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PubMed1982

Clear-cornea cataract extraction in eyes with functioning filtering blebs.

In 22 glaucomatous eyes with functioning filtering blebs and adequately controlled intraocular pressures (less than or equal to 22 mm Hg) that underwent clear-cornea cataract extraction, the intraocular pressure remained controlled in 20 (91%). Seven of the 21 eyes, however, required an increased dosage of antiglaucoma drugs. Sixteen eyes had final visual acuities between 6/6 and 6/9 (20/20 and 20/30) and only four eyes had final visual acuities worse than 6/60 (20/200). The only intraoperative complication was a ruptured lens capsule. Postoperative bullous keratopathy developed in two eyes, both of which had had corneal edema postoperatively. A third eye, which had undergone filtering surgery 17 years earlier, had vitreous incarceration after the sutures were removed.

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PubMedDate not supplied

Visual outcome of extracapsular cataract extraction and intraocular lens replacement in leprosy patients.

The study was carried out in Meshed, Islamic Republic of Iran, from 1998 to 2000 to explore the visual outcome of eye surgery with extracapsular cataract extraction and intraocular lens replacement on 18 leprosy patients (20 eyes). The most common complications of leprosy were madarosis (90%) and partial or total corneal opacity (90%). Visual acuity before surgery ranged from 'light perception' to 1/10, and this improved after surgery to 5/10-8/10 for 55% of patients. Postoperative infection leading to endophthalmitis occurred in only 1 patient and was treated with drugs; this patient's visual acuity remained at 10 cm finger count. Posterior synechia due to chronic uveitis in leprosy was diagnosed in 70% of eyes, obstructed iris in 25%, keratic precipitates in 25% and moderate iris atrophia in 10%.

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PubMed1979

The effects of timolol on cataract extraction and intraocular pressure.

We studied the effect of timolol on post-operative intraocular pressures (IOPs) in a control and experimental group of 30 eyes, each in patients who had uncomplicated intracapsular cataract extractions, most with iris clip lenses. Closure of the eye in each case was with three 6-0 silk sutures preplaced in a morticed incision. Six control eyes had IOP increases of 6 mm Hg or more within 24 hours of surgery. One patient treated with timolol had an IOP increase of 6 mm Hg or more. The differences in IOP between the control and experimental groups were statistically significant at the .01 level. The pressure lowering ability of timolol appears to be prophylactic as well as therapeutic. It is well suited for pseudophakic eyes as pressure reduction is not associated with pupillary alterations.

Cataract Extraction↗
PubMed1999

Changes in astigmatism after cataract extraction and intraocular lens implantation in children.

PURPOSE: To evaluate the post-operative changes in astigmatism in pseudophakic eyes in children. METHODS: The charts of children who had undergone surgery for non-traumatic cataract were retrospectively reviewed. In 10 eyes with astigmatism of 3.0 D or more, the refraction was tested and recorded at 1 week, 3 months and 5 months post-operatively. RESULTS: Mean astigmatism 1 week post-operatively was 6.2 +/- 2.7 D (range 3.0-11.0 D). Thereafter, the astigmatic component of the refractive error underwent a spontaneous steady decline, reaching a mean value of 1.2 +/- 1.1 D (range 0-3.0 D) 5 months after surgery. The change in the difference between the mean values at 1 week and at 5 months was statistically significant (p = 0.0002). CONCLUSIONS: Children who underwent cataract extraction and intraocular lens implantation showed a significant spontaneous reduction in astigmatism post-operatively. This finding suggests that there is no need to remove sutures in order to achieve reduction of post-operative astigmatism in these children.

Astigmatism↗
PubMed1984

The effect of sodium hyaluronate on endothelial cell damage during extracapsular cataract extraction and posterior chamber lens implantation.

