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At least 19 recordsLinked to original sources
PubMed1990

[Comparative evaluation of intracapsular cataract extraction, extracapsular cataract extraction and phacoemulsification].

In 1978 at the beginning of the modern lens implantation era, 6160 posterior chamber lenses (PCL) were implanted in the USA; 1,110,000 PCL were implanted in 1986. With reference to the total number of lenses implanted, PCL implantations amounted to 4% in 1978 and to 89% in 1986. The increasing use of PCL has mainly been due to the fact that patients with these lenses had significantly better visual acuity and fewer complications after surgery than patients with anterior chamber lenses (ACL). As an example, an FDH study in 1983 should be mentioned: more vision in an otherwise normal eye was more than 0.5: 90% (ACL) versus 94% (PLC); ablatio: 0.9% versus 0.5%; secondary glaucoma: 1.2% versus 0.5%; cystoid edema of the macula: 2.2% versus 0.8%. The considerable advantage in extracapsular extraction of a cataract lies in the fact that the anatomical and physiological conditions of the eye structure may be nearly completely maintained, and this is because the intact posterior capsule--similar to the lens with zonular fibers in the normal eye--forms a diaphragm between the vitreous and aqueous humor. Thus the stability of the eye will be maintained and prolapse of the vitreous with possible traction at the retina cannot occur. Phacoemulsification and ECCE are well-established methods. The clinical results of both methods are practically identical, except for a significantly lower rate of astigmatism with phacoemulsification, which was examined 8 to 10 weeks following surgery (phaco: 1.0 +/- 0.49; expression: 3.3 +/- 1.7).(ABSTRACT TRUNCATED AT 250 WORDS)

Cataract Extraction↗
PubMed2005

Alterations in human vitreous humour following cataract extraction.

Cataract extraction is associated with the risk of posterior vitreous detachment, macular edema and retinal detachment possibly as a result of a disturbance to the vitreous body during surgery. While it is common for lens cortical fiber debris to leak into the vitreous humour during cataract extraction, the extent to which the vitreous humour is altered post-surgery is unknown. The current study examines the integrity of the vitreous humour of pseudophakic and phakic human donor eyes by comparing the proteome, the viscosity and the size distribution of macromolecules in different regions of the vitreous humour from human pseudophakic and phakic donor eyes. Major differences between the proteomes of anterior and posterior vitreous humour were observed in phakic and pseudophakic donor eyes. Seventeen spots identified as complete, modified or cleaved forms of alphaA-, alphaB-, betaA4-, betaB2, and gammaS-crystallins were present in the anterior vitreous humour of all pseudophakic eyes studied. Crystallins were not detected in the posterior vitreous humour of the pseudophakic eye or the vitreous humour of the phakic eye. Significant alterations in abundance and/or modification of transthyretin, alpha antitrypsin, and retinoic acid binding protein were observed in all locations of pseudophakic vitreous humour as compared to phakic samples. In addition, a significant decrease in the number and intensity of protein spots was observed for the posterior vitreous humour of pseudophakic eyes when compared to posterior vitreous humour of phakic eyes. Proteins which were affected include antioxidant proteins and enzymes such as carbonic anhydrase and trisephosphate isomerase. A reversal of the viscosity gradient, anterior to posterior, in the vitreous humour of pseudophakic eyes was observed concomitant with alterations in the distribution of 50 nm particles. These particles are likely primarily composed of hyaluronan. While varying degrees of vitreous degradation may have existed prior to surgery and may have contributed to the cataract formation, in no case did the phakic donor eyes exhibit the same alterations in the vitreous humour proteome, viscosity or particle sizes as did the pseudophakic donor eyes. The examination of phakic/pseudophakic donor eye pairs confirmed that the vitreous humour proteome and structural integrity were very similar in the matched phakic donor eye to eyes from donors with no history of cataract. Even though the number of samples for this study was limited, the observed changes support the hypothesis that alterations in the vitreous humour proteome occur in psuedophakic eyes with concurrent alterations in the structure of the vitreous humor. These modifications of the microenvironment of the retina may contribute to the development of retinal complications following cataract surgery.

Adolescent↗
PubMed1984

The anterior capsulotomy of extracapsular cataract extraction.

Cataracts are a major cause of blindness, and more than 75% of all cataract operations performed in the United States are associated with an intraocular lens (IOL) implant. Since approximately 63% of all IOL implants are of the posterior chamber type and associated with extracapsular cataract extraction (ECCE), it is important for the ophthalmic surgeon to perfect this operation. We describe herein the important surgical anatomy of the zonular-lens capsular attachments and present the results of a poll of experts as to the important aspects of the anterior capsulotomy of the ECCE.

Adolescent↗
PubMed1998

The Madurai Intraocular Lens Study. I: A randomized clinical trial comparing complications and vision outcomes of intracapsular cataract extraction and extracapsular cataract extraction with posterior chamber intraocular lens.

