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Results for “CATARACT EXTRACTION”

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PubMed1998

Cataract extraction in eyes with diabetic iris neovascularization.

BACKGROUND AND OBJECTIVE: Iris neovascularization used to be considered a strict contraindication to intraocular surgery, especially intraocular lens implantation. In this study, the authors analyzed whether cataract extraction and posterior chamber lens implantation is associated with unacceptable intraoperative and early postoperative complications in patients with proliferative diabetic retinopathy and rubeosis iridis. PATIENTS AND METHODS: Using a computerized data retrieval system, the authors identified all the patients with manifest iris neovascularization and proliferative diabetic retinopathy who underwent cataract extraction in their institution between 1989 and 1995. The preoperative, intraoperative, and early postoperative data were analyzed retrospectively with regard to complications and visual results. RESULTS: Thirty-nine eyes of 33 patients (mean age 64.6 +/- 10.9 years) with manifest pupillary rubeosis iridis were analyzed. All but 3 of the eyes had undergone previous retinal laser treatment, with dense cataracts preventing additional photocoagulation. Additional chamber angle neovascularization was present in 11 eyes. Posterior chamber intraocular lenses were implanted in 35 eyes. Intraoperatively, iris hemorrhage was noted in 10 eyes and was significantly more frequent in eyes that underwent nuclear expression (50%) than in those that underwent phacoemulsification (12%; P = .019). Postoperatively, spontaneously resolving hyphema was observed in 7 eyes as well as reversible fibrin formation in 6 eyes. No severe sight-threatening complications occurred. Visual acuity improved in 33 (85%) of the eyes. CONCLUSION: Cataract extraction with posterior chamber lens implantation does not appear to be associated with unacceptable intraoperative or early postoperative complications. However, adequate treatment of underlying diabetic retinopathy prior to cataract extraction (and if necessary, postoperatively) is essential to prevent the progression of retinal and iris neovascularization.

Adult↗
PubMed1987

Management of increased intraocular pressure after cataract extraction.

We measured the change in intraocular pressure prospectively after extracapsular cataract extraction in 80 eyes after treatment with either pilocarpine gel, pilocarpine 4% solution, timolol 0.5% solution, or placebo. Intraocular pressure, pupil size, and anterior chamber cellular reaction were measured in a masked fashion on the first day after surgery. A significant increase in intraocular pressure was found in all groups postoperatively when compared with baseline values (P less than .001). Eyes treated with pilocarpine gel had an average intraocular pressure increase of 4.2 +/- 2.1 mm Hg (mean +/- 1 S.E.), eyes treated with pilocarpine 4% eyedrops had an average increase of 9.8 +/- 2.8 mm Hg, and eyes treated with timolol demonstrated an intraocular pressure increase of 8.25 +/- 3.19. The intraocular pressure in untreated eyes (controls) increased by an average of 12.9 +/- 2.7 mm Hg. Only the difference in intraocular pressure change between the eyes treated with pilocarpine gel and control eyes was statistically significant (P = .025). Postsurgical intraocular pressure exceeding 25 mm Hg was observed in three of 20 pilocarpine gel treated eyes (15%) and 11 of 20 control eyes (55%). Pilocarpine treatment was not associated with noticeable changes in intraocular inflammatory response, nor were significant ocular or systemic adverse reactions observed. A single administration of pilocarpine gel is effective in reducing increased intraocular pressure for the first 24 hours after extracapsular cataract extraction.

Cataract Extraction↗
PubMed1986

Cataract extraction and intraocular lens implantation in patients with retinitis pigmentosa or Usher's syndrome.

We report the results of cataract extraction in 26 eyes of 16 patients with retinitis pigmentosa or Usher's syndrome. There was no unusual incidence of intraoperative or postoperative complications in this group. After adequate preoperative counseling, and after we made certain that the patients' expectations were in line with anticipated results, 15 of our 16 patients were satisfied with the surgical outcome. Four patients who had a conventional cataract extraction with postoperative contact lens wear in one eye and an intraocular lens implanted in the other eye preferred the eye with the implant. There was no evidence that intraocular lens implantation interfered with the post-cataract-extraction care of the patients.

Adult↗
PubMed1981

The effect of timolol and acetazolamide on transient intraocular pressure elevation following cataract extraction with alpha-chymotrypsin.

Elevated intraocular pressure (IOP) early after cataract extraction with alpha-chymotrypsin is a well-described, common occurrence. To study the incidence of pressure increase and the efficacy of medical therapy, IOP was monitored every 12 hours beginning on the first postoperative day in 68 patients after otherwise uncomplicated intracapsular cataract extraction performed with one milliliter of alpha-chymotrypsin and wound closure with multiple sutures. Patients were randomly assigned to one of three groups: treatment with oral acetazolamide, treatment with topical timolol, or no treatment. Without prophylactic treatment, the prevalence of pressure elevation at 24 hours postoperatively was 69% with IOP greater than or equal to 25 mm Hg; 29% with IOP greater than or equal to 40 mm Hg. This was independent of the type of sutures used (10--0 nylon or 9--0 silk). The patients of four different surgeons had similar rates of occurrence of postoperative glaucoma. Both timolol and acetazolamide were essentially equally effective in lowering IOP in these patients. No adverse side effects were observed. With these effective treatments available if needed, we believe that routine monitoring of the IOP by applanation tonometry during the early postoperative course provides a good opportunity for reducing the risk of complications from excessive intraocular pressure.

Acetazolamide↗
PubMedDate not supplied

Cataract extraction and age-related macular degeneration: associations, diagnosis and management.

Both cataract and age-related macular degeneration (ARMD) are common findings in our aging population. At issue is the progression of ARMD following cataract extraction. The purpose of this paper is to review the data relevant to this subject and to offer suggestions as to the management of cataract associated with macular degeneration. Published data are reviewed and an attempt is made to interpret the results. Topics discussed include the epidemiology and association between the incidence of cataract and ARMD, the role of photo-oxidative damage and inflammation in the pathogenesis of ARMD, and the possible contribution of cataract extraction to the exacerbation and acceleration of ARMD through increased photo-oxidative damage and intraocular inflammation. Recommendations for the cataract surgeon and specialist are formulated on the basis of existing literature.

Cataract↗
PubMed1993

Chronic Nocardia asteroides endophthalmitis after extracapsular cataract extraction.

A 65-year-old man underwent an uncomplicated extracapsular cataract extraction with placement of a posterior chamber intraocular lens. The patient developed delayed-onset chronic endophthalmitis caused by Nocardia asteroides. This was confirmed on multiple intraocular cultures, as well as histopathologic examination of the lens capsular bag. The patient was treated with periocular, intravitreal, and systemic antibiotic treatment, combined with intraocular lens removal, total capsulectomy, and three vitrectomies in an attempt to eradicate the organism and calm the eye. The patient went on to develop widespread endophthalmitis that required enucleation of the infected globe. To our knowledge, this is the first case of delayed-onset chronic endophthalmitis caused by N asteroides after extracapsular cataract extraction with a posterior chamber intraocular lens.

Aged↗
PubMed1978

The effect of corneal section on early increased intraocular pressue after cataract extraction.

Increased intraocular pressure in the immediate postoperative period commonly occurs after cataract extraction. We compared a series of patients operated on through a limbal section to a series operated on through a corneal section. The incidence of increased IOP was significantly lower in the corneal section group. This supports the theory that trabecular damage is a major factor in causing early increased IOP after cataract extraction.

Cataract Extraction↗
PubMed1981

Combined cataract extraction and trabeculotomy; further experiences.

A procedure combining external trabeculotomy with intracapsular cataract extraction was performed in 40 eyes of 28 patients. 77.5% were controlled without medication and there was no final reduction in visual acuity due to complication from the combined operations. The procedure is advocated for patients with glucoma who must undergo cataract extraction.

Aged↗
PubMed2003

Retinal detachment after phacoemulsification cataract extraction.

PURPOSE: To estimate the incidence of retinal detachment (RD) after phacoemulsification cataract extraction in an unselected group of patients. SETTING: Herlev University Hospital, Copenhagen, Denmark. METHODS: This retrospective review comprised 6521 cataract patients who had phacoemulsification over a 3-year period. The incidence of postoperative RD and the risk factors were assessed. RESULTS: During the 15- to 52-month observation period, 22 cases of RD in 21 patients were observed, with an estimated risk (Kaplan-Meier) of 0.41% (95% confidence limit, 0.25%-0.57%) at 52 months. The results confirmed recognized preoperative risk factors for RD such as an axial length greater than 25.0 mm (P<.001), age younger than 65 years (P<.001), and male sex (P<.02). In 18 eyes, the retina was reattached after 1 operation. CONCLUSIONS: The incidence of RD after phacoemulsification cataract extraction in an unselected group of patients was low. A long axial length, young age, and male sex were confirmed as risk factors.

