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Results for “CATARACT EXTRACTION”

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PubMed1992

Cataract extraction in eyes filled with silicone oil.

A surgical technique for cataract extraction in eyes filled with silicone oil was developed that has two major objectives: removal of the entire cataractous lens and complete preservation of the silicone oil volume. A regular extracapsular cataract extraction or phacoemulsification is performed, and the incision is closed with the final sutures. All steps are performed under continuous positive pressure achieved with an anterior chamber maintainer connected to a bottle of balanced saline solution. An inferior basal iridectomy is created with a vitrectomy probe, and the posterior capsule is then slowly pulled out through the limbal incision with intraocular forceps, again under positive pressure, in an eye that is actually a closed system, without any loss of silicone. This step results in transformation of the extracapsular cataract extraction condition into an intracapsular cataract extraction condition. The described technique was successfully performed in nine eyes. In the younger patients, the whole procedure was completed through two very small limbal openings.

Adult↗

PubMed1994

[Ocular hypertension after intra-capsular cataract extraction].

During 20 months, 593 intracapsular cataract extractions have been studied, the authors founded 10 cases of ocular hypertension representing 1.68%. These eyes did not present any ocular pathology before and the intraocular pressure was normal before the operation. Among the 10 cases, 4 developed pupillary block. In 7 cases, the intraocular pressure was normalized within one month by local and general low pressure treatment, while 3 cases developed persistent ocular hypertension. The authors preconise to have a low pressure by premedication before surgery and to survey every day the intraocular pressure after intracapsular cataract extraction to prevent irreversible modifications of the optic nerve.

Aged↗

PubMedDate not supplied

Visual outcome with +10 diopter sphere correction after intracapsular cataract extraction.

BACKGROUND: The aim of curing cataract blindness is to restore the patient's vision after surgery. The aim of the study was to determine the proportion of surgeries done for cataract blind patients and the visual outcome with +10 diopter sphere (DS) aphakic correction in two consecutive years. METHODS: Of the cataract operations done in the years 1995 and 1996, 8-15 cases were selected from each month by proportionate simple random sampling. Thirty-two (32) were excluded for incomplete or missing records. One hundred and eighteen (118) and one hundred (100) patient records were analyzed for 1995 and 1996 respectively. RESULTS: The patients' ages ranged from 40 to 80 years and all had age related cataract. There were 161 males and 57 females. All had intracapsular cataract extraction (ICCE) without intraocular lens implantation. Eighty-nine patients (75%) and seventy-six patients (76%) had their sight restored in 1995 and 1996 respectively. The proportion of surgeries on blind patients' was 31% and 42% respectively. The proportion of those who remained blind after surgery was the same for both years (2%). Using chi-square test, there was a statistically significant difference in the patients' vision status after ICCE with +10 DS correction (1995, p = 0.021; 1996, p = 0.017) but no difference in the visual outcome due to gender. [1995, p = 2.09; 1996, p = 1.98 (Yates correction applied)] [corrected]. CONCLUSION: Intracapsular cataract extraction with +10 DS correction improves the patients vision status and priority must be given to those already blind.

Adult↗

PubMed2000

Prospective intrapatient comparison of extracapsular cataract extraction and lens implantation with and without trabeculectomy.

