1/7. Anterior lenticonus: histological evaluation and approach for cataract surgery.PURPOSE: To present 2 cases of anterior lenticonus in patients without Alport's syndrome, a surgical technique of cataract extraction in eyes with anterior lenticonus, and histological results of lenticonus specimens obtained intraoperatively. SETTING: From St. Eriks eye Clinic, Karolinska Institute, Stockholm, sweden. methods: Two otherwise healthy patients presented with anterior lenticonus but no history of Alport's or other pathology. Best corrected visual acuity (BCVA) was decreased. Both patients had cataract extraction by phacoemulsification with intraocular lens implantation under topical anesthesia. Two continuous curvilinear capsulorhexes (CCCs) were created. The entire lenticonus was embedded in formaldehyde buffer 4% for histological analysis. RESULTS: In the first patient, BCVA did not improve postoperatively because of amblyopia. The patient subjectively reported a substantial improvement in visual field clarity. The surgical and postoperative course in the other patient was uneventful. The sections were positive for collagen types IV and VI, and the arrangement of the collagen fibers was highly irregular. CONCLUSION: Anterior lenticonus was detected in patients without Alport's syndrome who were otherwise healthy. A modified 2-step CCC technique can be used to make cataract surgery in such eyes safe and relatively easy.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/7. A case of angle-closure glaucoma, cataract, nanophthalmos and spherophakia in oculo-dento-digital syndrome.BACKGROUND: We report a new case of oculo-dento-digital syndrome. methods: Case report. RESULTS: We saw a 34-year-old women with oculo-dento-digital syndrome. visual acuity was no perception of light (RE) and 1/35 (LE). Biomicroscopy revealed a flat anterior chamber and an advanced cataract. The intraocular pressure (IOP) was 60 mmHg in both eyes. Ultrasonographic biomicroscopy demonstrated a closed chamber angle in both eyes. Measurements of the axial length and of the diameter of the lens were 18.7 mm/6.0 mm for the RE and 18.7 mm/5.8 mm for the LE respectively. In the time following we conducted a cyclodestructive procedure in the RE and a cataract extraction with implantation of an intraocular lens in the LE. This led to a considerable reduction of the IOP in the RE and combined with local therapy to IOP regulation in the LE. CONCLUSION: In this patient nanophthalmos, cataract and spherophakia led to angle-closure glaucoma in both eyes. We recommend early monitoring of IOP, axial length and lens diameter. This case demonstrates that an early cataract extraction might beneficially influence the natural course of the disease.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/7. cataract extraction in X-linked megalocornea: a case report.OBJECTIVE: A case is described of a patient with X-linked megalocornea (XLM) who underwent bilateral consecutive phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation. methods: A 49-year-old man referred to us for cataract extraction was found to have XLM with mosaic corneal dystrophy. Pseudoexfoliation of the lens capsule was present in the right eye. phacoemulsification was planned, and the Holladay II formula was used to calculate the IOL power. RESULTS: During phacoemulsification, anomalies of the capsule and zonule were observed bilaterally. At the last examination (follow-up 28 months OS, 13 months OD), best spectacle-corrected vision was 20/20 in both eyes, but the IOL was slightly decentered in the right eye. CONCLUSIONS: Corneal enlargement and mosaic dystrophy are obvious features of XLM. Anomalies involving the anterior structures of the eye and in particular the lens capsule and zonule are also frequent. cataract extraction with phacoemulsification and PC IOL implantation can be successful, but special attention must be paid to both surgical technique and IOL selection.- - - - - - - - - - ranking = 3keywords = extraction (Clic here for more details about this article) |
4/7. persistent hyperplastic primary vitreous: roto-extraction and other surgical experience.We discuss nine cases of persistent hyperplastic primary vitreous seen recently, including mode of presentation, management and postsurgical follow-up. Emphasis is placed on early operative intervention in order to preserve the globe, as well as to prevent irremedial stimulus deprivation amblyopia. The advantages of roto-extraction in the surgical approach to this entity are considered, and the difficulties of postoperative visual rehabilitation are also discussed.- - - - - - - - - - ranking = 2.5keywords = extraction (Clic here for more details about this article) |
5/7. Secondary surgical procedures after epikeratophakia.Five patients required secondary surgical procedures after receiving epikeratophakia grafts. A neonate underwent epikeratophakia in combination with extracapsular cataract extraction, followed one week later by peripheral iridectomy and nine months later by strabismus surgery. A 53-year-old male had surgery to correct retinal detachment 4-1/2 months after epikeratophakia surgery for the correction of aphakia. A five-year-old male had epikeratophakia after removal of a traumatic cataract; five weeks later, retinal detachment necessitated vitrectomy, 360 degrees buckle, and cyclocryotherapy. A 4-1/2-year-old female had epikeratophakia for aphakia, followed nine months later by strabismus surgery. A 38-year-old female with keratoconus received a plano epikeratophakia graft, in combination with an extracapsular cataract extraction and anterior vitrectomy, followed two weeks later by an Ocutome vitrectomy. In all cases, the epikeratophakia grafts and interfaces remained clear, and in four of the five patients in whom secondary procedures were successful, vision continued to improve with time.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/7. weill-marchesani syndrome complicated by secondary glaucoma. case management with surgical lens extraction.BACKGROUND: A case of the rare weill-marchesani syndrome is presented with characteristic spherophakia, lenticular myopia and secondary glaucoma. The difficulties of management are described. methods AND RESULTS: Following failure of conservative medical treatment with timoptol, pilocarpine drops and diamox; laser iridotomies temporarily improved but did not halt progress of the glaucoma. Ultimate removal of the lens was required adequately to control the tensions, although this surgical procedure proved hazardous. CONCLUSIONS: The difficulties of management in the weill-marchesani syndrome as reported in the literature, are confirmed in this case. Surgical removal of the lens to control the glaucoma may ultimately be the only option, but this procedure can be hazardous with vitreous loss and other complications to be expected.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
7/7. Capsular tension ring in a patient with weill-marchesani syndrome.Weill-Marchesani patients with cataractous lenses may presnet a surgical challenge in the presence of zonular weakness and microsherophakia. A 52-year-old Weill-Marchesani patient developed zonular dehiscence during capsule contraction after cataract extraction in her right eye. Use of a poly(methyl methacrylate) capsular tension ring in the second eye facilitated lens removal and intraocular lens placement. Postoperative results suggest the capsular tension ring provides long-term zonular stabilization by maintaining an internal force against the capsule.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |