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At least 217 records · Page 12Linked to original sources
PubMed1985

Penetrating keratoplasty combined with extracapsular cataract extraction.

In my previous prospective study of 132 eyes, the incidence of clinically significant cystoid macular edema was 42% in aphakic penetrating keratoplasty, 33% in combined keratoplasty and cataract extraction with vitrectomy, and only 4% in combined keratoplasty and cataract extraction without vitrectomy. In the present study we added 26 aphakic and 11 pseudophakic keratoplasties and 17 procedures combining keratoplasty with extracapsular cataract extraction. Grafts were clear in 94% of patients, and 43% had visual acuity of 20/40 or better. Clinically significant cystoid macular edema occurred in 35% of aphakic and 27% of pseudophakic keratoplasties. Cystoid macular edema did not occur in combined keratoplasty and extracapsular cataract extraction.

Aphakia, Postcataract↗
PubMed1980

Correlation of aphakic retinal detachment and refractive error with gender.

I analyzed the aphakic refractive errors of men and women separately in a statistical study of patients with aphakic retinal detachments. I compared the distribution of aphakic refractive errors in a population of 81 adult patients with nontraumatic aphakic retinal detachment with that of a randomly selected control population of 93 adult patients with aphakia. As a group, women who developed aphakic retinal detachments were significantly more myopic than female controls (11.41 vs 12.37 diopters of spherical equivalent; P = .004). In contrast, the refractive error in men did not differ between the aphakic retinal detachment and control groups (11.31 vs 11.68 diopters; P = .156). A significantly higher percentage of patients with bilateral (87%) aphakic retinal detachments were men (P = .017). In men other risk factors for aphakic retinal detachment, including cardiovascular disease, may overshadow the influence of axial myopia.

Adult↗
PubMed1978

Retinal detachment and miotic therapy.

We studied a series of 34 eyes in 31 patients in whom retinal detachment occurred during miotic therapy. In 14 eyes, the duration of miotic use before the development of detachment was two months or less. Most detachments occurred in detachment-prone eyes either by virtue of myopia (62%), aphakia (24%), ipsilateral lattice degeneration (38%) or retinal pathology, in the fellow eye (50%). Virtually all detachments were rhegmatogenous. Distributions of retinal breaks are similar to the corresponding profiles in detached eyes not receiving miotics. The observed phenomena may be accounted for mechanistically, either with or without the role of miotics, so a specific causal role cannot be assigned to any given miotic in any given case. However, our data suggest that detachment-prone eyes may be at increased risk with miotic use, and thus demand careful retinal evaluation and prophylaxis when ominous peripheral symptoms are present.

Adult↗
PubMed1990

Ab interno laser sclerostomy in aphakic patients with glaucoma and chronic inflammation.

Five patients with aphakia, glaucoma, and chronic inflammation were treated with ab interno sclerostomy by using the continuous wave Nd:YAG laser focused through a sapphire probe. After a follow-up period of 24 to 28 months, three of five patients had good intraocular pressure control. The sclerostomy failed in one patient when it was occluded by vitreous. The second failure was attributed to closure of the sclerostomy because of chronic intraocular inflammation.

Aged↗
PubMed1978

Cyclocryotherapy of chronic open-angle glaucoma in aphakic eyes.

Twenty-six eyes of 25 patients with chronic open-angle glaucoma and surgical aphakia with inadequate control of intraocular pressure (IOP) despite maximal medical treatment were treated with cyclocryotherapy, according to a prospective protocol and specific technique. (Neovascular and synechial glaucoma were excluded from this series.) In most cases topical medications were resumed after cyclocryotherapy. During follow-up of seven to 95 months (average, 46 months), IOP was reduced to 19 mm Hg or lower in 24 out of 26 eyes (92%). In two eyes, persistent decrease in visual acuity, unrelated to reduction of IOP, occurred after cyclocryotherapy. On the basis of the long-term benefits obtained by this procedure, we concluded that cyclocryotherapy should be considered the procedure of choice in the treatment of primary open-angle glaucoma in surgically aphakic eyes when pressure cannot be adequately reduced by maximally tolerated medical treatment.