Adult↗
PubMed1994

Cataract extraction and intraocular lens implantation in an infant with a monocular congenital cataract.

A cataract extraction and primary capsulotomy with intraocular lens (IOL) implantation was performed on a 17-day-old infant with a monocular mature congenital cataract. The IOL power, calculated at the time of surgery, was undercorrected to compensate for the growth of the eyeball. Two additional surgical procedures were required to resolve visual axis obstruction caused by lens epithelial cell proliferation. Follow-up was 18 months, during which amblyopia prevention therapy was instituted.

Amblyopia↗
PubMed1993

Paresis of a vertical rectus muscle after cataract extraction.

Nine patients had a permanent paresis of a vertical rectus muscle after cataract extraction. We sought to determine the common factors associated with and their contribution to vertical muscle paresis after cataract extraction. The study design included a survey that was conducted among the referring cataract surgeons and anesthesiologists with particular attention to surgical technique and anesthetic administered, as well as a medical history and examination and appropriate laboratory tests. Patients had a complete ophthalmic examination including prism cover testing in all nine diagnostic positions, forced-duction testing, and saccadic velocity and generated muscle force estimation. The results of the study demonstrate no correlation between the pareses and the use of a bridle suture, antibiotic or corticosteroid injection, systemic disease, or surgical technique. Peribulbar anesthesia was the most consistent feature in seven of the nine cases. In the other two, an atypical retrobulbar injection had been given. On the basis of the location of the injections, the needle type, and the concentration and quantity of the anesthetic injected, we conclude that permanent pareses of a vertical rectus muscle may be caused by a myotoxic effect of the local anesthetic.

Aged↗
PubMed1997

[Cataract extraction and intraocular lens implantation after vitrectomy].

OBJECTIVE: To study the characteristics of cataract extraction and surgical techniques in cases following vitrectomy. METHODS: Extra-capsular extraction/phacoemulsification of cataract and intra-ocular lens implantation were performed under vitreous irrigation. RESULTS: Of 37 cases (40 eyes), 31 eyes (77.5%) had obtained post-operative visual acuity > or = 0.1, 12 eyes (30.0%) > or = 0.3. The complications included nuclear dislocation into vitreous cavity (1 eye) and vitreous hemorrhage (1 eye) in the operation, and rubeosis iridis (1 eye) and pupillary capture (1 eye) after the operation. CONCLUSION: Anti-hypotony must be emphasized in the operation of cataract extraction after vitrectomy, and the vitreous irrigation is a good way against hypotony, extra-capsular extraction is more suitable than phacoemulsification in cases with hard nucleus.

Adolescent↗
PubMed2005

Intensity of smoking and smoking cessation in relation to risk of cataract extraction: a prospective study of women.

The authors investigated the association of smoking and smoking cessation with the incidence of cataract extraction in a population-based prospective cohort study. A total of 34,595 women aged 49-83 years in the Swedish Mammography Cohort were followed from September 1997 through June 2002. Information on smoking, diet, and other lifestyle factors was collected through a self-administered questionnaire. A total of 2,128 cases of age-related cataract extraction were identified. Relative risks were estimated as rate ratios using Cox proportional hazards models. The authors observed a significant dose-response association between intensity of smoking and risk of cataract extraction (among current smokers, p for trend = 0.02; among past smokers, p for trend = 0.0002). After cessation of smoking, the risk decreased with time. Among women with a moderate lifetime smoking intensity (6-10 cigarettes/day), the relative risk was not significantly different from the risk among never smokers 10 years after smoking cessation. Among women who had smoked more intensively (>10 cigarettes/day), after 20 years of nonsmoking the increased risk became small and no longer statistically significant in comparison with never smokers (for trend over time, p < 0.0001). This prospective study confirmed smoking as a risk factor for cataract, with a dose response for smoking intensity. Smoking cessation predicts reduced risk over time, but a longer period of time is needed with a higher smoking intensity.