We conducted a prospective, randomized clinical trial of the use of 1% sodium hyaluronate (Healon) in the anterior chamber during anterior capsulotomy and nuclear expression in extracapsular cataract extraction with posterior chamber lens implantation. Two months postoperatively, the mean (+/- standard deviation) central endothelial cell loss was 6.1% +/- 11.4% in 92 eyes in which sodium hyaluronate was used for the capsulotomy and nuclear expression and 7.6% +/- 14.7% in 89 eyes in which it was not used (P greater than .6). Sodium hyaluronate was also used later in the procedure in all eyes to expand the capsular bag to facilitate lens implantation. No significant difference was noted between the two groups in the increase in intraocular pressure on the first postoperative day (mean increase, 4 mm Hg in each group) or in the corneal thicknesses preoperatively and two months postoperatively (no significant change in either group). Sodium hyaluronate was useful in maintaining the anterior chamber during difficult surgical cases.

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PubMed1985

Pirprofen in postoperative course following cataract extraction: a controlled trial.

In a double-blind, between-patient trial, a new cyclo-oxygenase inhibitor, pirprofen (800 mg/day), was compared with indomethacin (100 mg/day) and placebo in 56 patients undergoing cataract extraction. Treatment started 48 h before operation and continued for eight days. Patients were examined on days 1, 3 and 6 for objective signs of inflammation and pain. Both active drugs proved to have good anti-inflammatory action, clearly superior to placebo. No unwanted effects or modifications in laboratory parameters other than those related to the antiphlogistic effect were reported.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

The effect of retrobulbar anesthesia on visual acuity in planned extracapsular cataract extraction.

To our knowledge, this is the first evaluation of the effect of retrobulbar anesthesia on visual acuity. We compared the preoperative best corrected near visual acuity of 30 consecutive patients undergoing planned extracapsular cataract extraction with their best corrected near visual acuity 10 minutes following successful retrobulbar anesthesia. The mean decrease in acuity was 2.83 lines on a Jaeger near card. Postinjection visual acuity did not change in four eyes. In general, the longer the globe axial length, the greater the decrease in visual acuity following retrobulbar block. There was no significant correlation between postinjection acuity and patient age or volume of anesthetic injected.

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PubMed1994

Persistent Torulopsis magnoliae endophthalmitis following cataract extraction.

Postoperative fungal endophthalmitis typically manifests as an indolent uveitis, weeks to months after surgery. In our patient, Torulopsis magnoliae endophthalmitis appeared as an acute, purulent postoperative endophthalmitis on the third day following extracapsular cataract extraction with implantation of a posterior chamber intraocular lens (IOL). The patient required three separate vitrectomy operations with instillation of intravitreal Amphotericin B; the last operation also included complete removal of the posterior capsule and IOL. This case, which is to our knowledge the first reported case of T. magnoliae endophthalmitis, is unusual in that it manifested as an acute, fulminant infection in the early postoperative period and was recalcitrant to standard endophthalmitis therapy.

Acute Disease↗
PubMed1987

Vertical rupture in posterior corneal layers after cataract extraction.

The histopathological description of a 3 mm vertical cut in the posterior layers of a corneal button removed for pseudophakic bullous keratopathy is presented. The corneal complications became clinically evident several weeks after extracapsular cataract extraction with placement of a posterior chamber lens implant. Outstanding histological features were: wall-like elevation of the borders of the cut with swelling of the posterior stromal layers; rolled-in edges of Descemet's membrane; double interruption of Descemet's membrane on one side; regional endothelial atrophy; and total lack of any signs of endothelial regeneration.

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PubMedDate not supplied

Continuous tear capsulotomy and phacoemulsification cataract extraction combined with penetrating keratoplasty.

Continuous tear capsulotomy, or capsulorhexis, permits secure and precise placement of a posterior chamber intraocular lens. This technique can be used open sky during triple procedures combining penetrating keratoplasty with cataract extraction and intraocular lens insertion. Expression of the nucleus through a continuous tear capsulotomy can be difficult. Incisions in the anterior capsule facilitate nucleus expression but can extend, obviating the advantages of continuous tear capsulotomy. With phacoemulsification using low irrigation and adequate ultrasound power, the nucleus can be completely emulsified or fragmented into easily removable pieces. This permits continuous tear capsulotomy to be part of triple procedure surgery.

Cataract Extraction↗
PubMed1981

[Anterior chamber lens implantation with intracapsular cataract extraction (author's transl)].

