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PubMedDate not supplied

[Corneal thickness after cataract extraction. Early observations].

The corneal thickness was measured after cataract extraction. In 36 patients the thickness was tested by an ultrasound pachymetry before the operation and on the 1, 3 and 7 day after surgery. The visual acuity and the clinical status of the cornea of the operated eye were also examined. The most pronounced oedema was seen on the first day in the neighbourhood of the incision. On the 7th postoperative day the corneal thickness approximated the status existing before the operation in the majority of patients. There was a dependence between the corneal thickness and its clinical status and the visual acuity.

Cataract Extraction↗
PubMedDate not supplied

Pars plicata lensectomy/vitrectomy for developmental cataract extraction: surgical results.

Fifty-two cases of developmental cataracts extracted using the pars plicata lensectomy/vitrectomy technique were reviewed. Eyes with additional ocular anomaly other than microphthalmos were not included. No early complications were detected in a postoperative period ranging from 1.5 to 7 years with a median of 4 years, and late complications were limited to secondary membranes occurring in small eyes. Since secondary membranes occurred only in eyes in which the axial length was less than or equal to 17.4 mm and the corneal diameter was less than or equal to 9.5 mm, we suggest that eyes that are small by the absolute dimensions cited here are at greater risk of developing secondary membranes postoperatively. Small eyes by absolute dimensions should be distinguished from microphthalmic eyes, since the relative term microphthalmic is less predictive of risk of complication than are absolute dimensions. Linear Snellen acuity in 15 patients capable of response ranged as follows: 20/20-20/80 with a median of 20/40 in eyes with partial bilateral cataracts; 20/25-20/80 with a median of 20/50 in eyes with complete bilateral cataracts; 20/30-20/400 with a median of 20/200 in eyes with unilateral partial cataracts; and 20/60-CF with a median of 20/400 in eyes with complete unilateral cataracts. Mean patient ages at surgery were 3 months for those with bilateral complete cataracts, 5 months for those with unilateral complete cataracts, 18 months for those with bilateral partial cataracts, and 25 months for those with unilateral partial cataracts. The earliest possible removal of visually significant opacities must be combined with aggressive postoperative visual rehabilitation to obtain the best possible visual outcome.

Cataract Extraction↗
PubMed1989

[The kallikrein-kinin activity of the blood serum after intracapsular cataract extraction and the implantation of intraocular lenses].

After intracapsular cataract extraction the level of kallicrein in blood serum is slightly increased. The authors consider it as a compensatory, stimulating regeneration. The postoperative period after IOL implantation is characterized by a remarkable rise of kallicrein activity. This is accompanied gl a higher exudative reaction in the postoperative period. The manifestation of exudative changes after IOL implantation prevails in persons with a high initial level of kallicrein in blood serum. A high level of kallicrein before surgery may serve as a prognostic test of a pronounced exudative reaction in the postoperative treatment of patients after IOL implantation.

Aged↗
PubMed1980

Complications in 1,000 consecutive intracapsular cataract extractions.

In a series of 1,000 consecutive intracapsular cataract extractions, the most important peroperative complications were rupture of the capsule in 6.5% of the cases and vitreous loss in 3.0%. The most important immediate postoperative complications were delay in wound closure in 2.7% of the cases, iritis in 2.9%, ocular hypertension in 3.4%, and some other complications. The late complications were an Irvine-Gass syndrome in 2.8% of the cases, an epithelial downgrowth in the anterior chamber in 0.6%, and a retinal detachment in 2%. alpha-Chymotrypsin often causes a temporary ocular hypertension (in at least 25.2% of the cases). The functional results are very good, when there is no pre-existing ocular pathology: in 90% of the cases the vision was 7/10 or more.

Aphakia, Postcataract↗
PubMed1992

The effect of indomethacin, diclofenac and flurbiprofen on the maintenance of mydriasis during extracapsular cataract extraction.