PURPOSE: The Madurai Intraocular Lens Study (MIOLS) was designed to compare safety, efficacy, and quality of life outcomes after either intracapsular cataract extraction with aphakic glasses (ICCE-AG) or extracapsular cataract extraction with posterior chamber intraocular lens (ECCE/ PC-IOL). METHODS: The Madurai Intraocular Lens Study was a nonmasked randomized controlled clinical trial conducted at a single hospital. Thirty-four hundred patients with age-related cataracts and having a best-corrected visual acuity less than or equal to 20/120 in the better eye were randomly assigned to either of the two cataract operative procedures. The main clinical outcomes were safety (complication rates) and efficacy (best-corrected visual acuity at 1 year equal to or better than 20/40). In addition, a subset of 1,700 trial participants received questionnaires before surgery, at 6 months after surgery, and at 1 year after surgery to measure visual functioning and vision-related quality of life. RESULTS: Details of study design, study organization, clinical and quality of life outcome variables, sample size calculations, patient eligibility criteria and recruitment, randomization and masking, participant flow, adherence to follow-up, quality assurance, and statistical methods are presented. CONCLUSIONS: The Madurai Intraocular Lens Study has sufficient power to detect clinically significant differences between the treatment options. There were no statistically significant differences between the two treatment groups for any of the major study variables at baseline. A high level of quality assurance was maintained throughout the October 1993 to June 1996 study period. The results should be applicable to all settings where the requisite expertise and resources are present.

Adult↗
PubMed1992

Comparison of preoperative 10-Hz visual evoked potentials to contrast sensitivity and visual acuity after cataract extraction.

Cataract patients whose surgical outcomes were in question were referred for testing by visual evoked potentials, elicited through closed eyelids by a luminance stimulus (flash) that appeared 10 times per second. Visual evoked potentials were rated as normal (predicted acuity of 20/50 or better) or abnormal (predicted acuity of 20/60 or worse). Postoperative Arden and Optronix contrast sensitivities and visual acuities were determined in 37 patients who had no intraoperative or early postoperative complications. Arden grating scores of less than 100 were rated as normal. The optimal and cutoff spatial frequency values were determined for the Optronix scores. Optimal and cutoff values of greater or equal to 1 c/deg and 12 c/deg, respectively, were rated as normal. Visual acuities were considered normal at 20/50 or better. Preoperative visual evoked potentials were quantitatively compared to the postoperative contrast sensitivities and visual acuities by 2 x 2 contingency tables. The accuracy of prediction was 79% for the visual acuities, 62% for the Optronix optimal values, 70% for the Optronix cutoff values and 62% for the Arden gratings.

Aged↗
PubMed1976

Combined cataract extraction and thermal sclerostomy versus combined cataract extraction and trabeculectomy.

We performed either a combined cataract extraction and trabeculectomy or a combined cataract extraction and thermal sclerostomy on 43 eyes. All eyes had chronic open angle glaucoma or chronic angle closure glaucoma, or a combination of the two. In our cataract/trabeculectomy group, 74% had improvement in visual acuity, 91% had normalized intraocular pressure without anti-glaucoma medications, 31% had transient postoperative hyphemas. In our cataract/thermal sclerostomy group, 61% had improvement in visual acuity, 61% had normalization of intraocular pressures without antiglaucoma medications, 17% had transient postoperative hyphemas. We could not correlate any of the complications of surgery with poor intraocular pressure results in either groups. The mechanism for the higher success rate with a combined cataract extraction and trabeculectomy as compared with a combined cataract extraction and thermal sclerostomy was not obvious after analyzing these patients.

Cataract Extraction↗
PubMed2002

Phacoemulsification with indocyanine green versus manual expression extracapsular cataract extraction for advanced cataract.

PURPOSE: To compare the outcomes of indocyanine green dye (ICG)-assisted phacoemulsification with manual expression extracapsular cataract extraction (ECCE) in eyes with advanced cataract. SETTING: Parkland Memorial Hospital and Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. METHODS: In this retrospective study, 72 consecutive cases of advanced or mature cataract extractions performed in a 1-year period were reviewed. Fifty-nine eyes met the inclusion and exclusion criteria; 33 had ICG-assisted phacoemulsification and 26, manual expression ECCE. Preoperative and intraoperative findings and the postoperative outcomes up to 6 months were analyzed. RESULTS: Intraoperative complications included posterior capsule tear with vitreous prolapse in 2 eyes (6.6%) and conversion to manual expression ECCE in 1 eye (3.3%) in the ICG phacoemulsification group. There was no intraoperative complication in the manual expression ECCE group. There were significantly more patients with a best corrected visual acuity of 20/30 or better in the ICG phacoemulsification group than in the manual expression ECCE group at all postoperative periods. The mean logMAR visual acuities were significantly better in the ICG phacoemulsification group at all postoperative intervals. The ICG phacoemulsification group had significantly less postoperative astigmatism. There was no significant difference between the groups in the early postoperative intraocular pressure. CONCLUSIONS: Phacoemulsification with ICG led to better postoperative visual acuity and less postoperative astigmatism than manual expression ECCE. Phacoemulsification with ICG was associated with more intraoperative complications than manual expression ECCE; however, the complication rate is comparable to a previously published rate for phacoemulsification performed in a university training program. Phacoemulsification with ICG appears to be a reasonable alternative to manual expression ECCE for advanced cataract.

