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Results for “CATARACT EXTRACTION”

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PubMed1984

Intraocular pressure after intracapsular cataract extraction.

We studied the incidence of postoperative intraocular pressure elevations in 42 patients following intracapsular cataract extraction with alpha-chymotrypsin (1:5,000) and noted 17% to develop pressures greater than 30 mm Hg and 38% greater than 24 mm Hg within a 48-hour time interval. Additionally, we studied the effect of a single immediate postoperative instillation of timolol maleate 0.5%; this was associated with a slight reduction of intraocular pressure at the three- and six-hour time intervals, but did not eliminate the pressure spikes.

Aged↗
PubMed1985

Retinal detachment following extracapsular cataract extraction and posterior chamber intraocular lens implantation.

Fourteen cases of primary retinal detachment after extracapsular cataract extraction and posterior chamber intraocular lens implantation were treated by scleral buckling surgery. Retinal reattachment was achieved in 100% of the cases. All eyes had a postoperative visual acuity of 6/30 or better; in six eyes the visual acuity was 6/12 or better. We attributed our high anatomical success rate to early detection of the retinal detachment, good visibility of the retinal breaks, lack of inflammatory reaction in the vitreous body, and preoperative absence of fixed retinal folds and preretinal membranes.

Aged↗
PubMed1983

Amvisc in extracapsular cataract extraction.

Amvisc, a purified fraction of sodium hyaluronate, was evaluated and compared with Healon in cataract extraction and primary intraocular lens implantation. Both visco-elastic solutions are valuable adjuncts to intraocular surgery. A number of patients had moderately elevated IOP after these solutions had been used in the anterior chamber. This moderate elevation was observed less frequently with Amvisc than with Healon, and may be attributed to the lower viscosity of Amvisc. Both visco-elastic solutions provide good endothelial protection as evidenced by the minimal corneal edema seen in both groups. Postoperative anterior chamber inflammation was minimal in all patients in this study.

Aged↗
PubMed1982

Anterior vitrectomy for shallow anterior chamber after cataract extraction.

Pars plana anterior vitrectomy was performed in 9 patients with shallow anterior chamber after cataract extraction. Five patients had choroidal and/or ciliary body effusion (CCBE), and 4 had aphakic pupillary block (APB). Vitrectomy was performed only after medical treatment failed to restore a normal anterior chamber depth. In all patients the anterior chamber restored during surgery and remained so thereafter, although in patients with CCBE, the fundal pathology subsided days or even months later. The only surgical complication was a longstanding cystoid macular oedema in one patient. Pars plana vitrectomy would appear to have advantages over other surgical techniques, in similar circumstances.

Aged↗
PubMedDate not supplied

[Effects of surgical wounds hermetic closure methods in cataract extraction on postoperative corneal astigmatism].

Main factors of hermetic closure of the operation wound after cataract extraction are discussed. A new method of closing the wound in this operation is described. The opposition intracorneal mattress sutures are made across the section plane. Their principal difference is that the thread is not thrown over the external edge of the section of the cornea, as in traditional suturing, and when pulled tight, the thread does not deform the external surface of the cornea in the central zone, and thus does not induce postoperative astigmatism. Eighteen patients were operated on using this technique. Opposition sutures made after the above technique involve no high postoperative astigmatism or none at all.

Aged↗
PubMed1985

Intraocular lens calculation in combined penetrating keratoplasty, cataract extraction and intraocular lens implantation.

We retrospectively studied 53 consecutive triple procedures (combined penetrating keratoplasty, cataract extraction and intraocular lens implantation) performed at the Bascom Palmer Eye Institute from January 1980 through August 1983. Most patients had at rest six months of follow-up. The final postoperative refractive error was compared to the predicted refractive error using the preoperative axial length and the estimated keratometry readings. The deviation from the predicted refractive error was correlated with the source of preoperative keratometry readings, the degree of donor oversize, and the donor age. We found that using keratometry readings from the operated eye resulted in more accurate intraocular lens calculations than using estimated keratometry readings not obtained from either eye (P less than .05).

Adolescent↗
PubMed1979

A review of one thousand cases of intracapsular cataract extraction: II. Visual results and astigmatic analysis.

A review of 1,000 cases of intracapsular cataract extraction revealed that in eyes in which no factor predisposed to complication, the early visual results were equal to or better than 20/40 in 97% of the cases. Complications of surgery in this group accounted for decreased visual acuity in only 1.7% of the eyes. In the group of patients with high myopia, previous surgery, known corneal disease, or some other factor thought to predispose to a complication, the visual acuity was equal to or better than 20/40 in only 74% of the cases, most of the decrease being due to preexisting factors within the eye rather than complications themselves. In the first group, the total amount of astigmatism produced by all the suturing techniques reviewed was similar. With interrupted suturing techniques, the axis of the correcting cylinder was more often against the rule while continuous closures with monofilament nylon more frequently produced with the rule astigmatism.

Astigmatism↗
PubMed1996

Laser flare-cell measurement of inflammation after uneventful extracapsular cataract extraction and intraocular lens implantation.

