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At least 289 records · Page 16Linked to original sources
PubMed1980

Corneal response to extended wear of CAB contact lenses in aphakia.

We studied 41 aphakic eyes in 30 patients who had been wearing CAB (cellulose acetate butyrate) contact lenses on an extended basis. Patients were 51 to 81 years old and averaged 14.3 months of wearing time. Visual acuity was very good. Pachometry measurements ranged from 0.42 mm to 0.66 mm and averaged 0.550 mm. This compares favorably with data in the literature on corneal thickness seen with routine use of PMMA or hydrogel lenses or with extended wear of hydrogel lenses. Corneal thickness was also compared with unoperated fellow eyes and eyes using CAB lenses on a daily basis only.

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PubMed1980

Anterior vitrectomy for chronic aphakic cystoid macular edema.

This report describes a series of 13 patients who underwent anterior vitrectomies for chronic aphakic cystoid macular edema (CME). All eyes had formed vitreous adherent to the intracapsular wound, vision of 20/50 or worse, and fluorescein angiographically documented CME for six months or more. Following the presentation of the results (success rate of 69%) and a discussion of this form of treatment, the beginning of a national, randomized, prospective study designed to evaluate the effectiveness of this treatment is described.

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PubMed1980

Which lens: contact lenses currently available for extended wear in aphakia.

To date, a number of specific materials have been used for extended wear lenses in aphakia. While none of the materials are ideal, reasonable results have been achieved with three types of materials: thin hydrophilics, silicone, and high water content hydrophilics. The various available lenses are described, and their physical properties are related to the process of extended wear. The authors' techniques for fitting, follow-up, evaluation, and prevention of complications are presented.

Aphakia, Postcataract↗
PubMed1980

Intraocular hemorrhage from vascularization of the cataract incision.

In a survey of 58 aphakic eyes examined 5 to 10 years after surgery, 12% had episcleral vessels in the inner aspect of the cataract incision and almost half of these eyes showed evidence of mild intraocular hemorrhage. Analysis of these and 33 other eyes indicates that argon laser treatment is only temporarily effective in preventing intraocular hemorrhage. Limbal cryotherapy is effective in a one- to four-year follow-up. While these vessels are a common cause of transient intraocular hemorrhage in aphakic eyes, serious sequelae are rare and treatment is usually unnecessary.

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PubMed1981

Endophthalmitis in aphakic patients with unplanned filtering blebs wearing contact lenses.

Four female patients with known unplanned filtering blebs following cataract surgery developed endophthalmitis, two weeks to 30 months after being fit with corneal contact lenses. Three patients were wearing hard contact lenses and one wore a soft lens. Significant blepharoconjunctivitis was present and treated in two patients, but intraocular infection was not averted. When endophthalmitis was diagnosed, all patients had clinical evidence of a bleb infection as well as hypopyon. Despite aggressive medical therapy, two eyes required enucleation while two eyes survived with good vision. We recommend that eyes that have unplanned filtering blebs following cataract surgery should not have a contact lens inserted until the blebs have been closed.

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PubMed1981

Closed vitrectomy and the intraocular implant.

Closed vitrectomy was successfully performed on eyes containing intraocular lenses (IOLs) in order to remove retropseudophakic membranes, remove vitreous strands surrounding IOLs or adherent to the corneoscleral incision and iris in cases of persistent cystoid macular edema (CME), assist in the relocation of IOLs which had dislocated into the vitreous, and to relieve pseudophakic pupillary block. Closed vitrectomy was also performed to remove vitreous present in the anterior segment prior to secondary IOL implantation. Techniques and results of 33 closed vitrectomies in such instances are presented.

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PubMed1981

The effect of total vitrectomy on filtration surgery in the aphakic eye.

The influence of total vitrectomy on the success rate of filtration surgery was investigated, with 47 operations (6 reoperations) being performed on 41 patients. At six months postoperatively, successful control (IOP less than 21 mm Hg) was achieved in 32 of 41 patients (78%). Twenty-four patients had filtration blebs present. Total vitrectomy favorably influences the result of filtration surgery. However, the morbidity rate (two retinal detachments and two cases of cystoid macular edema) is higher than in standard filtration procedures.

Adult↗
PubMed1981

Empirical fitting of hard contact lenses in infants and young children.