PURPOSE: To determine whether extracapsular cataract extraction and posterior chamber lens implantation combined with trabeculectomy provides better long-term results than extracapsular cataract extraction and lens implantation alone in a group of patients with primary open-angle glaucoma and cataract. METHODS: In a prospective, randomized clinical trial, 35 patients with bilateral, symmetric, primary open-angle glaucoma and visually disabling cataracts were randomly selected to undergo surgery with trabeculectomy in one eye and without in the other. All procedures were performed by a single surgeon in a private practice setting with follow-up for more than 5 years in all cases. RESULTS: After an average of 87 months of follow-up, extracapsular cataract extraction and posterior chamber lens implantation reduced intraocular pressure by 4.4 +/- 3.3 mm Hg, reduced the number of medications by 1.28 +/- 0.86, increased diopter vector of astigmatism by 1.49, and was associated with visual field loss in six of 35 eyes. After an average of 80 months of follow-up, extracapsular cataract extraction and posterior chamber lens implantation with trabeculectomy reduced intraocular pressure by 8.2 +/- 4.6 mm Hg (P =.0001), reduced the number of medications by 1.76 +/- 0.82 (P=.0002), increased diopter vector of astigmatism by 1.14, and was associated with visual field loss in one eye (P =.05). Both groups had similar improvement in visual acuity and perioperative complications. CONCLUSIONS: Extracapsular cataract extraction and posterior chamber lens implantation with trabeculectomy was beneficial in the long-term control of intraocular pressure and in prevention of visual field loss. This procedure should be considered for patients in whom long-term pressure control at a lower level would be beneficial in preventing further optic nerve damage.

Adult↗

PubMed2004

Visual field changes after cataract extraction: the AGIS experience.

PURPOSE: To test the hypothesis that cataract extraction in glaucomatous eyes improves overall sensitivity of visual function without affecting the size or depth of glaucomatous scotomas. DESIGN: Experimental study with no control group. METHODS: One hundred fifty-eight eyes (of 140 patients) from the Advanced Glaucoma Intervention Study with at least two reliable visual fields within a year both before and after cataract surgery were included. Average mean deviation (MD), pattern standard deviation (PSD), and corrected pattern standard deviation (CPSD) were compared before and after cataract extraction. To evaluate changes in scotoma size, the number of abnormal points (P < .05) on the pattern deviation plot was compared before and after surgery. We described an index ("scotoma depth index") to investigate changes of scotoma depth after surgery. RESULTS: Mean values for MD, PSD, and CPSD were -13.2, 6.4, and 5.9 dB before and -11.9, 6.8, and 6.2 dB after cataract surgery (P < or = .001 for all comparisons). Mean (+/- SD) number of abnormal points on pattern deviation plot was 26.7 +/- 9.4 and 27.5 +/- 9.0 before and after cataract surgery, respectively (P = .02). Scotoma depth index did not change after cataract extraction (-19.3 vs -19.2 dB, P = .90). CONCLUSIONS: Cataract extraction caused generalized improvement of the visual field, which was most marked in eyes with less advanced glaucomatous damage. Although the enlargement of scotomas was statistically significant, it was not clinically meaningful. No improvement of sensitivity was observed in the deepest part of the scotomas.

Aged↗

PubMed1980

Anterior ischemic optic neuropathy. IV. Occurrence after cataract extraction.

Findings are described from 13 eyes in which post-cataract-extraction anterior ischemic optic neuropathy (PCE-AION) developed immediately after an uncomplicated cataract extraction. During the early stages of the disease, the disc is edematous, with optic disc-related visual-field defects, but after about two months, the disc is pale. The almost invariable high rise of intraocular pressure during the immediate postoperative period plays a critical role in production of PCE-AION in eyes with vulnerable optic nerve head circulation. There is a high risk of development of PCE-AION in the second eye in patients with PCE-AION in the first eye, but this can be prevented by prophylactic measures. Post-cataract-extraction AION needs to be differentiated from ordinary AION seen in aphakic eyes months or years after the cataract extraction.

Adult↗

PubMedDate not supplied

The triple procedure: cataract extraction in a different setting.

This article compares and contrasts ordinary cataract extraction, including lens implantation, with cataract extraction and lens implantation in eyes also undergoing penetrating keratoplasty. Variations in cataract extraction technique which are necessary when a keratoplasty is added are described, and differences in an important complication which occurs in both settings, cystoid macular edema, are evaluated.

Cataract Extraction↗

PubMed1978

[Computerized evaluation of cataract extractions (author's transl)].