Aged↗
PubMed1988

[Simultaneous penetrating keratoplasty, cataract extraction and artificial lens implantation ("triple procedure") 1981-1987].

Between June 1981 and March 1987, the authors performed simultaneous penetrating keratoplasty, cataract extraction, and intraocular lens implantation in 90 eyes. The main indications were Fuchs's corneal endothelial dystrophy (38 cases), corneal cicatrization (33 cases) and corneal or scleral perforation (7 cases). Extracapsular cataract extraction with posterior chamber lens implantation was performed in 82 patients. The posterior capsule ruptured in nine eyes, necessitating an anterior vitrectomy in four of them. The corneal transplant was rejected in nine eyes (10%). The mean preoperative visual acuity of 9/100 in 89 patients improved to 39/100 six months after surgery in 59 patients who were followed up and to 50/100 in the 29 patients with Fuchs's corneal dystrophy. The authors believe that in cases presenting with both cataract and medically uncontrollable corneal disease, simultaneous penetrating keratoplasty with extracapsular cataract extraction and implantation of a posterior chamber lens represents the treatment of choice.

Adolescent↗
PubMed1997

[Changes in corneal thickness and endothelial cell density after cataract extraction using phacoemulsification].

UNLABELLED: Corneal metabolism is reduced after cataract extraction. PATIENTS AND METHODS: In a prospective study the corneal thickness and endothelial cell count of 48 patients were examined after phacoemulsification. Corneal thickness was measured with an ultrasound pachymeter and the endothelial cell count with a contact endothelial camera at the 12 o'clock position and in the corneal center before and 4 weeks, 4 months and 1 year after operation. RESULTS: One year after the operation, corneal thickness increased about 9% in the 12 o'clock position and about 12% in the corneal center. The endothelial cell count decreased about 27% in the 12 o'clock position and about 18% in the corneal center. We measured a significant correlation between cell loss and age at both points. Concerning the corneal thickness, no significant correlation was found. CONCLUSION: After cataract extraction corneal metabolism is reduced. The endothelial cell count or corneal thickness can be used as an indicator of the corneal trauma resulting from the operation.

Aged↗
PubMed2000

[Glaucoma and cataract: combined operation or trabeculectomy first and cataract extraction later?].

BACKGROUND: The aim of this retrospective study is to evaluate the difference in postoperative intraocular pressure (IOP) control, number of antiglaucoma medications and visual acuity (VA) between combined phacoemulsification and trabeculectomy (Glaucoma triple) surgery and two-stage procedures with trabeculectomy first and cataract extraction later. PATIENTS AND METHODS: Two groups of glaucoma patients were assessed: In group 150 consecutive patients undergoing combined phacoemulsification and trabeculectomy were enrolled. In group two, 51 consecutive patients were included, that had undergone trabeculectomy first and cataract surgery later. The mean interval between the two procedures was 3.2 years, 35/51 patients (71%) underwent conventional extracapsular cataract extraction, the other 16 patients (29%) had phacoemusification via clear cornea incision. RESULTS: One year postoperative both groups revealed a significant IOP reduction. IOP-reduction was significantly better in the two-stage group one year after trabeculectomy (12.8 +/- 4.0 mm Hg) and one year after cataract extraction (14.0 +/- 2.8 mm Hg) as compared to the combined surgery group (15.3 +/- 4.0 mm Hg). Kaplan-Meier survival analysis revealed a 90% success-rate 12 months after trabeculectomy only as compared to 65% success-rate in the combined surgery group. The number of antiglaucoma medications was significantly reduced in both groups. One year after cataract surgery no difference in VA could be seen between the two groups. CONCLUSIONS: If medically uncontrolled glaucoma with advanced optic nerve head changes in patients with coexisting glaucoma and cataracts is the main indication for surgery, a two-stage procedure (i.e. trabeculectomy first, cataract extraction later) yields better long-term IOP control. If glaucoma is medically controlled with a simple regimen, conjunctiva-sparing cataract surgery may be the treatment of choice. In all other cases of coexisting glaucoma and cataract combined phacoemulsification and trabeculectomy (Glaucoma triple) is preferrable, either performed through a single incision or as two separate procedures in the same session (i.e. trabeculectomy from above, phacoemulsifiaction via clear cornea from temporal).

Age Factors↗