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PubMed1983

Clinical cystoid macular edema with intracapsular cataract extraction and posterior chamber lens implantation.

A prospective clinical study has been undertaken to determine the rate of clinical cystoid macular edema in a population that has had intracapsular cataract extraction with the implantation of an iris-supported posterior lens. Transient cystoid macular edema developed in 7.2% of the patients in this study, and persistent cystoid macular edema developed in 1.02% of the patients. A chi 2 test shows that there is no significant difference in the rates of transient and persistent cystoid macular edema in this group with intracapsular cataract extraction and a group reported in the literature who had extracapsular cataract extraction and the implantation of a Shearing lens.

Acute Disease↗

PubMed1996

[Evaluation of posterior capsule opacification after extracapsular cataract extraction with and without implantation of intraocular lens].

PURPOSE: The aim of the study was evaluation of the rate of posterior capsule opacification after extracapsular cataract extraction with and without implantation of intraocular lens. MATERIAL AND METHOD: The clinical material comprised 77 patients operated on in the years 1990-1994. Only the cases in which visual acuity exceeded 5/10 were included into the study. 107 eyes were examined, among them 75 after implantation of posterior chamber intraocular lens. RESULTS: Opacification of the posterior capsule occurred in 37 eyes, but only in 25 of 75 eyes in the patients with implantation of the artificial lens. We found that following extracapsular cataract extraction without implantation of intraocular lens, opacification of the posterior capsule occurs more frequently, especially during 1-2 years after the surgery. CONCLUSION: Cortical-nuclear cataract and not much advanced age are factors predisposing for greater rate of opacification of the posterior capsule after extracapsular cataract extraction.

Adult↗

PubMed1996

Extracapsular cataract extraction after vitrectomy.

OBJECTIVE: To ascertain the reliability, safety, and effectiveness of extracapsular cataract extraction (without the use of pars plana infusion) in eyes that have had vitrectomy. SETTING: The Manchester Royal Eye Hospital. METHODS: A retrospective analysis of surgical and postsurgical complications and visual acuity change in 41 patients who had one or more vitreoretinal procedures, followed by extracapsular cataract extraction and intraocular lens implantation at a subsequent date. RESULTS: No significant operative complications were encountered using an extracapsular technique without pars plana infusion. Thirty eyes (73.2%) had a significant increase in visual acuity, 10 (24.4%) did not change, and 1 worsened. CONCLUSIONS: A modified form of extracapsular extraction, with control of intraocular fluid flow but without the use of a pars plana infusion, is safe and effective in post-vitrectomy eyes.

Cataract↗

PubMedDate not supplied

Cataract extraction with lens implantation at Biloxi Veterans Affairs Medical Center: experience of ophthalmology residents.

We reviewed and analyzed the visual acuities achieved and the complications after 949 cataract operations done by ophthalmology residents during the transitional period in which an intracapsular cataract extraction technique was replaced by an extracapsular one. The available records of all patients from 1982 through 1991 were reviewed. Eighteen intracapsular and 896 extracapsular cataract extractions were performed, followed by 906 primary and 43 secondary implants. Posterior capsular rupture occurred in 6.3% of the cases with vitreous loss in 3.4%. Cystoid-macular edema was the most common postoperative complication. The postoperative visual acuity was 20/40 or better in 91% of cases, and it was better than the preoperative visual acuity in 99.5% of cases. With appropriate training and supervision, a resident can achieve good results by doing extracapsular cataract extractions with lens implantations. These results were comparable to those reported by others.

Cataract Extraction↗

PubMed1979

Cataract extraction in glaucoma.

Cyclodialysis lens extraction or cyclodialysis canalicular trabeculectomy lens extraction in one eye and cataract extraction in the fellow eye were performed in 24 glaucoma patients. The combined procedure follow-up was from five to 12 years in the first group, two to four years in the second group, and from three to ten years in the control group. The 50% success rate of cyclodialysis lens extraction can be enhanced with no significant increase in surgical morbidity or postoperative complications by performing a cyclodialysis canalicular trabeculectomy where the disinsertion of the scleral spur is carried out under direct visualization.

Aged↗

PubMed1978

[Postoperative astigmatism and visual acuity after cataract extraction with various operative methods (author's transl)].

UNLABELLED: The postoperative findings after cataract extraction with corneoscleral incision were compared with those after corneal incision in two groups consisting of 70 patients each. The criteria used were the degree and axis of postoperative astigmatism evaluated ophthalmometrically and the postoperative visual acuity. The preoperative values were taken into account. RESULTS: The mean values of astigmatism shortly after corneal incision were very much higher than those after corneoscleral incision, and they approached each other 6 months after cataract extraction. Patients who had an operation done with corneoscleral incision had a better visual acuity than those with corneal incision.

Astigmatism↗

PubMed1992

Prevention of acute postoperative pressure rises in glaucoma patients undergoing cataract extraction with posterior chamber lens implant.

Acute elevations in intraocular pressure (IOP) commonly follow extracapsular cataract extraction and lens implant in glaucoma patients. Thirty six patients with glaucoma undergoing cataract extraction and posterior chamber lens implantation received one of three treatments. Group 1: 500 mg of Diamox Sustets (acetazolamide) 1 hour preoperatively (10 patients); Group 2: peroperative intracameral Miochol (acetylcholine) (11 patients); Group 3: the above treatments combined (15 patients). IOPs were measured at 3, 6, 9, and 24 hours postoperatively. The average of the maximum pressure rises above the preoperative level over the 24 hour period was greatest for the group receiving acetazolamide only at 8.9 mm Hg; for the acetylcholine group the average maximum rise was 6.3 mm Hg; while the combined treatment group showed a decrease of 0.7 mm Hg. IOP rises of > 6 mm Hg were seen in 7% of patients (one of 15) in the combined treatment group, 45% (five of 11) of the acetylcholine group, and 70% (seven of 10) of the acetazolamide group. IOP rises of > 10 mm Hg were seen in 7% of the combined treatment group, in 18% of the acetylcholine only group, and in 50% of the acetazolamide only group. A pressure rise > 20 mm Hg was seen in one patient receiving acetazolamide only and one patient receiving acetylcholine only. The difference between the acetylcholine group and the combined group for rises > 6 mm Hg was significant using the chi 2 test while the acetazolamide group showed a significant difference for rises > 6 and 10 mm Hg compared with the combined group. All acute pressure rises were recorded before or at 9 hours following operation except in the combined treatment patient where the rise occurred at 24 hours. To prevent the acute IOP rises seen following cataract surgery with lens implant in glaucoma patients we recommend combined ocular hypotensive therapy.

Acetazolamide↗

PubMed2004

Comparing phacoemulsification and extracapsular cataract extraction in eyes with pseudoexfoliation syndrome, small pupil, and phacodonesis.

BACKGROUND: This study aims to compare the frequency of intraoperative and postoperative complications between the modern phacoemulsification technique and the extracapsular cataract extraction technique in patients with pseudoexfoliation syndrome. PATIENTS AND METHODS: A prospective randomized study comprised 94 eyes with cataract, pseudoexfoliation syndrome, small pupil and slight to moderate phacodonesis. These eyes were randomly assigned into two groups. In the first group all patients (47 eyes) were operated on using a standard phacoemulsification technique (iris hooks, anterior capsule staining and capsular tension ring after capsulorhexis), while in the second group all patients (47 eyes) underwent a classic extracapsular cataract extraction. The main outcome measures were the frequency of intraoperative zonular tears, capsular rupture, vitreous loss and corneal edema, as well as the best-corrected visual acuity. RESULTS: Intraoperative zonular separation was recorded in one eye (2.1 %) and in 15 eyes (31.9 %) for the first and second groups, respectively (P < 0.001). Posterior capsule rupture with or without zonular separation occurred in two eyes (4.2 %) of the first group and in eight eyes (17.0 %) of the second group (P < 0.05). Vitreous loss also had a higher rate in the second group (17.0 % versus 4.2 %, P < 0.05). The postoperative difference in best-corrected visual acuity was also significant between the two groups, being higher in patients operated on using phacoemulsification technique (P < 0.001). CONCLUSIONS: In the difficult cases of cataract associated with pseudoexfoliation syndrome, small pupil and phacodonesis, the modern small-incision cataract surgery provides better results with a low rate of intraoperative and postoperative complications when compared with the extracapsular cataract extraction technique.

Aged↗

PubMed2000

Audit of outcome of an extracapsular cataract extraction and posterior chamber intraocular lens training course.

BACKGROUND: A training course for cataract surgery with intraocular lens implantation was organised in April 1997 at the National Eye Centre, Kaduna, Nigeria. Operations were performed by six Nigerian consultant ophthalmologists under the supervision of two surgeons from Aravind Eye Hospital, India. METHODS: A total of 175 eyes with uncomplicated cataracts were operated on after careful selection. All but six patients had extracapsular cataract extraction with posterior chamber intraocular lens insertion during the training programme. RESULTS: The mean age of the patients at operation was 54. 2 years. One hundred and forty five of the operated eyes (85.8%) were blind before surgery of which six (3.6%) remained blind postoperatively. An uncorrected visual acuity of 6/60 or better was achieved in 87.3% eyes after surgery. Forty one patients (24.3%) were blind before surgery, two of whom (1.2%) remained blind afterwards. The most common intraoperative complication was posterior capsular rent which occurred in 10 eyes (5.7%); striate keratopathy/corneal oedema and cortical remnant were the most common immediate postoperative complications, occurring in 44.6% and 8.0%, respectively. CONCLUSION: With adequate surgical skills, extracapsular cataract extraction with posterior chamber intraocular lens implantation offers good visual rehabilitation even under training conditions.

Adult↗

PubMed1982

Cystoid macular edema after intracapsular and extracapsular cataract extraction with and without an intraocular lens.

A prospective cystoid macular edema study of aphakic and pseudophakic patients showed that extracapsular cataract surgery has a lower rate than intracapsular surgery when the surgery is uncomplicated. There was no difference in the rates with intracapsular surgery with and without an intraocular lens. A complicated extracapsular with an intraocular lens has a higher rate than when the surgery is uncomplicated. In extracapsular surgery with complications, there is no difference in the rates with and without an intraocular lens. When complications occur, the ratio of clinical to angiographic-proven cases is higher than when the surgery is uncomplicated. This study included four series of uncomplicated cataract extractions and three series of complicated cataract extractions. A fluorescein angiogram was performed on every patient at least one year after surgery.

Cataract Extraction↗

PubMed1998

Staphylococcal endophthalmitis following cataract extraction in a patient with Darier's disease.

PURPOSE: To report staphylococcal endophthalmitis following cataract extraction in a patient with Darier' s disease. METHODS: A 67-year-old man presented with decreased visual acuity OD and hypopyon 3 days status post-cataract extraction with intraocular lens placement. The patient was hospitalized and placed on topical and intravenous antibiotics. A diagnostic vitreous tap, pars plana vitrectomy, and intravitreal antibiotic installation were performed. RESULTS: Vitreal tap cultures indicated Staphylococcus epidermidis. His clinical status improved after vitrectomy and antibiotic therapy. The same bacteria was cultured from the patient's eyelids. CONCLUSIONS: The source of the S. epidermidis was the skin lesions on the patient's face and eyelids. Darier's disease is an exfoliative hyperkeratotic skin disease that affects all areas on the body except the buttocks. Although clean, sterile surgical techniques were followed, the risk of endophthalmitis following intraocular surgery in a patient with Darier's disease may be increased due to his or her dermatologic condition.

Aged↗

PubMed2001

Prospective study of cataract extraction and risk of coronary heart disease in women.

Oxidative damage to proteins in the human lens is believed to be important in the etiology of age-related cataract. Because free radical-mediated oxidative damage to lipoproteins may accelerate atherosclerosis, the authors hypothesized that the development of cataract might be a marker for such damage and therefore might be associated with future risk of coronary heart disease (CHD). The authors followed 60,657 women aged 45--63 years and without known coronary disease, stroke, or cancer in 1984. During 10 years of follow-up (674,283 person-years), the authors documented 887 incident cases of CHD and 2,322 deaths. After adjustment for age, smoking, and other coronary risk factors, cataract extraction was significantly associated with higher risk of CHD (relative risk (RR) = 1.88, 95% confidence interval (CI): 1.41, 2.50) for total CHD, 2.44 (95% CI: 1.54, 3.89) for fatal CHD, and 1.63 (95% CI: 1.14, 2.34) for nonfatal myocardial infarction). The positive association between cataract extraction and total CHD was stronger among women with a history of diabetes (RR = 2.80, 95% CI: 1.77, 4.42) than among those without reported diabetes (RR = 1.51, 95 percent CI: 1.04, 2.18). In multivariate analyses, cataract extraction was associated with significantly increased overall mortality (RR = 1.37, 95 percent CI: 1.13, 1.66), which was entirely explained by the increased mortality from cardiovascular disease (RR = 1.84, 95% CI: 1.29, 2.64). These findings are compatible with current hypotheses relating oxidative damage and tissue aging to the development of cataract and CHD.