UNLABELLED: The evaluation of large series of cataract extractions is most feasible using a computer. We have computerized the details of 7503 cataract extractions (performed in the years 1961-1975). The analysis is based on a new computerreadable form. Its application is shown in two examples for comparing surgical results: 1. cataract extractions by forceps, suction cup or cryoprobe, the surgeon wearing magnifying-goggles; 2. cataract extractions by cryoprobe using the surgical microscope. The evaluation of results had been done separately for residents and experienced surgeons. RESULTS: In experienced surgeons the percentage of uncomplicated extractions increased considerably with the cryoprobe (86.5%) as compared to 77% using the suction cup. The surgical microscope in that series have no significant increase of the success rate (cryoprobe 88.4%). Residents had more advantages from both technical aids: no microscope, suction cup: 73.5%, cryo: 82.5%, with microscope, cryo: 90.3%. Their results compare well with those of the experienced surgeons, since they are given straight-forward cases only and they operate under the strictest supervision of an experienced surgeon.

Cataract Extraction↗

PubMed1998

[The frequency of secondary cataract after extracapsular cataract extraction].

A complication of extracapsular cataract extraction is posterior capsule opacification (secondary cataract). In this study we found that 26.0% of patients operated for cataract with extracapsular technique were treated for secondary cataract. The average postoperative time to treatment with Nd-YAG-lasercapsulotomy was 15.2 months with a follow-up time of 34 months.

Adolescent↗

PubMedDate not supplied

Combined pars plana vitrectomy and cataract surgery: outcome of phacoemulsification versus manual extracapsular cataract extraction through a sclerocorneal tunnel.

BACKGROUND AND OBJECTIVE: To compare the results of combined pars plana vitrectomy and cataract extraction with intraocular lens implantation by phacoemulsification versus manual extracapsular cataract extraction through a sclerocorneal tunnel. PATIENTS AND METHODS: Retrospective chart review of all patients who underwent combined pars plana vitrectomy with intraocular lens implantation and phacoemulsification or extracapsular cataract extraction through a sclerocorneal tunnel between March 1992 and July 2002. RESULTS: Fifty-four eyes of 51 patients were evaluated. Mean age was 69.68 +/- 9.11 years, and mean follow-up was 9 months. Phacoemulsification was performed in 35 cases (64%) and manual extraction in 19 cases (36%). Visual acuity improved from mean logarithm of the minimal angle of resolution 1.69 +/- 0.54 before surgery to 1.22 +/- 0.76 after surgery. There was a greater improvement of visual acuity in the phacoemulsification group (0.59 +/- 0.67) than in the extracapsular cataract extraction group (0.22 +/- 0.68) (P = .06). Final visual acuity was correlated to the vitreoretinal pathology. Ultrasound biomicroscopy showed well-positioned foldable or rigid intraocular lens in the bag or in the sulcus. CONCLUSION: Combined cataract extraction by phacoemulsification or extracapsular cataract extraction through sclerocorneal tunnel and pars plana vitrectomy are safe and effective procedures.

Adult↗

PubMed1979

Epithelial downgrowth following cataract extraction.

This case of epithelial downgrowth following cataract extraction shows the typical sequence of a noneventful cataract extraction with satisfactory recovery but after a time, the appearance of conjunctival injection, iritis and attacks of elevated ocular pressure. A minimal membrane on the posterior surface of the cornea could be seen but the diagnosis rested on the sequence of events and was confirmed by the pathologic investigation. The apithelial cells grow freely on the iris, but extend onto the cornea and posteriorly apparently without hindrance. The epithelial cells form a basement membrane next to the iris, much as they do on the surface of the cornea next to Bowman's membrane. The source of the cells in this case was not identified; they presumably came from conjunctiva although no track through the sclera was found and the cells themselves did not show goblet cells.

Aged↗

PubMed2004

Cataract extraction and risk of breast cancer.

