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Results for “CATARACT EXTRACTION”

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PubMed1978

[Trabeculectomy-iridencleisis combined with cataract extraction].

On 31 eyes (23 patients, average age 74 years) with cataract and primary open-angle or chronic angle-closure glaucoma modified trabeculectomy with lobelike iridencleisis was performed combined with cataract-extraction. They were followed up for periods between 6 months and 3 years. In 84% of cases the i.o. pressure continued to be normalized without further antiglaucomatous therapy, in 16% additional treatment with drugs achieved sufficient lowering of i.o. pressure. In nearly all of the cases I observed a diffuse, very flat filtering bleb. Gonioscopy shows, that filtering channels stay open along the margin of the imbedded iris flap. Complications were rare and demanded no further surgery.

Aged↗

PubMed1989

Long-term evolution of astigmatism following planned extracapsular cataract extraction.

Sixty-six eyes of 66 patients undergoing planned extracapsular cataract extraction with interrupted 10-0 nylon suture wound closure were followed up prospectively for three years following surgery to evaluate the long-term evolution of postoperative astigmatism. The study examined the period beginning three months postoperatively, well after all suture cutting was completed, a point often considered to represent "final postoperative astigmatism." For the group as a whole, the induced astigmatism measured at three months was not stable, but gradually shifted 0.69 diopter toward against-the-rule astigmatism. Three specific patterns of evolution of postoperative astigmatism were identified, depending on the amount of induced astigmatism found at three months. The data revealed that it was not possible to consistently induce with-the-rule astigmatism, although permanent against-the-rule induced astigmatism could be produced. The long-term evolution of postoperative cataract wounds toward more against-the-rule astigmatism seen in this study was not affected by the number of intact nylon sutures. Proper evaluation of any technique to modify postoperative astigmatism must consider the long-term evolution of the cataract wound.

Aged↗

PubMed1996

Recurrent choroidal detachment following combined trabeculectomy and cataract extraction.

Two patients with glaucoma who underwent uneventful trabeculectomy and extracapsular cataract extraction with posterior chamber intraocular lens implantation, experienced late and recurrent choroidal detachment. Both patients received aqueous suppressant therapy before and after surgery. Hypotony and choroidal detachment occurred 7 months and 15 months after the combined surgery. There was no shallowing of the anterior chamber or leakage from the filtering blebs, and there were no signs of inflammation. The choroidal detachment completely resolved in the two patients 4 days and 4 weeks following discontinuation of the aqueous suppressant therapy.

Aged↗

PubMed1991

[Observations on the intraocular pressure after extracapsular cataract extraction].

The author observed the IOP of 32 eyes after extracapsular cataract extraction with posterior chamber intraocular lens implantation. The IOP was elevated in all cases, over 0.67 kPa (5 mmHg) in 22 cases, over 1.33 kPa (10 mmHg) in 12 cases, and the highest was 5.05 kPa (38 mmHg). The peak of elevation was at 24 hours after operation and most cases resumed the preoperative levels in 48 hours. The IOP of eyes with intracameral carbachol was significantly lower than that of those without at 6 hours after operation, but the difference became insignificant after 24 hours.

Adolescent↗

PubMed1978

A comparison of 500 Binkhorst implants with 500 routine intracapsular cataract extractions.

We compared 500 Binkhorst lens implants with 500 routine intracapsular cataract extractions. The two groups consisted of consecutive cases matched according to surgeons, surgical technique, time interval of the study, and ocular status. The results of visual acuity were comparable in the two groups; 89.0% of the implant group and 85.4% of the routine intracapsular group achieved 6/12 (20/40) or better visual acuity. The rate of complications in each group was comparable except in the case of corneal edema, which was higher in the implant group (1.2%) than in the routine intracapsular group (0.4%). The rate of clinically significant cystoid macular edema was higher in the routine intracapsular group (2.2%) than in the implant group (1.4%).

Aged↗

PubMed1998

Managing inferior zonule tears during manual extracapsular cataract extraction.

We describe a new technique for safely concluding manual extracapsular cataract extraction in the presence of a rupture of the interior zonules. A lens glide is inserted in the anterior chamber. The tip of the glide is placed in the inferior part of the capsular bag, pushing it toward the ciliary sulcus at 6 o'clock. The extraocular part of the glide is sutured to the sclera to prevent its displacement during manipulation of the eye. The glide spreads the rolled inferior capsule, allowing aspiration of retained cortical material and in-the-bag intraocular lens implantation. The glide is then removed. This technique was used in 12 eyes with pseudoexfoliation in which the complication occurred. No vitreous loss, lens displacement, or other intraoperative or postoperative complications were observed.