Aged↗
PubMed1978

Endothelial degeneration and posterior collagenous proliferation in aphakic bullous keratopathy.

In series of 39 corneal grafts, aphakic bullous keratopathy comprised 13 (33%) of the cases. By scanning and transmission electron microscopy, endothelial degeneration and posterior collagenous proliferation were consistent features. In all 13 cases, the patchy loss of endothelial cells occurred diffusely over the entire posterior corneal surface. The remaining endothelial cells had become extremely attenuated to increase their surface area. In nine cases, acellular proliferations of collagenous tissue were interposed between the endothelial cells and Descemet's membrane. These posterior collagenous layers were composed of collagen fibrils and basement membrane material, randomly arrayed in a feltwork of uniform thickness; they appeared ultrastructurally identical to those encountered in a variety of conditions involving endothelial distress.

Aphakia, Postcataract↗
PubMed1983

Apparent accommodation in pseudophakic eyes after implantation of posterior chamber intraocular lenses.

We measured apparent accommodation in 42 pseudophakic eyes (34 patients) after implantation of posterior chamber intraocular lenses. The mean apparent accommodation was 2.03 +/- 1.03 diopters. The mean accommodative power of 16 phakic eyes used as controls was 2.91 +/- 1.29 diopters. The diameter of the pupil appeared to be the most important factor in apparent accommodation--the smaller the pupil, the greater the apparent accommodation. Apparent accommodation was inversely proportional to the pupillary diameter. There was no correlation, however, between apparent accommodation and corrected visual acuity, refractive error, corneal astigmatism, or axial length. There was a negative correlation between apparent accommodation and anterior chamber depth.

Accommodation, Ocular↗
PubMed1998

Cystoid macular edema associated with latanoprost in aphakic and pseudophakic eyes.

PURPOSE: To describe four patients who developed cystoid macular edema shortly after onset of treatment with latanoprost. METHOD: Retrospective review of medical records of patients with open-angle glaucoma who developed cystoid macular edema shortly after starting latanoprost. RESULTS: The use of topical latanoprost was temporally related to the development of cystoid macular edema in four patients (six eyes; two aphakic eyes and four pseudophakic eyes). Cystoid macular edema resolved in all patients after latanoprost was discontinued. CONCLUSIONS: Cystoid macular edema is a potential complication of latanoprost therapy. Further observations are needed to determine if the risk of cystoid macular edema is limited to or greatest in patients who are pseudophakic or aphakic.

Aged↗
PubMed1998

Visual acuity and quality of life outcomes in patients with cataract in Shunyi County, China.

PURPOSE: To measure visual acuity and vision-related quality of life in individuals in rural China operated on for cataract. METHODS: Five thousand fifty-two persons age 50 years and older, 90.9% (5,052/5,555) of a randomly selected population in Shunyi County, were examined in the fall of 1996. Visual functioning and quality of life questionnaires were administered to those with presenting visual acuity less than 6/60 in either eye and to those who were aphakic or pseudophakic. RESULTS: Of the 87 individuals operated on for cataract, 12% (10/87) had presenting visual acuity of 6/18 or more in both eyes, and 24.1% (21/87) had less than 6/60. Twenty-five percent (29/116) of the 116 eyes operated on for cataract had presenting visual acuity of 6/18 or more, and 44.8% (52/116) had less than 6/60. Aphakic cases without glasses and uncorrectable aphakia attributable to surgical complications were common. In a multivariate regression model, including time period of surgery, hospital type, and surgical procedure, only pseudophakia was associated with better outcomes (P = .05). On a scale from 0 (maximum problems) to 100 (no problems), the mean visual functioning score (+/-SD) for the operated-on population was 61.9 +/- 30.0, and 71.0 +/- 31.8 for the quality of life questionnaire. These scores were comparable to those of the unoperated-on population with moderate bilateral blindness (<6/60 to > or =3/60 in the better eye). Visual functioning and quality of life scores were closely correlated with visual acuity in operated-on (r = 0.64 and r = 0.61, respectively) and unoperated-on populations (r = 0.68 and r = 0.59, respectively). CONCLUSIONS: Both clinical and patient-reported cataract surgery outcomes are below what should be achievable. Improvement in outcomes must be given greater emphasis if the potential of cataract surgery in restoring sight is to be realized.