Surgically induced miosis (SIM) frequently occurs during extracapsular cataract extraction (ECCE). A randomized clinical trial was performed to evaluate the effect of 3 nonsteroidal antiinflammatory drugs Indomethacin 1%, Diclofenac 0.1% and Flurbiprofen 0.03%, administered topically before ECCE, on the maintenance of mydriasis during surgery. The patients were grouped based on the type of NSAID given preoperatively in addition to the standard mydriatic agents: 46 patients in group A (Indomethacin), 40 patients in B (Diclofenac), 44 patients in C (Flurbiprofen) and 34 patients formed control group D (no NSAID was instilled). Horizontal pupillary diameter measurements were taken, using a caliper, immediately prior to surgery (step 0), after capsulotomy (step I), after expression of the lens nucleus (step II) and after irrigation-aspiration of the cortical remnants (step III). Differences in pupillary diameter between step 0 and the different surgical steps were used as indices of pupillary constrictions observed in the 4 groups. A significantly less pupillary constriction was found in groups A and C than in D between steps 0 and II (p = 0.01) and in groups A and C than in B and D between steps 0 and III (p = 0.001). Our results show that Indomethacin 1% and Flurbiprofen 0.03%, compared to Diclofenac 0.1% and no NSAID regime, are significantly more effective in maintaining mydriasis during cataract surgery.

Aged↗
PubMed2005

Effect of cataract extraction on the visual fields of patients with glaucoma.

OBJECTIVE: To investigate the effect of cataract extraction on the visual fields of patients with open-angle glaucoma. METHODS: Patients in a prospective cohort study in a tertiary center underwent standard automated perimetry every 6 months. We compared the mean results of the 2 examinations immediately before and 2 examinations immediately after phacoemulsification cataract extraction and intraocular lens implant (effect analysis) and the mean results of the first 2 and last 2 examinations from 4 consecutive examinations obtained more than 1 year after the cataract surgery (control analysis). RESULTS: Our sample contained 34 eyes of 26 patients (mean +/- SD age, 69.2 +/- 10.8 years). While the mean logMAR best-corrected visual acuity improved significantly by approximately 2 Snellen lines after surgery (P < .001), the average change in mean deviation in both the effect and control analyses was less than 0.1 dB and not statistically significant (P = .85). There was a strong correlation between change in foveal sensitivity and change in mean deviation in the effect analysis but not in the control analysis (r = 0.76 [P < .001] and r = 0.30 [P = .08], respectively). There was no relationship between change in visual acuity or initial mean deviation and change in mean deviation in either analysis. Change in pointwise total deviation was not systematically related to the respective baseline value in either analysis; however, the variance of the distribution of change in total deviation was significantly higher in the effect analysis (P < .001). CONCLUSION: While there was an improvement in best-corrected visual acuity after cataract surgery, the changes in the visual field as a group were negligible.

Aged↗
PubMed1990

[Endocapsular cataract extraction with in-the-bag IOL implantation].

The authors performed in-the-bag IOL implantation in 34 eyes after endocapsular cataract extraction. The surgical key points, the complications and their management were discussed. The postoperative visual acuity s. c. was 0.5 or better n 23 eyes (67.6%), the corrected vision was 0.5 or better in all patients. The advantages of endocapsular cataract extraction are (1) ensured in-the-bag implantation and optical centering, (2) diminution of surgical complications, and (3) ready resort to posterior chamber IOL in the ciliary sulcus should the posterior capsule rupture.

Adult↗
PubMedDate not supplied

Long-term prognosis of extracapsular cataract extraction and intraocular lens implantation in diabetic patients.