Cataract Extraction↗

PubMedDate not supplied

Early acute aseptic iritis after cataract extraction.

Severe iritis which occurs within the first five days after cataract extraction may be categorized as (1) bacterial endophthalmitis, (2) toxic iritis, or (3) aseptic iritis. These entities can sometimes be distinguished because of their clinical features. If bacterial endophthalmitis is suspected, anterior chamber paracentesis should be considered and appropriate antibiotic treatment should be initiated. Acute iritis may result from the introduction of toxic agents into the eye, and may follow the use of products sterilized with ethylene oxide. Early acute aseptic iritis probably occurs more often than has previously been recognized. Response to intensive anti-inflammatory treatment is usually prompt and dramatic. The judicious use of cryoextraction and the careful manipulation of intraocular tissues may minimize the incidence and the severity of postoperative inflammation.

Acute Disease↗

PubMed1983

A long-term follow-up of cataract extraction with and without intraocular lens implantation.

In 176 consecutive intracapsular cataract extracted eyes with an iris clip lens (IOL) and 159 eyes with consecutively performed intracapsular extractions (ICCE), the visual outcome and complications were examined in a follow-up study. The average observation time was 48 months in the IOL group and 53 months in the ICCE group. In both groups the main cause of a visual acuity less than 0.5 was pre-operatively recognized maculopathy. Eighty-six per cent of the remaining IOL eyes and 93% of the remaining ICCE eyes achieved a visual acuity greater than or equal to 0.5. Post-operative complications were the cause of a visual acuity less than 0.5 in 11.9% of the IOL and 6.9% of the ICCE group. The most frequent complications were corneal oedema and retinal detachment. Pre-operative and early post-operative complications were important factors in the development of late complications in the IOL group. With proper pre-operative evaluation and good surgical technique intraocular lens implantation is a safe procedure.

Aged↗

PubMed1985

Diagnosis and surgical management of phacoanaphylactic uveitis following extracapsular cataract extraction with intraocular lens implantation.

One year after a successful extracapsular cataract extraction with posterior chamber lens implantation of a Cilco Kratz modified J-loop lens, the patient, a 79-year-old white female, developed a severe granulomatous uveitis unresponsive to topical or systemic steroid therapy. All usual uveitis tests were negative, and no evidence of masquerade-syndrome-type uveitis was found. The possibility of lens-induced uveitis was considered. A B-scan ultrasound revealed high density echoes in the superotemporal portion of the capsular bag, and an operative procedure consisting of a sector iridectomy, removal of the implant, removal of white cortical material in the capsular bag as well as residual lens capsule, and an anterior vitrectomy was done. Pathologic examination of the specimens revealed lens material engulfed by large macrophages, foam cells, and plasma cells. The patient's uveitis rapidly subsided. She is now off all medication and has normal aphakic vision. The differential diagnosis, surgical management, and implications of this problem are discussed.

Aged↗

PubMed1988

Regional anaesthesia for 12,000 cataract extraction and intraocular lens implantation procedures.

Twelve thousand regional anaesthetics for cataract extraction and intraocular lens implantation surgery were administered by one anaesthetist over a period of 52 months in a free-standing outpatient surgical facility. The ophthalmologist, who did all the operations, assessed the quality of the blocks using an objective scoring system which is described. The first 3,595 patients had retrobulbar and seventh nerve blocks. The following 1,640 patients had higher volume retrobulbar blocking alone. The next 3,478 had peribulbar blocks, followed by 2,226 who had a modified form of peribulbar blocking. A final group of 1,061 had a combination of peribulbar and periorbital blocks with added retrobulbar injection if indicated. As the method of blocking evolved, the more closely was the goal of safe, painless and effective regional anaesthesia approached. The requirements for effective anaesthesia of this type are presented, the complications described and the importance of familiarity with the anatomy of the orbit and its contents stressed.

Aged↗

PubMed1989

Gonioscopic findings following insertion of Pearce Lasagap and Nova Curve Kratz posterior chamber intraocular lenses in extrapsular cataract extraction.

The gonioscopic appearances of 45 eyes that had undergone extracapsular cataract extraction with insertion of a Pearce Lasagap posterior chamber intraocular lens (group A) were compared with those of 45 eyes that had undergone the same procedure except for insertion of a Nova Curve Kratz posterior chamber lens (group B). Prominence of one or both loops was seen in 35 eyes (78%) of group A, with peripheral anterior synechiae (PAS) in 25 (55%). Prominence of one loop was seen in 14 eyes (31%) of group B, with PAS in 8 (18%) (P less than 0.001). Final visual acuity was comparable in both groups, 98% achieving 6/12 (20/40) or better. Although not statistically significant, the incidence of pigment dispersion, uveitis, discomfort and visual aberrations was greater in group A than in group B. We suggest that the apparent superiority of the Nova Curve Kratz lens in terms of the smaller incidence of loop prominence, as well as the reduced incidence of these other complications, is due to the fact that its haptic is inserted into the optic's edge rather than into the anterior surface of the lens optic, as is the case with the Lasagap lens.