Cataract↗

PubMed2001

Effects of cataract extraction with intraocular lens placement on scanning laser polarimetry of the peripapillary nerve fiber layer.

PURPOSE: To determine the effects of cataract extraction with intraocular lens placement on scanning laser polarimetry of the peripapillary nerve fiber layer. DESIGN: Cohort study. METHODS: Thirty-four eyes of 33 patients undergoing phacoemulsification cataract surgery with intraocular lens were imaged using the GDx Nerve Fiber Analyzer within 4 weeks before and at least 4 weeks after cataract surgery. Preoperative and postoperative mean images were compared. The effects of cataract severity and type, and intraocular lens material, were also examined. RESULTS: Comparison of preoperative and postoperative mean scanning laser polarimetry measurements revealed that eyes in which acrylic intraocular lenses (n = 11) were placed had a significant increase in scanning laser polarimetry for the total band circumference, and superior, inferior, and nasal quadrants (P < or =.041). Placement of silicone (n = 15) and polymethylmethacrylate (n = 8) intraocular lenses did not result in statistically significant changes in scanning laser polarimetry measurements. However, eight of 34 eyes (23.5%) had changes of 15% or more postoperatively in the total circumference measurement, including eyes with acrylic, silicone, and polymethylmethacrylate intraocular lenses. CONCLUSIONS: Cataract extraction with intraocular lens was associated with a statistically significant change in mean scanning laser polarimetry values in eyes that received an acrylic intraocular lens. In individual patients, clinically important changes (15% or greater) in scanning laser polarimetry measurements were not uncommon irrespective of intraocular lens type. New baseline scanning laser polarimetry measurements may be warranted in eyes that undergo cataract extraction with intraocular lens.

Acrylic Resins↗

PubMed1993

[Comparative study of extracapsular and intracapsular cataract extraction in Kinshasa (zaire)].

In the developed countries, the great majority of operations for cataract are performed using the extracapsular cataract extraction (ECCE) and phacoemulsification generally combined with the implantation of an intraocular lens in the posterior chamber of the eye. However, in most developing countries, like Zaïre, the more widespread method is still intracapsular cataract extraction (ICCE). In a retrospective study, the results of the 33 first consecutive ECCE with or without IOL performed during six months (from January 1990 through June 1990) were reviewed. These results of ECCE were compared to those of patients who underwent ICCE (52 eyes) during the same period. The follow-up ranged from one month to 32 months with a mean of 7 months for the ECCE group and from one month to 24 months with a mean of 5 months for the ICCE group. The number of eyes that had peroperative complications was one (3%) for the ECCE and 14 (27%) for the ICCE. The number of eyes that had immediate postoperative complications was 12 (36%) for the ECCE and 20 (38%) for the ICCE. And the number of eyes that had later postoperative complications was 4 (9%) and 11 (22%) for respectively the ECCE and ICCE. The most important peroperative complication for the ECCE group was vitreous loss in 6% of the cases compared to 16% for the ICCE group. The most important immediate postoperative complication was striate keratitis (24%) in the ECCE group and striate keratitis (15%), iritis (12%), pupillary block (6%) in the ECCE group. The most important late complications were posterior capsule opacification (6%) for the ECCE and glaucoma (6%) for the ICCE. Of 33 eyes which underwent ECCE, 73% achieved a visual acuity of 0.5 or better. Of 52 eyes which underwent ICCE, 56% achieved a visual acuity of 0.5 or better. In this study, rates of complications were higher in ICCE and visual outcome was better in ECCE. This study shows that the ECCE with IOL implantation would be preferable than the ICCE in our country.

Adult↗

PubMed2000

[Intraocular correction of aphakia after cataract extraction for uveitis in adolescents].

