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At least 127 records · Page 7Linked to original sources
PubMed1979

Time analysis of corneal endothelial cell density after cataract extraction.

Serial endothelial photographs were taken preoperatively and postoperatively in 200 eyes; 111 eyes contained a Rayner iris clip lens, 54 eyes contained a Fyodorov Sputnik lens, and 35 eyes had no lens. Central endothelial cell density was changed in all instances, with counts in implanted eyes declining 25 to 30%, and in nonimplanted eyes 10 to 15%. In both instances, the decline essentially ceased at about three months. The cause of the greater decline in implanted eyes appeared to be mechanical and subsequent cell loss after the 90-day period was virtually equal for the two groups. Methods that may be used to alter the difference in cell density occurring with implantation are best analyzed by using the 90-day period data for comparison.

Animals↗
PubMed1980

The correction of aphakia. XXXVI Edward Jackson Memorial Lecture.

Major advances in the correction of aphakia have been made in the past few years. Extended-wear contact lenses constitute one advance, if not a perfect one. Intraocular lenses are now safer to use, and new research is seeking ways to improve their safety through protection of the corneal endothelium during surgery and stimulation of endothelial healing where damage does occur. Altering the refractive power of the cornea offers another possible approach to the correction of aphakia. Modifications of Barraquer's keratomileusis procedure using preserved, preground corneas may have definite indications for certain types of aphakia, such as monocular aphakia in children and in individuals who would otherwise require secondary implants. We have experimented with a "living contact lens" of shaped donor tissue attached to the de-epithelialized surface of the eye. Such a lens of preground, preserved cornea tissue can be sutured to the patient's cornea with its central Bowman's membrane intact. A peripheral trephine mark is made, but the central cornea is untouched and the attachment of the living lens is simple. The procedure is apparently safe, and should be usable by any competent ophthalmic surgeon if the long-term results continue to be as encouraging as our early experience now suggests.

Adolescent↗
PubMed1981

Good visual function after neonatal surgery for congenital monocular cataracts.

We treated eight neonates who had total, monocular, congenital cataracts with surgery, occlusion, and contact lenses. Visual results in all eight patients were good. In five patients visual acuities improved to 6/9 (20/30) or better in the aphakic eye. In three patients visual acuities improved to 6/24 (20/80) or better. Problems with contact lenses probably accounted for the poorer results in two of these three patients. Binocularity was not demonstrated in any of our patients.

Aphakia, Postcataract↗
PubMed1981

Fungal growth in aphakic soft contact lenses.

Fungal growth was detected in two aphakic hydrophilic contact lenses. Aspergillus species was cultured from the extended-wear contact lens and Dermatophilus congolensis was identified by specific antibody staining of the daily-wear contact lens. As in the 16 previously described cases of fungal contact lens growth, our patients had no evidence of ocular infection but did experience irritation which cleared up when contact lens wear was discontinued. Although only a small percentage of contact lenses are prescribed because of aphakia, these thicker contact lenses may be more susceptible to fungal growth and should be monitored carefully.

Actinomycetales↗
PubMed1981

Contraindications for mannitol in aphakic glaucoma.

When prescribing mannitol to decrease intraocular pressure, the physician must be alert to potential complications. A 72-year-old woman suffered obtundation, intractable pulmonary edema, acidemia, and irreversible renal insufficiency despite vigorous hemodialysis. When renal function is compromised, careful monitoring of electrolyte levels, daily urine output, and renal function is necessary with mannitol therapy.

Aged↗
PubMed1981

Senile lens changes and diabetes in two population studies.

Clinical and epidemiologic studies of the association between senile cataract and diabetes have produced what initially appears to be conflicting evidence. Three studies of extracted cataract have found a positive association in persons less than 70 years old. Conversely, two studies of senile lens changes (including aphakia) reported no association with diabetes. These apparently disparate findings led to the hypothesis that the diseases are in fact not associated, but that diabetics are more likely to be referred to ophthalmologists and therefore to have cataracts removed. We tested this hypothesis with data from two population surveys, the Framingham Eye Study and the Health and Nutrition Examination Survey (HANES). Both studies showed a marked excess prevalence of senile cataract (including aphakia) in diabetics less than 65 years old (relative risks of 4.02 and 2.97, respectively). Beyond the age of 64 years, the HANES study but not the Framingham study showed an excess prevalence, although it was less marked (relative risks of 1.63 and 1.02, respectively). For senile lens changes other than cataract, both studies showed little, if any, association with diabetes. Our results for cataract (whether removed or not) were generally consistent with those of previous studies of extracted cataract for persons under the age of 70 years and for persons aged 70 years or more. The two studies that reported no association between lens changes and diabetes provided information inadequate to support or refute the foregoing findings. The various studies failed to support increased referral of diabetics to ophthalmologists as an explanation for the observed association. All these studies found the association in persons less than 70 years old, whether the cataract had been removed or not.

Age Factors↗
PubMed1981

The exfoliation syndrome in the aphakic eye.

A 79-year-old man developed the classical signs of exfoliation syndrome bilaterally ten to 13 years after bilateral intracapsular cataract surgery. There is, therefore, at least one type of exfoliation syndrome where the lens does not produce the exfoliative material.

Aged↗
PubMed1982

A mirror for self-examination by a patient with an aphakic eye.

A mirror with a radius of curvature of 211.5 mm permits a patient who has undergone cataract surgery to examine his own aphakic eye without corrective lenses. A slight adjustment of the eye-to-mirror distance also permits examination of a normal eye, a hyperopic eye, and a presbyopic eye requiring a plus lens correction. The mirror can be used to monitor postoperative status and the course of a disease, and for inserting and removing contact lenses.