A method of empirically fitting hard contact lenses in infants and young children is described. It can be performed without the benefit of "K" readings and does not require the patient to be anesthetized. Lens fit is judged by fluorescein pattern, degree of finger tightness on the cornea, and indirect determination of steepness by comparing baseline refraction with final over-refraction using a contact lens of known power. This simplified technique has been found to be reliable and practical with good lens fit obtained in most patients. The visual results achieved in unilateral aphakic patients using this method are comparable to those found elsewhere in the literature.

Aphakia, Postcataract↗
PubMed1981

Keratophakia update.

Since October 1977, the authors have attempted 32 keratophakias (refractive corneal surgery using an interlamellar homograft disc). Twenty-nine of these were primary and three secondary on aphakic eyes. These cases were divided into two series. In the first series, the dioptric correction was 28.5% less than the amount calculated to correct the aphakic error. In the second series, only 6.5% of the calculated dioptric power remained uncorrected. Keratophakia is an alternative to other modalities of secondary full-time correction of aphakia since the internal eye is not compromised by this secondary procedure as it is with a secondary intraocular implant. Further improvements in instrumentation techniques and mathematic programs will broaden the application of refractive keratoplasty techniques.

Adult↗
PubMed1982

Epikeratophakia -- the surgical correction of aphakia. Update 1981.

Epikeratophakia grafts used to rehabilitate vision in adult monocular aphakic patients intolerate of contact lens correction or not candidates for IOLs were studied prospectively. Thirty-two patients who entered this study between its inception in February 1980 through February 1981 were followed for at least eight months. Patients with normal visual potential before surgery had average visual acuities with spectacle overcorrection of 20/50 at four months, 20/40 at eight months, and 20/30 at one year. Few long-term complications were seen. Empirical modification of the lathing process has decreased the undercorrection from the 5.5 diopters seen in the early patients to the 1.0 diopter seen in the more recent patients. Problems with predictability are related to the behavior of preserved corneal tissue during the lathing and the healing of these lamellar grafts. This procedure is intended for aphakic patients of whom IOL and contact lens correction is not possible.

Adult↗
PubMed1982

Surgical therapy for chronic aphakic cystoid macular edema.

Aphakic cystoid macular edema (ACME) is a common condition seen after intracapsular cataract extractions. In an overwhelming majority of these cases, the condition improves spontaneously. Those cases that persist for months or years, however, are often associated with vitreous strands adherent to the surgical wound and distortion of the pupil. This article reviews the surgical and photocoagulation therapies for this condition that have been reported over the past two decades. All studies report encouraging results, but all have been nonrandomized, uncontrolled trials. This paper describes two randomized, controlled clinical studies that are attempting to evaluate objectively the role of vitrectomy for chronic cases of aphakic cystoid macular edema.

Aphakia, Postcataract↗
PubMed1982

Extended-wear contact lenses in patients with corneal grafts and aphakia.

Extended-wear contact lenses (EWCL) were fitted successfully on 61 aphakic eyes with penetrating corneal grafts. In two- to 32-months follow-up there were 26 eyes that had varying amounts of superficial neovascularization of the grafts and one Staphylococcus epidermidis corneal graft ulcer. There were five homograft rejections, all occurring in severely diseased eyes. Variable vision and visual acuity less than that with hard contact lenses or aphakic spectacles were the most frequent problems. Both were due to the high corneal astigmatism present in many patients. The results indicate that EWCLs may be used safely by patients with penetrating corneal grafts and aphakia, particularly if there is no host corneal edema, scarring, or vascularization, if these are no synechias to the graft wound, and if the astigmatism is less than 3.0 diopters.

Adolescent↗
PubMed1983

Posterior capsule opacification in pseudophakic eyes.

Posterior capsule opacification following extracapsular cataract extraction is a manifestation of proliferation of anterior lens epithelium onto the posterior capsule. In addition to Elschnig pearl formation, vision is decreased in two ways. Multiple layers of proliferated epithelium produce a frank opacity. Also, the lens cells show myofibroblastic differentiation and their contraction produces numerous tiny wrinkles in the posterior capsule resulting in visual distortion. Because the cells that proliferate are anterior lens epithelial cells and because proliferation begins at the site of apposition of anterior capsular flap and the posterior capsule, a wide anterior capsulectomy should help reduce the risk of and delay the onset of visual loss from this complication of extracapsular surgery. Polishing the posterior capsule at the time of surgery will not help in this regard unless there is a complicated cataract with pre-existing posterior migration of lens epithelium. The presence of a potential cleavage plane between the proliferating epithelium and the posterior capsule provides a therapeutic alternative to surgical or laser discission.