PURPOSE: To prospectively evaluate the inflammation response after uneventful extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation. SETTING: Department of Ophthalmology, University of Alicante, Spain. METHODS: Using a Kowa laser flare-cell meter, we measured cell and flare for 3 months postoperatively in 550 eyes of 435 consecutive patients who had uneventful ECCE and IOL implantation. We compared the results in terms of the type of IOL implanted. RESULTS: The amount of inflammation varied, but not significantly, according to the IOL type. The highest level of flare and cell always occurred the day following surgery regardless of which IOL was used. A small increase in flare was observed on the 30th day. CONCLUSION: Inflammation after uncomplicated ECCE, as measured with a laser flare-cell meter, resolved by 3 months and was not significantly affected by the type of IOL implanted. More sensitive instruments should be developed to measure inflammation immediately after surgery.

Adult↗
PubMed1993

Combined extracapsular cataract extraction, posterior chamber intraocular lens implantation, and pars plana vitrectomy.

The surgical management of coexisting cataract and vitreoretinal disease has been controversial, particularly for eyes with a history of proliferative diabetic retinopathy (PDR) or chronic uveitis. We retrospectively studied the results of combined extracapsular cataract extraction (ECCE), posterior chamber intraocular lens (PC-IOL) implantation, and pars plana vitrectomy in 20 eyes of 16 patients. The indications for combined vitrectomy included dense, nonclearing vitreous hemorrhage attributed to PDR in 10 eyes, age-related macular degeneration in 2, and trauma in 1. The remaining 7 eyes had pars plana vitrectomy to remove inflammatory vitreous cell and debris associated with chronic uveitis. Follow up ranged from 4 to 32 months (average, 17.4 months). Visual acuity improved in 19 eyes (95%)--to 20/100 or better in 12 (60%). The improvement ranged from 1 to 13 Snellen lines (average, 4.9 lines). Postoperative visual acuity improvement averaged 7.5 Snellen lines for eyes with chronic uveitis, 7.0 lines for those with age-related macular degeneration, and 3.3 lines for those with a history of PDR. Postoperative visual acuity was less than 20/100 in 8 eyes (40%). In most cases, these latter results were attributed to macular changes associated with the underlying ocular disease. Our results confirm previous studies that have shown that combined ECCE/PC-IOL implantation and pars plana vitrectomy is a well-tolerated surgical procedure for diabetics, which can provide clear anterior and posterior segment media. In addition, our results suggest that this combined procedure can be useful in restoring vision in certain eyes with uveitis in the short-term postoperative period.

Adult↗
PubMedDate not supplied

[The state of corneal endothelium after cataract extraction as examined by contact endothelial microscopy].

The central area of the corneal endothelium was examined in 130 patients after an intracapsular extraction of a senile cataract without implantation of an intraocular artificial lens, with implantation of an anterior chamber artificial lens and after an extracapsular extraction of senile cataract with implantation of a posterior chamber artificial lens. The authors used the endothelial contact microscope Copper Vision with an endothelial cell counter from MLC Technologies. The mean proportional loss of the corneal endothelial cells for the 1st group after 1 month amounted 11.6%, after 6 months from operation 13.0%; for the 2nd group after the 1st month 15.0%; for the 3d group after 1 month 13.5% and after 6 months 17.0%.

Aged↗
PubMedDate not supplied

Inappropriateness of cataract extraction: an analysis in two Israeli hospital settings.

OBJECTIVE: To assess and compare the appropriateness of cataract extraction in two Israeli regional hospitals. SETTINGS: Two Israeli hospitals located in different geographic areas. DESIGN: A randomized sample of 150 patients was drawn from a list of all patients who underwent cataract surgery at the two study hospitals during 1995. Detailed extraction of hospital medical records was performed. The appropriateness of cataract surgery was assessed using the Medical Review System, an interactive expert system that assesses the appropriateness of selected medical and surgical procedures. RESULTS: The rates of cataract surgery in the two hospitals were 0.54 and 0.59 operations per 1,000 population, respectively, and the age-adjusted rates per 1,000 population were 5.7 and 6.2, respectively. The percentage of patients with only light perception or hand-motion perception in the operated eye before the operation was 62.2%, with no difference in the two hospitals. There was not a significant difference in the distribution of visual acuity before the operation; however, there was a significant difference in the distribution of visual acuity after the surgery. Rates of inappropriate surgeries in the two hospitals were found to be similar to the inappropriate rate in the United States (1.3%). The preoperative visual acuity of patients undergoing cataract surgery in Israel was inferior to the visual acuity of patients undergoing cataract surgery in the United States. CONCLUSION: To increase quality and cost-effectiveness in the Israeli medical system, future studies of this type are warranted in connection with surgical procedures.

Cataract Extraction↗
PubMed1994

[Small incision extra-capsular cataract extraction with a manual nucleus division technique and intraocular lens implantation].