Between 1977 and the end of August 1980 150 anterior chamber lenses were implanted at the Basel Eye Clinic. Ninety six eyes were followed up for more than three months after intracapsular cataract extraction and implantation of a Binkhorst 4 loop lens. The indications for the operation are reviewed, the operative technique and postoperative management are briefly mentioned and the complications are discussed. One lens was removed because of hypopyon iritis and four lenses became subluxated but were all repositioned without resorting to surgery. The most worrying complication was cystoid macular edema, observed in 8% of cases and always associated with iritis. So far no patients have developed permanent corneal edema. It is important that lens implantation is only attempted when one is fully conversant with anterior segment surgery; having mastered the technique of implantation one should perfect one method before trying out another. The question of intracapsular versus extracapsular extraction and the type of lens used, provided one chooses a currently available model, is probably of secondary importance. Clearly defined indications and a detailed discussion with the patient are prerequisites. Despite this, an anterior chamber lens represents a very dubious benefit for certain patients.

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PubMedDate not supplied

[Cell loss in the posterior corneal epithelium after cataract extraction by Nd:YAG laser with wave length 1.44 mcm].

The purpose of the case study, as described in the paper, was to evaluate the cell loss in the corneal posterior epithelium (CPE) after laser cataract extraction (LCE) by means of a new laser unit designed on the basis of ND:YAG laser with a wave length of 1.44 microns. The conditions of 59 eyes with high (degrees 3-4) and extra high (degree 5) lens density were analyzed preoperatively and 3 months after LCE. Group 1 comprised 51 surgical cases, which were ideal in the technical respect; Group 2 comprised 8 surgical cases involving an intraoperative short-time lifting of the fragmentized lens mass into the eye anterior chamber during aspiration. The method of contactless endothelial biomicroscopy ("SP-1000" unit, "Topcon Co.", Japan) was made use of. According to the obtained results, it can be stated: the CPE cell loss made 1-9% (4.69 +/- 0.7%) and 1-18% (9.4 +/- 8.4%) in Groups 1 and 2, respectively. The total energy exposition level to laser radiation is the most significant factor affecting the CPE cell loss. The pulse energy radiation level did not affect the CPE cell loss. The corneal posterior surface was subject to a highly adverse impact in the fragmentation of brown cataracts. Finally, the results are indicative of an insignificant surgical trauma in LCE.

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PubMed1986

The use of hydroxypropyl methylcellulose in extracapsular cataract extraction with intraocular lens implantation.

We conducted a prospective randomized clinical trial on the use of 2% hydroxypropyl methylcellulose and 1% sodium hyaluronate in the anterior chamber during anterior capsulotomy and nuclear expression in extracapsular cataract extraction with posterior chamber lens implantation in 70 patients. Both viscoelastic substances helped maintain the anterior chamber and facilitated the operation, although sodium hyaluronate was preferred. There was no excessive intraocular inflammation or toxicity noted with either agent. Patients given sodium hyaluronate had a larger increase in intraocular pressure during the early postoperative period (2.04 mm Hg) than did those given hydroxypropyl methylcellulose (1.1 mm Hg), but the difference was not significant. Nine weeks after surgery, the mean (+/- SD) central endothelial cell loss was 4.84% (+/- 7.26%) in the 17 eyes with sodium hyaluronate and 4.37% (+/- 9.84%) in the 53 eyes with hydroxypropyl methylcellulose. The intraocular pressure and corneal thickness were not significantly different before operation and nine weeks after it.

Anterior Chamber↗
PubMed1997

Xanthomonas maltophilia endophthalmitis after cataract extraction.

PURPOSE: To report a case of Xanthomonas maltophilia endophthalmitis and to increase awareness of its potential as an intraocular pathogen. METHOD: Case report. RESULTS: A 76-year-old woman developed X maltophilia endophthalmitis after cataract extraction. To eradicate the infection, we performed two vitrectomies and treated the patient with numerous intravitreal antibiotic injections. CONCLUSIONS: X maltophilia is a potential intraocular pathogen in an immunocompetent host. If the infection takes a persistent course, persistent topical and intravitreal antibiotic treatment and possibly vitrectomy are needed to eradicate the infection.

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