Although cataract extraction with intraocular lens implantation (IOL) is being used for increasing numbers of patients, there is still insufficient information regarding the long-term outcome for these patients. In this retrospective study of 140 eyes of 102 patients, 97 eyes (69%) achieved a best visual acuity of 20/40 or better. After a minimum 6-month postoperative period, 26 eyes (19%) had developed retinopathy: eight eyes progressed from nonproliferative to proliferative retinopathy. Glycosylated hemoglobin levels and fasting blood glucose were significantly higher at time of surgery in the eight that progressed than in those who did not (P = 0.002, P = 0.034). There were 65 unilateral IOL implantations; in 10 (15%) of these eyes, retinopathy progressed. Retinopathy also progressed in 70% of the fellow eyes of these patients. In patients whose retinopathy did not progress, 95% of the fellow eyes also showed no progression. Also, patients with progression in the pseudophakic eye frequently had progression in the fellow unoperated eye. Postoperative progression was symmetrical (P = 0.0001). Our analysis suggests that progression of diabetic retinopathy following IOL implantation can be correlated to diabetic control at the time of surgery.

Adult↗
PubMed1992

[Clinical aspects, follow-up and results of cataract extraction in uveitis].

Over a 5-year period, a consecutive series of 52 eyes in 46 patients with uveitis underwent extracapsular cataract extraction. Twenty-eight of these cases received a posterior chamber intraocular lens (IOL). During an average follow-up of 25 months (range 7 to 58 months) 71% of eyes receiving an IOL achieved postoperatively a visual acuity of 0.5 or better; 54% of aphakic eyes reached this level. Persistent cystoid macular edema limited the visual improvement to 20/200 in 6 patients; none of the patients developed cystoid macular edema postoperatively on clinical observation. Intraocular hypertension occurred postoperatively in 12 eyes, but was limited to a 4-week postoperative period in 9 cases. YAG laser capsulotomy was performed in 2 eyes with opacification of the posterior lens capsule without any further complications. The results suggest that uveitis patients benefit from cataract extraction and in selected cases can tolerate IOL implantation without major complications.

Adolescent↗
PubMed1988

Pseudophakic cystoid macular edema: a revised comparison of the incidence with intracapsular and extracapsular cataract extraction.

A previous study by one of the authors found no significant difference in the incidence of cystoid macular edema with an intracapsular cataract extraction and the implantation of an iris-supported posterior chamber optic lens, compared with the incidence of cystoid macular edema with an extracapsular extraction and the implantation of a Shearing lens. To test the validity of that conclusion, the charts of 686 patients operated on by one of the authors were reviewed. It was determined that the incidence of both transient and persistent cystoid macular edema was significantly higher in patients who had an intracapsular cataract extraction. Reasons for the contradictory findings are discussed.

Cataract Extraction↗
PubMed1990

Sterile corneal ulceration after cataract extraction in patients with collagen vascular disease.

We report the occurrence of sterile corneal ulceration in 11 eyes of eight patients with collagen vascular diseases and dry eyes after cataract extraction with intraocular lens implantation. Keratolysis occurred after both extracapsular and intracapsular cataract extraction and appeared unrelated to the type of intraocular lens. Despite aggressive lubrication and other medical treatment, including systemic immunosuppressive agents, penetrating keratoplasty was often required. Although all eyes were saved, visual outcome was usually poor. The histopathologic finding of polymorphonuclear leukocytes localized near the areas of corneal dissolution provides evidence for the role of polymorphonuclear leukocyte-derived collagenase as a contributing factor in the pathogenesis of sterile corneal ulceration in these patients.

Aged↗
PubMed1975

Combined Kelman procedure (phaco-emulsification cataract extraction) and simultaneous aphakic penetrating keratoplasty.

The problem of management of coexistent lenticular and corneal opacification is, as yet, unresolved. Combined intracapsular cataract extraction and penetrating keratoplasty affords the risk of vitreous loss at the time of surgery or perhaps the even greater risk of vitreous adhesion to the donor cornea. Leaving an intact posterior capsule would certainly avoid the problems of vitreous touch. Where applicable, we have been utilizing the technique of combined phaco-emulsification cataract extraction followed by aphakic penetrating keratoplasty leaving an intact posterior capsule and removing all cortical remnants with the irrigation-aspiration probe of the Kelman Cavitron unit. This technique has proved extremely useful in our hands and we suggest that it is a useful alternative in the management of coexistent lenticular and corneal opacification.

Cataract Extraction↗
PubMed1991

Cataract extraction after brachytherapy for malignant melanoma of the choroid.

Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.

Adult↗
PubMed1987

Combined extracapsular cataract extraction and posterior chamber intraocular lens implantation and trabeculectomy.

In a retrospective study in a consecutive series of operations performed by the author, 13 eyes in 10 patients underwent combined extracapsular cataract extraction, posterior chamber intraocular lens (IOL) implantation and trabeculectomy. All had significant cataract and chronic open-angle glaucoma with field loss, uncontrolled or marginally controlled on maximum tolerable medical treatment. All had a postoperative reduction in intraocular pressure. Significant complications included malignant glaucoma (in two eyes) and a late choroidal detachment (in one eye). The indications for and the advantages of the combined procedure are discussed, emphasising the advantages of extracapsular cataract extraction (ECCE) and posterior chamber lens implantation, in patients with chronic open-angle glaucoma (COAG).

Anterior Chamber↗
PubMed1979

Indomethacin as a means of preventing cystoid macular edema following intracapsular cataract extraction.

It has been theorized that prostaglandins E1 and E2 may be responsible for the vascular leakage leading to cystoid macular edema following cataract extraction. Indomethacin is a known inhibitor of prostaglandin synthesis. A prospective, double-blind study to evaluate the effect of oral indomethacin on four and eight week cases of postoperative CME following intracapsular cataract extraction as determined by fluorescein angiography was carried out on 42 patients. Twenty patients received 25 mg of indomethacin three times a day for three days preoperatively and three weeks postoperatively. Twenty-two patients received a placebo on an identical schedule. Four (20%) patients in the indomethacin group and five (22.7%) patients in the placebo group had positive angiograms for CME. No contributory factor resulting in CME was found.

Aged↗
PubMed1976

Perifoveal vascular leakage and macular oedema after intracapsular cataract extraction.

Perifoveal capillary leakage of fluorescein was demonstrated in 60 per cent of 50 eyes when angiography was performed two weeks after cataract extraction. Repeat angiography six weeks postoperatively in 17 eyes demonstrated persistence of already established leakage in 11 of 12 eyes and no new leakage in five eyes previously negative. Cystoid macular oedema with visual acuity of less than 20/40 six weeks postoperatively occurred in five eyes (10 per cent). Eyes of patients with vascular disease and those patients of 60 years or older were found to have altered vascular permeability significantly more frequently. Inflammation was no more severe or prevalent in those patients who demonstrated leakage and no inflammation was clinically apparent in 10 of 11 eyes demonstrating dye leakage six weeks postoperatively. We conclude that the constitutional factors of age and vascular disease are of prime importance in causing altered vascular permeability in the early postoperative period after cataract extraction; factors causing sustained leakage with reduction of visual acuity were not demonstrated.

Adult↗
PubMedDate not supplied

Review of sterile, postoperative, anterior segment inflammation following cataract extraction and intraocular lens implantation.

PURPOSE: To evaluate unexpected, acute intraocular anterior segment inflammation following uneventful cataract extraction by phacoemulsification and foldable posterior chamber intraocular lens (PCIOL) implantation. METHODS: This retrospective study evaluated five cases of postoperative inflammation that occurred after cataract extraction with foldable PCIOL implantation. Medical records were reviewed to analyze the unexplained postoperative inflammation. RESULTS: The five patients who developed inflammatory activity during the postoperative period responded well to corticosteroid treatment. Toxic maculopathy developed in one patient after aggressive antibacterial therapy. Vitrectomy was performed for one patient with prolonged vitreal inflammatory activity. CONCLUSIONS: Noninfectious endophthalmitis developing upon surgery may be caused by a multifactorial process or an interindividual variable response to a common factor as a hypersensitivity reaction. It should be remembered in inflammatory cases after surgery in order to prevent the toxic, irreversible side effects of bacterial endophthalmitis treatment.

Acute Disease↗