PURPOSE: To demonstrate 3 cases with pediatric pseudophakia after cataract extraction as a complication of unilateral uveitis. MATERIAL AND METHODS: The boys were at the age of 8, 11 and 15 years at the moment of surgery. Uveitis was monocular, the etiology unknown and clinically significant cataract was diagnosed after several months from the beginning of inflammation. The last recurrence of uveitis was observed 1 to 6 months before operation. There were intermediate uveitis (2 cases) and anterior uveitis (1 cases). In 2 eyes PMMA implant was placed in-the-bag and in one eye in the ciliary sulcus. During surgery we did not observe any complications except greater tendency to bleeding. Follow-up after operation ranged from 1.5 to 2.5 years. RESULTS: Visual acuity before cataract extraction was 0.01; 0.04 and 0.02 and during last visit after surgery it was 0.9, 0.6 and 0.4 respectively. Postoperative near distance visual acuity was 0.5, 0.75 and 1.25. We observed cystoid macular oedema in the latter case. Two months after PC-IOL implantation the symptoms of mild inflammation in the eye of 15-year-old boy with anterior uveitis occurred. Intraocular pressure before and after operation ranged from 12 to 17 mm Hg. Corneal central endothelial cell density was from 2850/mm2 to 3100/mm2 before and from 2469/mm2 to 2979/mm2 during last visit. CONCLUSION: Cases of posterior pseudophakia during uveitis in children showing good functional and anatomical state of eyes in the long term observation after IOL implantation recommend the intraocular correction in carefully selected uveitic pediatric patients.

Adolescent↗

PubMed2003

[Evaluation of the results of cataract extraction and lends implantation in eyes after vitrectomy].

PURPOSE: To evaluate the results of cataract surgery in previously vitrectomized eyes. MATERIAL AND METHODS: In 41 eyes, that had undergone prior vitrectomy, extracapsular cataract extraction was done and intraocular lens was implanted. The average time between operations was 14.5 months (range from 2 months to 6 years). The mean follow-up was 19 +/- 12.2 months (range from 4 months to 4 years). RESULTS: Statistically significant improvement was observed in visual acuity after cataract extraction and IOL implantation, compared to the results after vitrectomy. The most frequent complication was posterior capsule opacification, which occurred in 9 eyes (22%). CONCLUSIONS: The results show, that intraocular lens implantation in eyes after vitrectomy is safe and achieved visual acuity is similar or better, than before cataract formation.

Adult↗

PubMed1985

My method of extracapsular cataract extraction with implantation of a posterior chamber intraocular lens.

Simplified manual forms of extracapsular cataract extraction appear to be more economical, yet as safe and simple as techniques employing more complex instrumentation. The following method, employed in 40,000 cases, seems to the author to be an efficient and effective way of performing cataract extraction. One hour prior to surgery, modified retrobulbar anesthesia alone is employed using the technique described, and provides adequate akinesia as well as anesthesia. Positive pressure is applied to the eye preoperatively to assure softness of the globe at the time of surgery. An anterior capsulectomy is made with scissors, using the open-sky technique. Following the delivery of the lens nucleus and as much cortex as possible with a lens loop, the remaining cortex is removed with an angled, 23-gauge, double irrigation-aspiration cannula. Filtered balance salt solution, containing gentamycin flows into the eye through the side port (inflow) and a 3-cc syringe with 2 cc BSS for irrigation-aspiration is connected to the other (aspiration) port. A single, 25-gauge, angled irrigation cannula is used to clean up the finger cortical remains. A firm-loop intraocular lens is inserted into the capsular bag. The posterior capsule is left intact.

Cataract Extraction↗

PubMed1995

Inflammation after cataract extraction and intraocular lens implantation in patients with rheumatoid arthritis.

AIMS: The purpose of this study was to examine whether preoperative activity of rheumatoid arthritis influences the extent of anterior chamber inflammation after cataract extraction and intraocular lens implantation. METHODS: The medical records of 23 consecutive patients (33 eyes) with rheumatoid arthritis, who underwent cataract extraction with intraocular lens implantation, were reviewed during a 4 year period from April 1990 to March 1994. RESULTS: Eleven patients who still showed a 1+ level of aqueous cells 1 month after the surgery had significantly higher titres of rheumatoid factor preoperatively, compared with the other 12 patients who showed no aqueous cells (p = 0.0019, Mann-Whitney U test). The persistence of aqueous cells also had a significant correlation with extracapsular cataract extraction compared with phacoemulsification (p = 0.0391, chi 2 test). Multivariate analysis showed that the titre of rheumatoid factor was the more significant element to determine the persistent aqueous inflammation. All the eyes, except for four which had a macular hole, optic disc atrophy, or retinitis pigmentosa gained visual acuity of 20/30 or better. The aqueous cells cleared 3 months after the surgery and left no complications in any of the eyes. CONCLUSION: Intraocular lens implantation is basically a safe procedure for patients with rheumatoid arthritis, although postoperative aqueous inflammation tends to be persistent in patients with high titres of rheumatoid factor.

Aged↗