Adolescent↗
PubMed1990

A modified extracapsular cataract extraction for pediatric cataracts.

We present a modified procedure of extracapsular cataract extraction (ECCE) with a small central posterior capsulectomy for pediatric cataracts that is designed to eliminate posterior capsule opacification and to keep open the option of later secondary implantation of a posterior chamber intraocular lens. Of 76 study eyes in which the procedure was performed only three developed posterior capsule opacification. All seven control eyes that had standard ECCE with the posterior capsule left intact developed secondary membranes shortly after surgery.

Adolescent↗
PubMed1993

[Cystoid macular edema and visual acuity with intracapsular cataract extraction and Choyce anterior chamber lens vs. extracapsular cataract extraction and posterior chamber lens in the partner eye].

A prospective study was conducted on 65 patients who had a cataract operation. One eye had intracapsular cataract extraction (ICCE) with a Choyce-IX anterior chamber lens (ACL) and the fellow eye extracapsular cataract extraction (ECCE) with a posterior chamber lens (PCL). To evaluate the cystoid macular edema (CME), a fluorescence angiogram was recorded on the day of discharge and after 6 months. The severity of the CME was classified in three stages (degrees I-III). At discharge, no eye had CME grade III. CME grade I or grade II was seen in the ICCE group in 23% and in the ECCE group in 7.6%. After 6 months one eye of each group showed CME grade III (1.5%). CME grades I and II were seen after ICCE in 13.8% and 7.8% while the eyes with ECCE presented CME in 6.1% of grade I and of grade II, respectively. Visual acuity (VA) in the eyes with grades I and II CME was the same as in eyes without CME. The VA (median) of the ICCE group was 0.8 and of the ECCE 0.7. Because of infection of the capsular bag (toxic lens syndrome), in one case the PCL together with the capsular bag had to be explanted after 7 months. As for visual acuity and clinically significant CME (grade III), there was no statistical difference between ICCE plus Choyce-IX ACL eyes versus ECCE plus PCL eyes in the same patient.

Aged↗
PubMed2001

Multifocal versus monofocal intraocular lenses after cataract extraction.

BACKGROUND: Good unaided distance visual acuity is now a realistic expectation following cataract surgery and intraocular lens implantation. Near vision however still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal) intraocular lenses are available that are claimed to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal intraocular lenses. OBJECTIVES: The objective of this review is to assess the effects of multifocal intraocular lenses, including effects on visual acuity, subjective visual satisfaction, spectacle dependence, glare and contrast sensitivity, compared to standard monofocal lenses. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register - CENTRAL (which includes the Cochrane Eyes and Vision Group specialised register), MEDLINE and EMBASE. The reference lists of relevant articles were searched. Investigators of included studies and manufacturers of multifocal intraocular lenses were contacted for information about additional published and unpublished studies. SELECTION CRITERIA: All randomised controlled trials comparing a multifocal intraocular lens of any type with a monofocal intraocular lens as control were included. Both unilateral and bilateral implantation trials were included. DATA COLLECTION AND ANALYSIS: Data were collected and trial quality assessed. Where possible, statistical summary measures were calculated, otherwise data were tabulated. MAIN RESULTS: One ongoing and six completed trials were identified. There was significant variability between the trials in the outcomes reported. Unaided distance acuity was similar in multifocal and monofocal intraocular lenses (Peto odds ratio 1.27 (95% Confidence Interval (CI) 0.76 to 2.11)), with a small increase in the proportion of multifocal intraocular lens participants achieving less than 6/6 best corrected visual acuity (Peto odds ratio 1.64 (95% CI 1.10 to 2.42)). Unaided near vision tended to improve with the multifocal intraocular lenses. This resulted in decreased spectacle dependence with use of the multifocal intraocular lenses (Peto odds ratio 0.16 (95% CI 0.11 to 0.23)). Adverse effects included reduced contrast sensitivity and the subjective experience of haloes around lights. REVIEWER'S CONCLUSIONS: Multifocal intraocular lenses are effective at improving near vision relative to monofocal intraocular lenses. Whether that improvement outweighs the adverse effects of multifocal intraocular lenses will vary between patients, with motivation to achieve spectacle independence likely to be the deciding factor.

Cataract Extraction↗
PubMed1990

[Comparison of extracapsular cataract extraction with implantation of the artificial lens into the posterior chamber and intracapsular cataract extraction with implantation of the artificial lens into the anterior chamber].

Advantages and disadvantages of both methods are presented on the basis of comparison of 1200 cases of intracapsular cataract extraction with anterior chamber lens implantation and 600 cases of extracapsular cataract extraction with implantation of posterior chamber lens. One has to state that in general the preferential method of extracapsular cataract extraction with posterior lens implantation is connected with several complications. The main disadvantage of intracapsular cataract extraction with anterior chamber implantation is--in 66 p.c.--deformation of the pupil. From our point of view this is a problem of cosmetic nature. On the basis of comparison of disadvantages and advantages we are of opinion that both methods are equally suitable for a broad clinical use.

Anterior Chamber↗