Aged↗

PubMed1996

[Observations on early stage intraocular pressure after modern extracapsular cataract extraction].

OBJECTIVE: To observe the early intraocular pressure (IOP) after extracapsular cataract extraction (ECCE). METHOD: ECCE was performed on 58 eyes which were randomly divided into 3 groups, and postoperatively, at various intervals the IOP was measured and compared. RESULTS: The low IOP was not measurable by tonometer at 1 hour after the operation. At postoperative 3 hours, the mean IOP was higher than that of the preoperative level. The peak of IOP elevation was between postoperative 6-12 hours, over 2.80 kPa (1 kPa = 7.5 mmHg) and > or = 4.0 kPa were in 31 eyes (53.45%) and 4 eyes (6.90%) respectively, and the highest IOP was 4.40 kPa. Naturally, the levels of IOP resumed normal in all cases in postoperative 24 hours. The IOPs in 5 eyes (8.62%) were lower than the normal level (< 1.33 kPa) within 72 hours after the operation. The postoperative IOP of the group with diamox administered preoperatively was lower than that of the group with either mannitol or without drugs (P < 0.05) to lower the IOP preoperatively. The eyes with normal postoperative IOP accounted for the majority. CONCLUSION: Preoperative oral administration of diamox is a measure to prevent the early elevation of IOP after ECCE.

Acetazolamide↗

PubMed1975

Bacterial flora in relation to cataract extraction. II. Peroperative flora.

The peroperative flora of 499 patients undergoing cataract extraction was studied with local bacterial cultures taken at the beginning and end of surgery and compared with the preoperative flora examined previously (Fahmy et al. 1975 b) on admission the day prior to surgery. The local application of a single dose of oxytetracycline - polymyxin B, approximately 18 hours before surgery, significantly reduced the incidence of bacteria at the time of surgery. However, 92% of the conjunctivas examined immediately before operation proved to harbour one or more kinds of microorganisms. Futhermore, 61% of the wound sites were found to be contaminated with bacteria at the conclusion of surgery. The reasons are discussed. The origin of Staphylococcus aureus isolated peroperatively from the conjunctiva and wound site was studied. The great majority of strains could be traced to the patient's own conjunctiva preoperatively. In a few cases S. aureus was traced to the patient's own nose, skin of face or to the surgeon's nose. The air of the wards and operating theatre as well as the hands and gloves of surgeons and assistant nurses apparently did not play any role as a source of S. aureus infection.

Adult↗

PubMedDate not supplied

Surgically induced astigmatism after manual extracapsular cataract extraction or after phacoemulsification procedure.

Astigmatic changes in three series of cataract surgical procedures were compared. The first two series comprised eyes having a manual extracapsular cataract extraction (ECCE) through a 12.0 mm or 8.0 mm incision and implant of a PMMA posterior chamber lens. The third series comprised eyes having phacoemulsification through a scleral pocket and implant of a PMMA posterior chamber lens. Preoperative keratometry measurements and corneal topography maps were compared with those obtained two days, one week, one, three and six months postoperatively. The keratometry measurements, obtained with computerized videokeratography, revealed: on day 2, 4.89 D (1st series), 3.95 D (2nd series), 2.66 D (3rd series); one week, respectively 4.46 D, 3.51 D and 2.14 D; one month, 0.65 D, 0.53 D and 0.05; three months, 1.44 D, 0.35 D and 0.36 D; six months, 1.36 D, 0.42 D and 0.48 D. The surgically-induced cylinder at three months was four times greater in the manual ECCE 12.0 mm incision series than in the phacoemulsification series. However, by six months all differences were markedly reduced. The results add to the growing evidence that the phacoemulsification procedure produces less astigmatism and more rapid visual rehabilitation than the manual ECCE procedure. Topographic analysis showed much less corneal steepening after phacoemulsification than after manual ECCE. However, all three surgical procedures offered satisfactory clinical results.

Aged↗

PubMed1987

Effect of age on visual acuity after cataract extraction.