Aphakia, Postcataract↗
PubMed1983

Surgical management of chronic glaucoma in aphakia.

The surgical management of glaucoma in aphakia has been limited by poor success in the control of intraocular pressure and serious postoperative complications that threaten vision. A consecutive series of trabeculectomy filtering procedures in aphakic eyes with a mean preoperative intraocular pressure of 38 mmHg was followed for an average of 26 months and revealed a 62% control of intraocular pressure at 21 mmHg or less. Five additional patients (24%) had pressures lower than 21 mmHg following digital massage. The complication of decreased visual acuity following surgery was significant but not directly related to the surgical procedure. Another patient population with glaucoma and aphakia with a mean preoperative pressure of 25 mmHg was treated with laser trabeculoplasty. In 12 of 15 patients (80%) intraocular pressure was lower than 22 mmHg for an average of eight months and did not require glaucoma surgery. There were no significant complications following this therapy and all patients retained preoperative level of visual acuity. In aphakic patients who have uncontrolled glaucoma on maximal medical therapy, surgery is indicated. We recommend the following approach to surgical management: (1) Laser treatment to the trabecular meshwork if the angle is open; (2) if this fails, or the angle is extensively closed, a trabeculectomy filtering procedure is suggested; (3) cyclocryotherapy has been effective in controlling pressure but the unpredictable loss of vision has prompted caution in seeing eyes; (4) cyclodialysis; and (5) transpupillary or transscleral treatment of the ciliary processes are additional modes of therapy. Improved results of surgical treatment for glaucoma and aphakia have been encouraging and should be used when maximal medical therapy is ineffective.

Adult↗
PubMed1983

Keratophakia. Long-term results.

Thirty-three keratophakias were performed at Holy Cross Hospital in Mission Hills, California between August 1979 and October 1982. Nineteen were primary, combined with cataract surgery; 14 were secondary, performed on aphakic eyes. Data on the 23 cases that had a minimum follow-up time of one year were analyzed by an independent observer. Best visual acuity obtained at seven months was 20/40 or better in 62% of the patients. Induced keratometric astigmatism averaged 1.0 diopter and manifest refractive astigmatism 2.0 diopters. The results of secondary keratophakia vs keratophakia combined with cataract extraction were compared. Accuracy, complication rate and final visual recovery suggest that the combined procedure is safe and effective, and that primary keratophakia does not add a significant risk to cataract surgery.

Adult↗
PubMed1983

Epikeratophakia: the surgical correction of aphakia. Update: 1982.

Sixty-five epikeratophakia procedures have been performed in 63 patients; visual acuity data have been tabulated on 31 patients with 4 to 30 months follow-up. Patients with more than a year of follow-up showed stable keratometry readings. Early patients achieved 70% of the predicted dioptric correction; more recent patients have achieved 87% with improvements in the lathing procedure, tissue handling, and surgical technique. Visual acuities improve with time. At any given time after surgery, acuities measured with a hard contact lens are better than those measured with spectacles; the decrease in spectacle acuity is probably a result of irregular refraction at the graft surface. The gap between contact lens and spectacle acuity decreases with time. A number of patients achieve postoperative visual acuities better than their preoperative acuities, and most achieve final spectacle acuities within a line or two of their preoperative acuities.

Aphakia, Postcataract↗
PubMed1983

Diabetes mellitus and intraocular lens implantation.

Prospective evaluation of extracapsular cataract extraction with posterior chamber intraocular lens (ECCE-posterior chamber IOL) in 234 eyes of 20 diabetics, with and without nonproliferative retinopathy, and 209 nondiabetics demonstrated no statistically significant difference in operative or postoperative complications. A postoperative final visual acuity of 20/40 or better was achieved in 65% of diabetic surgical eyes and in 90% of nondiabetic surgical eyes, a difference that was statistically significant (P = 0.0049). When eyes with diabetic retinopathy or other pre-existing ophthalmic disease responsible for decreased vision were excluded, postoperative visual acuity of 20/40 or better was obtained in 93% of diabetic eyes and 96% of nondiabetic eyes, a difference that was not statistically significant (P = 0.5045). Therefore, the relatively less favorable outcome of ECCE-posterior chamber IOL surgery in diabetics, with or without nonproliferative retinopathy, is due to greater frequency of retinopathy or other ophthalmic disease responsible for decreased vision. Based on this study and all available information, guidelines regarding diabetes mellitus and intraocular lens implantation are presented.

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