Aged↗
PubMed1999

Foldable posterior chamber intraocular lens implantation in the absence of capsular and zonular support.

PURPOSE: To implant foldable posterior chamber intraocular lenses in the absence of capsular and zonular support. METHODS: Case reports. In two patients, two eyes with aphakia, lack of capsular or zonular support, and contact lens intolerance underwent the implantation of a silicone and an acrylic foldable posterior chamber intraocular lens, respectively. RESULTS: In the two eyes, final visual acuity was 20/25 and 20/50, respectively. No intraoperative vitreal, retinal, or choroidal complications were noted. The postoperative recovery was rapid, and there was minimal induced astigmatism. CONCLUSIONS: The implantation of foldable posterior chamber intraocular lenses in aphakic eyes without capsular and zonular support may result in fewer intraoperative complications. It also allows for faster postoperative recovery and less postoperative astigmatism.

Acrylates↗
PubMed2000

Combined pars plana vitrectomy and glaucoma drainage implant placement for refractory glaucoma.

PURPOSE: To report visual acuity and intraocular pressure outcomes among patients who have undergone combined pars plana vitrectomy and placement of a glaucoma drainage implant. METHODS: The medical records of all patients who underwent combined pars plana vitrectomy and placement of a glaucoma drainage implant at the Bascom Palmer Eye Institute by one of the authors between January 1, 1990, and February 28, 1998, were reviewed. Forty patients (40 eyes) were identified, including 14 patients with neovascular glaucoma secondary to proliferative diabetic retinopathy or central retinal vein occlusion, 15 patients with other posterior segment disease, seven patients with secondary angle-closure glaucoma, and four patients with aphakia with ruptured anterior hyaloid face. Main outcome measures included visual acuity and intraocular pressure at 1 year postoperatively. RESULTS: At 1 year postoperatively, 31 (77.5%) of 40 patients had stable or improved visual acuity; three eyes (7. 5%) had a final visual acuity of no light perception and three additional eyes (7.5%) were enucleated (because of chronic pain in two eyes and endophthalmitis in one eye). Mean preoperative intraocular pressure was 34 mm Hg and the median number of preoperative antiglaucoma medications was two. At 1 year postoperatively, mean intraocular pressure was 13 mm Hg and the median number of antiglaucoma medications was zero. Twenty-two patients (55.0%) achieved an intraocular pressure greater than 5 mm Hg and less than or equal to 21 mm Hg without antiglaucoma medication, and an additional seven patients (17.5%) achieved this level of intraocular pressure control with medication. Only one patient (2.5%) underwent further glaucoma surgery for uncontrolled intraocular pressure. CONCLUSIONS: Although combined pars plana vitrectomy and placement of a glaucoma drainage implant is often a successful management option in selected patients with refractory glaucoma, visual outcome may be poor because of severe underlying ocular disease and postoperative complications.

Adult↗
PubMed1984

Cataracts and cataract operations (1).

Cataract operations are commonly performed in either a primary-care or a tertiary-care center. A plethora of information (some of which is unfounded) has been disseminated in the lay news media about the advances in the surgical techniques of cataract removal. This article reviews some of the recent concepts about the formation of cataracts and the modern approaches for their extraction. It is directed at the nonophthalmologic primary-care physician who refers patients for evaluation or performs the ancillary tests in preparation for a cataract operation. Space limitations prevent a complete review of the subject. Some of the controversial aspects of cataract surgical procedures are addressed objectively, but bias is unavoidable.

Adult↗