathy was observed in 1 eye (9%). CONCLUSION: The control of intraocular pressure is improved in diabetic patients who have undergone this combined procedure. The postoperative course in these diabetic patients is similar to that previously described in the general population.

Aged↗
PubMed1997

Combined trabeculectomy and extracapsular cataract extraction with mitomycin C.

BACKGROUND: To evaluate the long-term intraocular pressure (IOP) reduction effect and safety of adjunctive mitomycin C (MMC) (0.02%) in combined trabeculectomy and extracapsular cataract extraction (ECCE) procedure. METHODS: Thirty of forty-one consecutive patients who underwent MMC trabeculectomy and ECCE with a minimum follow-up of 12 months were evaluated. RESULTS: The mean IOP was reduced significantly (p < 0.001) from preoperative 19.2 +/- 3.2 mmHg to postoperative 12.1 +/- 2.7 mmHg, while the mean number of medications decreased from 2.1 to 0.2 at 1-year follow-up. Twenty-seven (90%) patients had IOPs controlled at 15 mmHg or less, and 26 (86.7%) patients required no medication. Net astigmatism and polar value converted from keratometric readings were 1.43 +/- 0.94 diopters and 0.07 +/- 1.38 diopters, respectively, in 1-year follow-up, which were not significantly different from the preoperative values. CONCLUSIONS: Intraocular pressure could be maintained in the low teens without the need for medication in a majority of patients even one year after the combined procedure. No adverse effect on corneal endothelium or limbal wound healing was detected with intraoperative application of 0.02% MMC.

Aged↗
PubMed1978

Unplanned extracapsular cataract extraction in postvitrectomy eyes.

A 70-year-old man, a 59-year-old woman, and a 57-year-old woman underwent pars plana vitrectomy. In all three cases, cataracts developed in the eyes that had been operated on. During cataract extraction, which included massage of the globe after retrobulbar anesthesia and a conventional ab externo incision, loss of lens material into the vitreous cavity occurred in all three postvitrectomy eyes.

Aged↗
PubMed2003

Rhizobium (Agrobacterium) radiobacter identified as a cause of chronic endophthalmitis subsequent to cataract extraction.

Herein, we report a case of chronic endophthalmitis caused by a ceftazidime-resistant Rhizobium radiobacter strain in a 62-year-old male. The patient underwent an uneventful cataract extraction of the right eye a week prior to the appearance of symptoms (pain, redness, and blurring vision) which developed following a golf outing. Upon admission the patient received an emergency vitrectomy. The patient remained symptomatic, and R. radiobacter was isolated repeatedly from vitreous fluid cultures over a 5-month period. Ultimately, the infection responded to intravitreal gentamicin, oral ciprofloxacin, and removal of the lens implant.

Anti-Bacterial Agents↗
PubMed1991

Factors influencing the formation of posterior capsular opacities after extracapsular cataract extraction with posterior chamber lens implant.

This study was designed to determine whether different factors could influence the formation of posterior capsular opacities. The study group comprised 271 patients who had undergone an extracapsular cataract extraction with implantation of a posterior chamber lens either with or without laser ridge. Between 12 and 25 months after surgery, a statistically significant difference was found with a lower rate of secondary cataract in the laser ridge group, but with respect to advanced secondary cataract, i.e. eyes which needed YAG capsulotomy, no statistically significant difference was found (P-value 0.99). No association was found between age or sex of patients, different surgeons or complications during or after surgery and the risk of getting a secondary cataract.

Adult↗
PubMed1992

Orbital cellulitis and cavernous sinus thrombosis after cataract extraction and lens implantation.

Orbital cellulitis as a complication of ophthalmic surgery is uncommon. We treated a patient who had orbital cellulitis and cavernous sinus thrombosis three weeks after uncomplicated cataract extraction and lens implantation. Sinus x-rays showed sphenoid sinus opacification. Computed tomographic scan confirmed the sphenoid sinus disease, and no abscess was found. The patient recovered completely after treatment with intravenous antibiotics. Most orbital cellulitis is secondary to sinus disease. The trauma of surgery and the retrobulbar block must be considered possible causative factors in this patient, but sinus disease is still the most likely cause. Intraocular inflammation did not increase during the illness although the intraocular pressure rose from 14 to 23mmHg.

Cataract Extraction↗
PubMed1992

The effect of Healon and timolol on early postoperative intraocular pressure after extracapsular cataract extraction with implantation of a posterior chamber lens.