A 6mm incision extra-capsular cataract extraction (ECCE) with a manual nucleus division technique and intraocular lens implantation was performed on 70 eyes of 66 patients with senile or complicated cataracts. Post-operatively, the visual acuities were 0.5 or better in 76.6% at one week and in 96.4% at three months. The mean post-operative astigmatism was 1.96 +/- 1.08D at one week and 0.92 +/- 0.68D at three months which was less than that in the control group, large incision (10-12mm) ECCE performed in the same period and compared at the same times, respectively (P < 0.001). The technique and instruments of this procedure were described, and its key steps and complications discussed.

Aged↗
PubMed1994

[Bacteriological detection of anterior chamber aspirate after extracapsular cataract extraction with intraocular lens implantation].

We cultured the anterior chamber aspirates of 83 patients with extracapsular cataract extraction and IOL implantation. Of the 83 cases, 5 (6.1%) had positive aspirates including 3 cases of staphylococcus epidermidis and 2 cases of staphylococcus aureus. No eye in our study developed bacterial endophthalmitis. Our study suggests that the anterior chamber of human eyes is capable of clearing a low inoculum of bacteria after cataract surgery without the development of bacterial endophthalmitis.

Aged↗
PubMed2005

Aqualase for cataract extraction.

PURPOSE: To report our experience of using Aqualase technology for cataract extraction. METHODS: In total, 33 patients (20 females; mean age 71.4 years) underwent cataract surgery using Aqualase through a 3.2-mm corneal incision. Grade of nucleus, nuclear removal technique, and intraoperative complications were noted. Clinical parameters from postoperative visits were collected. RESULTS: Aqualase is capable of removing cataracts up to nuclear sclerosis 2+ (out of 4) with relative ease. Nuclei graded 2+ or greater were technically more difficult and conversion to ultrasound phacoemulsification was required in one case. Two posterior capsule ruptures occurred: one during nucleus removal (contact with the tip while aspirating without Aqualase) and one unrelated to Aqualase during aspiration of cortex. Of 25 patients seen on the first postoperative day, 22 had a clear cornea. A total of 96% patients without preoperative comorbidity achieved 6/9 or better postoperatively. One patient had transient postoperative uveitis. CONCLUSIONS: Removal of softer cataracts with Aqualase has the theoretical advantage over phacoemulsification, by carrying less risk to the posterior capsule, since the handpiece has a smooth polymer tip that has no mechanical motion inside the eye. However, the tip should not be considered entirely capsule-friendly, as rupture is possible with the foot-pedal in position two (aspiration only). Although certain adjustments to the technique are required, the method is similar enough to phacoemulsification to ensure a brief learning curve. With increasingly firm cataracts, Aqualase becomes less effective and ultrasound phacoemulsification is still superior for such cases, in our experience.

Adult↗
PubMed2001

Topical anesthesia with or without propofol sedation versus retrobulbar/peribulbar anesthesia for cataract extraction: prospective randomized trial.

PURPOSE: To evaluate the feasibility of intravenous sedation in addition to topical anesthesia during cataract extraction. SETTING: Helsinki University Eye Hospital, Helsinki, Finland. METHODS: Three hundred seventeen eyes of 291 consecutive patients having cataract surgery were prospectively randomized to receive topical (oxybuprocaine 0.4%, n = 96), combined (topical anesthesia and propofol sedation, n = 107), or retrobulbar/peribulbar (prilocaine 1.5%, n = 114) anesthesia. The intraoperative conditions were judged by the surgeon. A numerical scale (0 to 10) was used to assess the degree of pain during surgery. Outcome measures were the number of complications and adverse events registered perioperatively and 1 week postoperatively as well as Snellen visual acuity. RESULTS: The success of posterior chamber intraocular lens (IOL) implantation through a self-sealing clear corneal incision was 97.9%, 96.3%, and 98.2% in the topical, combined, and retrobulbar/peribulbar groups, respectively. There was no difference among the groups in pain during surgery, frequency of complications, or outcome measures. One week postoperatively, visual acuity was 20/40 or better in 81.7%, 78.5%, and 77.5% of eyes in the topical, combined, and retrobulbar/peribulbar groups, respectively. The surgeon reported significantly fewer difficulties in the retrobulbar/peribulbar group (9.8%) than in the topical (26.0%) (P =.004) or combined (21.0%) (P =.036) groups. Additional sedative/analgesic medication given intraoperatively was required significantly more often in the topical (15.6%) than in the retrobulbar/peribulbar group (2.6%) (P =.002). Patients with bilateral surgery preferred combined anesthesia over retrobulbar/peribulbar anesthesia; however, there was no significant difference in patient acceptance among groups in patients having unilateral surgery. CONCLUSION: Intravenous propofol sedation added to topical anesthesia did not improve the operative conditions or surgical outcome. Retrobulbar/peribulbar anesthesia ensured the best surgical conditions. Patients in all anesthesia groups reported high satisfaction. However, patients having bilateral surgery seemed to prefer combined anesthesia over retrobulbar/peribulbar anesthesia.

Adult↗