OBJECTIVE: To prospectively examine the association between cataract extraction and breast cancer risk among 66,782 postmenopausal women who were 50 years or older in the Nurses' Health Study cohort from 1984 to 1998. METHODS: Cataract extraction information was collected in each biennial questionnaire since 1984. A total of 2555 incident breast cancer cases were documented during 14 years of followup. The Mantel-Haenszel method and pooled logistic regression with two-year time increments were used to estimate the relative risk and 95% confidence interval. RESULTS: We found that cataract extraction was not significantly associated with increased risk of breast cancer; the relative risks were 1.08 (95% CI, 0.89-1.31) after controlling for age and 1.06 (95% CI, 0.88-1.29) after multivariate adjustment for other risk factors for breast cancer. Also, there were no significant differences in the association between cataract extraction and risk of breast cancer according to history of diabetes (p for interaction = 0.11), smoking status (p for interaction = 0.58), and family history of breast cancer (p for interaction = 0.22). CONCLUSION: These data suggest that cataract extraction is not associated with risk of breast cancer and may not be a good indicator of oxidative stress for breast cancer.

Aged↗

PubMed1989

Extracapsular cataract extraction and posterior chamber implantation in primary ocular hypertension: preliminary report.

Extracapsular extraction of cataract followed by I.O.L., implantation in P.C. was performed in 10 patients affected by Primary Ocular Hypertension and cataract. The aim of this study was to evaluate if implantation could support a modification of I.O.P. and an evolution from hypertension to glaucoma. The postsurgical stability of I.O.P., the absence of alterations in visual field and optic disc during the 6 months after surgery demonstrate that ocular hypertension is not contraindicative to I.O.L. implantation in P.C.

Aged↗

PubMed1991

Progression of diabetic retinopathy after cataract extraction.

The course of diabetic retinopathy following cataract extraction was studied retrospectively in 89 patients (89 eyes). Cataract extraction was extracapsular in 12 eyes (13.5%), extracapsular with intraocular lens implantation in 37 (41.6%), and intracapsular in 40 (45%). In 55 eyes (61.8%) there was no change in the retinal status after surgery, and in 34 (38.2%) there was progression of diabetic retinopathy. In the eyes showing progression there was appearance or aggravation of non-proliferative changes in 85.3% and development of proliferative diabetic retinopathy in 14.7%. Most of these eyes (91%) deteriorated within six months of surgery. Risk factors for the progression of diabetic retinopathy were the preoperative existence of diabetic retinopathy (p less than 0.005) and the need for antidiabetic agents in addition to dietary control in the management of diabetes (p less than 0.025).

Aged↗

PubMed1998

Cataract extraction and lens implantation with and without trabeculectomy: an intrapatient comparison.

OBJECTIVE: To determine whether cataract extraction and lens implantation combined with trabeculectomy provides better long-term results than cataract extraction and lens implantation alone in a group of patients with primary open-angle glaucoma and cataract randomly selected to receive surgery with trabeculectomy in one eye and without in the other. METHODS: A prospective, randomized clinical trial involving 35 patients with bilateral symmetric primary open-angle glaucoma and visually disabling cataracts with procedures performed by a single surgeon in a private practice setting with follow-up for more than 5 years in all cases. RESULTS: After an average of 87 months of follow-up, cataract extraction and lens implantation reduced intraocular pressure 4.4 mm Hg, reduced number of medications by 1.28, increased diopter vector of astigmatism by 1.49, and was associated with visual field loss in 6 of 35 eyes. After an average of 80 months of follow-up, cataract extraction, lens implantation, and trabeculectomy reduced intraocular pressure 8.2 mm Hg, reduced number of medications by 1.76, increased diopter vector of astigmatism by 1.14, and was associated with visual field loss in 1 eye. Both groups had similar improvement in visual acuity and perioperative complications. CONCLUSIONS: Extracapsular cataract extraction, lens implantation, and trabeculectomy is a complex procedure that was beneficial in the long-term control of intraocular pressure and in prevention of visual field loss. This procedure should be considered in patients who may not be able to comply with a complex medical regimen, in whom pressure elevation in the immediate postoperative period would be undesirable, or in whom long-term pressure control at a lower level would be beneficial in preventing further optic nerve damage.

Aged↗

PubMed1996

[Extra-capsular cataract extraction and intraocular lens implantation in cases with cataract and a small pupil with synechiae].