In a prospective, randomized, masked study the effect of sodium hyaluronate (Healon) and timolol on the acute intraocular pressure rise after extracapsular cataract extraction with implantation of a posterior chamber lens were evaluated. Intraocular pressure was measured preoperatively and 3-6 h and 24 h postoperatively. When no timolol was used, a significant rise in intraocular pressure was observed at 3-6 h, whether or not Healon was aspirated. Timolol reduced the intraocular pressure rise, especially during the first 3-6 h after surgery. When timolol was not applied at the end of surgery, IOP exceeded 30 mmHg in 28% 3-6 h postoperatively, compared to only 4% when timolol was applied.

Adult↗
PubMed1988

Pre- and postoperative refraction after cataract extraction with implantation of standard power IOL.

The pre- and postoperative refraction results are reported in 99 patients receiving an anterior chamber lens of standard 19.0 D power after intracapsular cataract extraction. The mean refraction after the operation was -0.76 D, SD 2.13. Apart from eight patients with suspected lenticular myopia, 5% of the patients ended up with a refraction that differed more than +/- 5D from the preoperative value. This variation was due to variation in the power of the biological lens removed at surgery, the mean value of which was 22.8 D, SD 3.3. As a measure of the aniseikonia induced at surgery, the ocular magnification was calculated to increase 2.7%, SD 4.2%, as compared with the preoperative value. The variation should be considered in the discussion of whether a preoperative biometry and calculation of appropriate IOL power are recommended or not.

Aged↗
PubMed1999

Low-cost high-volume extracapsular cataract extraction with posterior chamber intraocular lens implantation in Nepal.

OBJECTIVE: To improve current clinical practices and ways of thinking about the problem of curable Third-World blindness resulting from cataract. DESIGN: A two-site prospective, nonrandomized, comparative clinical trial. PARTICIPANTS: Patients from 2 distinct surgical venues underwent cataract surgery following the same carefully outlined protocol: 62 consecutive cases from the Tilganga Eye Centre in Katmandu, Nepal, and 207 cases from a remote eye camp in rural Chaughada, Nepal. INTERVENTION: Extracapsular cataract extraction with posterior chamber intraocular lens (IOL) implantation surgery using a technique developed by Dr. Sanduk Ruit of the Tilganga Eye Centre in conjunction with the Medical Directorate of the Fred Hollows Foundation of Australia. Also presented is the teaching method used to help make local doctors proficient in this technique. MAIN OUTCOME MEASURES: Visual acuity recorded at 2 months after surgery as well as surgical complications. RESULTS: Preoperative visual acuities for the 62 patients from the Tilganga Eye Centre ranged from 20/60 to light perception only (4 patients were untested). At 2 months after surgery, 87.1% had a best-corrected visual acuity of 20/60 or better. There were zero major surgical complications reported from the Tilganga group. Of the 207 patients at the Chaughada eye camp, preoperative visual acuities (recorded for 177 [85.5%]) ranged from 20/200 or greater to light perception only. One hundred eighty-nine (91.3%) of the patients returned for an examination at 2 months after surgery, at which time 54.5% had an uncorrected visual acuity of 20/60 or greater, improving to 74.1% with correction. There were six (2.9%) surgical complications documented at Chaughada. CONCLUSIONS: Because the average operative time using the technique presented here is less than 10 minutes per case and the cost per surgery is less than $20, the surgical results are significant in addressing the massive problem of cataract blindness in the Third World. With some changes in preoperative care, a simplified surgical technique, the development of local lens factories, and the implementation of teaching programs, effective lens implantation cataract surgery can be done in high volume at affordable costs in remote areas of underserved nations.

Cataract↗
PubMed1988

The effect of ketorolac tromethamine solution 0.5% in reducing postoperative inflammation after cataract extraction and intraocular lens implantation.

Ketorolac tromethamine solution 0.5% (1 drop 3 times daily) was more effective than the placebo vehicle solution in suppressing postoperative anterior ocular inflammation after extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation in this multicenter, double-masked, randomized study. Four of 60 ketorolac-treated patients compared with 25 of 58 placebo-treated patients required supplemental corticosteroid therapy to suppress inflammation in the postoperative period which was statistically significant (P less than 0.001). Even though these supplemental steroid-treated patients were kept in the analysis, the placebo-treated group showed more evidence of anterior ocular inflammation as measured by anterior segment fluorophotometry. This was consistent with slit-lamp observations of increased anterior ocular inflammation. This study supported previous studies that suggested ketorolac tromethamine ophthalmic solution 0.5% was effective and safe as a nonsteroidal anti-inflammatory agent for topical use after ECCE and IOL implantation.

Adult↗