The best Snellen visual acuity in the three months after cataract extraction was found to decline with the age of the patient. The relationship was identical in 111 patients who had extracapsular extraction and a Pearce tripod posterior chamber intraocular lens and in 50 patients who had intracapsular extraction with spectacle correction. Vision after operation varied from a mean value of 6/5 at 50 years to 6/12 at 90 years, a decline of 1 line per 13.4 years. In the intracapsular group, over a mean follow-up period of 14 years, the rate of fall in acuity with increasing age after operation was found to be statistically similar to that of the early postoperative acuity plotted against age for both types of operation. This suggests that the rate of decline with age is unchanged after a prolonged period of aphakia with presumed increased exposure to ultraviolet and blue light. The data were found to be similar to the decline in the neurosensory elements of vision with age measured experimentally in 20 phakic subjects by laser interferometry. This method of assessment of contrast sensitivity threshold effectively bypasses changes in the optical media. The findings indicate that the previously recognised drop in visual acuity with age is not related to changes in the aging crystalline lens and support the view that there is a decline in the neurosensory elements of vision. It is important to recognise this deterioration so that results of surgery or other treatment are adjusted to allow for the age of the patients.

Adult↗

PubMed1998

[Primary posterior chamber intraocular lens implantation of posterior capsular ruptur with cataract extracted by phacoemulsification].

OBJECTIVE: To evaluate the effect of primary posterior chamber intraocular lens (IOL) implantation of posterior capsular rupture (PCR) with cataract extracted by phacoemulsification. METHOD: Primary posterior chamber IOL implantation was performed on 29 cases (29 eyes) with PCR occurring in 184 cases (200 eyes) during cataract extraction by phacoemulsification. RESULTS: In-the-bag implantation was performed on 10 cases, and sulcus-fixed lens implantation on 19 cases. The post-operative uncorrected visual acuities in 17 cases (58.62%) were 1.0 or better and 0.5 - 0.9 in 10 cases (34.48%). The corrected visual acuities in 22 cases (75.86%) were 1.0 or better and 0.5 - 0.9 in 5 cases (17.24%) after 3 months of operation. The complications included corneal edema and damage of pupillary margin in the operation, and anterior vitreous inflammatory reaction after the operation. CONCLUSION: The posterior chamber IOL can be primarily implanted in cases with PCR and functional anterior or posterior capsular support after the anterior segment vitreous was cleaned.

Adult↗

PubMed1994

Phacolytic glaucoma--its treatment by planned extracapsular cataract extraction with posterior chamber intraocular lens implantation.

Phacolytic glaucoma has traditionally been treated with intracapsular lens extraction to avoid any anaphylaxis. Various mechanisms have been described for the rise of intraocular pressure in these cases. The present study was undertaken to evaluate the response of extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens implantation (PC IOL) in five cases of phacolytic glaucoma that occurred between March 1989 and August 1990. A planned extracapsular cataract extraction with can-opener capsulectomy was done in all the cases with placement of a sulcus-fixated modified J-loop Sinskey design intraocular lens. With a mean follow-up period of two years, all patients (100%) maintained a normal postoperative intraocular pressure of less than 20 mm Hg without any additional medical therapy. The final best-corrected visual acuity in 4 cases (80%) was 6/12 or better, while in one case it was 6/24 due to a senile maculopathy. These results show that ECCE with PC IOL implantation is a safe and efficacious method of visual rehabilitation in cases of phacolytic glaucoma.

Aged↗

PubMed1999

Simultaneous bilateral cataract extraction.

PURPOSE: To evaluate the visual outcome and safety of simultaneous bilateral cataract extraction. SETTING: Stobhill Hospital NHS Trust, Glasgow, United Kingdom. METHODS: This retrospective case review comprised 259 consecutive patients (518 eyes) who had simultaneous bilateral cataract surgery. Surgeries included bilateral extracapsular procedures, uniocular extracapsular procedures performed simultaneously with a different type of intraocular lens surgery in the other eye, and 1 bilateral intracapsular procedure. Outcome measures were postoperative best spectacle-corrected visual acuity (BSCVA), intraoperative and postoperative complication rates, and conjunctival swab culture results. RESULTS: Eighty-three percent of patients (75% of eyes) with measured preoperative and postoperative BSCVA achieved an acuity of 6/12 or better. Intraoperative and postoperative complication rates were similar to those in previous reports of unilateral extracapsular surgery and simultaneous bilateral cataract surgery. Endophthalmitis occurred in 1 eye (0.19%). There were no bilateral complications that resulted in visual loss. Cultures were positive from 42% of conjunctival swabs; 81% of positive cultures were coagulase-negative Staphylococcus and 10% were Staphylococcus aureus. CONCLUSIONS: Simultaneous bilateral cataract surgery did not lead to an increased incidence of serious intraoperative or postoperative complications, and visual acuity results were good.

Adult↗