Aphakia, Postcataract↗
PubMed1982

Prevalence of ocular disease in a population study of subjects 65 years old and older.

During a two-year period a randomly selected age-stratified sample of subjects 65 years old and older living in Gisborne, New Zealand, was examined by an ophthalmologist to investigate visual acuity and the prevalence of the major disorders of vision in old age. A total of 481 subjects (a response rate of 86.2%) completed the study. When the results were weighted to remove the effect of stratified sampling, the following prevalence rates for the population 65 years and over were obtained: cataract, 30.1% with no sex difference and an increasing prevalence with increasing age; senile macular degeneration, 6.4% with no sex difference and an increasing prevalence with increasing age; glaucoma, 3.6% with no sex difference except for women 90 years old or older who had a higher rate. The prevalence of glaucoma increased with increasing age in women, but in men there was no clear pattern; diabetic retinopathy, 0.5%. In the population 65 years old and older, we estimated that 81% of the men and 68.8% of the women had best corrected visual acuities of 6/9 (20/30) or better in the better eye.

Age Factors↗
PubMed1982

Visual results in aphakic children.

Sixty-five patients less than 10 years of age had cataract surgery on 99 eyes. The visual prognosis depended on the cataract type and whether the treatment was undertaken during the critical period for development of the fixation reflex. All patients received the same surgical technique, aggressive optical correction, and occlusion therapy, if needed. Partial cataracts were the most frequent and the two largest groups were lamellar and axial. The visual outcome was excellent for the lamellar cataracts, whereas axial cataracts were the most amblyogenic. Obtaining a good visual result demanded an understanding of the complexities of amblyopia.

Amblyopia↗
PubMed1982

A histopathologic study of bilateral aphakia with a unilateral intraocular lens in a child.

A 7-year-old boy who had had electrically induced cataracts since he was 6 months old underwent a lens extraction by phacoemulsification in his right eye. He later refused to wear a contact lens. When the boy was 10 year old, the lens of his left eye was removed by phacoemulsification and an intraocular lens was implanted. The intraocular lens functioned well and was tolerated by the boy until he died in an automobile accident at the age of 16 years. A histopathologic study of the eyes, which were obtained post mortem, showed a decreased corneal endothelial cell population, mild focal atrophy of iris structures, and mild lymphocytic infiltration in the implanted eye. Vitreous liquefaction and epiretinal membrane formation occurred in both eyes.

Adolescent↗
PubMed1982

Action spectrum for retinal injury from near-ultraviolet radiation in the aphakic monkey.

We found that the action spectrum for retinal damage (determined by the fundus photographic appearance of a minimal lesion immediately after exposure) extends into the near-ultraviolet by exposing three aphakic eyes from rhesus monkeys to 405-, 380-, 350-, and 320-nm wavelengths produced by a 2,500-W xenon lamp equipped with quartz optics and 10-nm interference filters. Exposure times were 100 and 1,000 seconds and the spot diameter on the retina was 500 micrometers. The retina was six times more sensitive to 350- and 325-nm wavelengths than to blue light (441 nm). Both ophthalmoscopic and histologic data showed that near-ultraviolet lesions differed in important respects from blue-light lesions. Near-ultraviolet produced irreparable damage to rod and cone photoreceptors.

Animals↗
PubMed1983

An anterior surgical approach to aphakic cystoid macular edema.

Fifteen consecutive eyes in 14 patients (six men and eight women, ranging in age from 43 to 75 years) underwent anterior vitrectomy for chronic cystoid macular edema documented by fluorescein angiography. All eyes had either vitreous adhesions to the cataract incision with pupillary distortion, or adherence of vitreous strands to the iris. Anterior vitrectomy via the corneoscleral limbus was performed in each case to remove vitreous from anterior segment structures. Thirteen of the 15 eyes showed visual improvement, with 12 of the 15 showing improvement of two Snellen lines or more. There was no direct correlation between the duration of aphakic cystoid macular edema and final visual acuity.

Adult↗
PubMed1983

Pupillary block after intraocular lens implantation.

Seventeen patients, ranging in age from 40 to 86 years, developed pupillary block detected one week to three years after intraocular lens implantation. Sixteen of the implants were anterior chamber intraocular lenses and one was a posterior chamber intraocular lens. Despite iris bombé that closed the anterior chamber angle, many cases were asymptomatic and were discovered fortuitously during routine postoperative examinations. Laser iridotomy or iridectomy eliminated the pupillary block in all 17 cases, but permanent synechial closure of a portion of the anterior chamber angle persisted in most cases and sometimes required medication or further surgery. One eye eventually lost all light perception.

Adult↗
PubMed1983

Retinal detachment following late posterior capsulotomy.

When we compared the incidence of retinal detachment in 27 eyes after extracapsular cataract surgery and late posterior capsulotomy with the incidence of general aphakic detachment, we found no relationship between the onset of retinal detachment and the numbers, types, or locations of breaks. The interval between cataract extraction and discission had a significant effect on recovery of visual acuity. Final visual acuities of 20/400 or better were attained in 22 of 23 eyes in which discission followed cataract extraction by one year or more but in only one of four eyes in which the procedures were separated by less than one year. Delaying discission for more than 12 months may reduce the extent of retinal detachment and produce the best functional results. Detachments that occurred less than one year after discission were more extensive but achieved better functional results than those that occurred later.

Aphakia, Postcataract↗