OBJECTIVE: To introduce a new surgical technique for cataract with a small synechia pupil and evaluate its effects. METHODS: 43 eyes of 40 patients were operated on and followed up for 3-30 months. Surgical procedures included iridectomy, separating the posterior synechiae, straight cutting of upper iris and making 3 little cuts at inferior pupillary margin, extracapsular cataract extraction, intraocular lens implantation, and at last suturing the iris cuts to form a round pupil. RESULTS: Postoperatively, all 43 eyes had 3-4 mm basically round pupil and 42 eyes (97.7%) had improved vision. Of the 32 eyes followed up for more than three months, 22 eyes (68.8%) obtained visual acuities 0.5 or better, 10 eyes (31.2%) had visual acuities worse than 0.4 which were attributed to posterior segment abnormalities. Intraoperatively, no posterior capsular rupture was seen, and postoperatively, no severe complications were found. CONCLUSION: The results suggest that patients with cataract and a small synechia pupil obtain improved vision and round pupil without unacceptable risk by means of the surgical technique mentioned in this paper.

Adolescent↗

PubMed2002

Retained lens fragments in resident-performed cataract extractions.

PURPOSE: To investigate the incidence, management, and outcome of retained lens fragments following resident-performed cataract extraction. METHODS: A retrospective review of all eyes undergoing cataract extraction by the residents of Baylor College of Medicine over a 4-year time frame (July/95-June/99). RESULTS: A total of 3389 eyes underwent cataract extraction, and 26 patients (0.8%) required pars plana vitrectomy (PPV) for retained lens fragments. One or more vision threatening complications occurred in 19 (73%) of these patients. The most common complications were cystoid macular edema (CME) (8 eyes, 31%) and rhegmatogenous retinal detachment (RRD) formation (6 eyes, 23%). Additional surgical procedures were required for 9 (35%) eyes; the most common were repeat PPV, and placement of focal photocoagulation for diabetic macular edema (4 eyes per each procedure, 15%). Six-month follow-up was available for 16 eyes; of these, best-corrected visual acuity was 20/40 or better in 5 (31%) and 20/200 or worse in 7 (44%). The most common reasons for limited visual acuity were RRD (3 eyes, 19%) and CME (3 eyes, 19%). CONCLUSION: In this retrospective series, the incidence of retained lens fragments following resident-performed cataract extraction was less than 1%. Significant complications, resulting in the need for additional surgical procedures, occurred in most of these eyes, and this was associated with limited visual function at final follow-up. Retention of lens fragments following resident-performed cataract extraction remains an infrequent yet serious complication associated with a guarded visual prognosis.

Cataract Extraction↗

PubMed1992

Extracapsular cataract extraction with and without intra-ocular lenses in black patients.

Cataracts are the commonest cause of blindness in Third-World countries and cataract extraction is the commonest eye operation performed anywhere. Patients require optical correction after surgery either in the form of an intra-ocular lens (IOL) or bifocal aphakic glasses. The standard operative procedure in First-World countries is an extracapsular cataract extraction with an IOL. This type of operation has been thought to be contraindicated in black patients because of the complications and lack of adequate postoperative follow-up. During 1987-1989 3,144 cataract extractions, of which 2,157 were simple extracapsular extractions and 987 had IOLs inserted, were performed at the above hospitals. The two groups were compared for complications and visual results. The complications were similar in both groups and were acceptable, therefore posterior lens implantation confers no additional risk on routine extracapsular cataract extraction. The visual results in the IOL group with and without additional glasses were compared with those patients who had correcting aphakic glasses. In the corrected IOL group, 98% of patients saw better than 6/24, whereas in the aphakic spectacle group, 87.5% saw 6/24 or better. Since the majority of black patients cannot afford costly prescribed spectacles, it was important to analyse the visual acuity in patients who had IOLs and were uncorrected; 81.6% saw 6/24 or better. IOLs in black patients are therefore indicated but the disadvantage is the cost.

Black or African American↗