1/19. Pseudocapsulorrhexis in a patient with iridocorneal endothelial syndrome.We describe a patient with Chandler's syndrome variant of the iridocorneal endothelial syndrome in whom ectopic Descemet's membrane was found intraoperatively on the anterior surface of the lens. Initially, the membrane was confused with the anterior lens capsule during extracapsular cataract extraction, leading to the performance of a pseudocapsulorrhexis. Electron microscopy disclosed that the epilenticular membrane was composed of multiple layers of abnormal basement membrane consistent with the iridocorneal endothelial syndrome.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/19. Loss of iridolenticular contact in eyes with exfoliation syndrome may protect against glaucoma.PURPOSE: To provide evidence for the hypothesis that dynamic iridolenticular contact predisposes to the development of glaucoma in exfoliation syndrome (XFS). methods: We present four patients with bilateral XFS and unilateral exfoliation glaucoma (XFG) whose normotensive eyes had suffered traumatic loss of dynamic iridolenticular contact. RESULTS: All 4 patients had bilateral XFS and developed XFG only in the untraumatized eyes. One patient had loss of iridolenticular contact in the traumatized eye, two had a nonreactive pupil, and one had had intracapsular cataract extraction at age 28. CONCLUSIONS: Loss of dynamic iridolenticular contact may help to protect against development of glaucoma in eyes with XFS.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/19. Black intraocular lens for leukocoria.We describe a 33-year-old man with leukocoria and no visual potential who obtained an excellent cosmetic result after cataract extraction and implantation of an intraocular lens with an entirely black optic.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/19. Acquired anterior ocular melanocytosis following cataract extraction.The right eye of a 59-year-old man was the subject of extracapsular cataract extraction and posterior chamber lens implantation. He gradually developed superior sectoral scleral and diffuse iris hyperpigmentation within 7 years postoperatively. The iris was also uniformly thickened. He sustained 20/20 visual acuity in the pseudophakic eye. Despite marked pigmentation of the angle, his right intraocular pressure remained within normal limits. We use the term acquired anterior ocular melanocytosis because the pigmentary changes were confined to the anterior segment and the choroid was not involved. We conclude that surgical injury in the form of cataract extraction can induce episcleral/scleral hyperpigmentation and iris hyperchromia.- - - - - - - - - - ranking = 6keywords = extraction (Clic here for more details about this article) |
5/19. Epithelial ingrowth in a phakic corneal transplant patient after traumatic wound dehiscence.PURPOSE: To report a case of epithelial ingrowth (downgrowth) occurring in a phakic corneal transplant patient after traumatic wound dehiscence with iris prolapse that was successfully eradicated with early surgical intervention. methods: Interventional case report of a 70-year-old monocular, phakic patient who developed epithelial ingrowth within 1 week of repair of a traumatic penetrating keratoplasty wound dehiscence, with reposition of the iris that had been prolapsed for 36 hours. A gradually expanding membrane developed from the surface of the reposited iris, across the anterior lens capsule. argon laser photocoagulation applied to the surface of the iris confirmed the diagnosis and outlined the extent of the epithelial tissue on the iris. RESULTS: Intraoperative peeling of the epithelial membrane from the surface of the lens and excision of the involved iris were performed combined with extracapsular cataract extraction and insertion of a posterior chamber intraocular lens via an open-sky technique through a repeat penetrating keratoplasty opening in the cornea. This resulted in complete resolution of the intraocular epithelialization. Histopathologic examination of the excised tissue confirmed the diagnosis of epithelial ingrowth. CONCLUSIONS: Reposition of traumatically prolapsed iris tissue can result in epithelial ingrowth. Early aggressive surgical intervention can successfully remove all the epithelial tissue from within the anterior segment.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/19. Development of epithelial downgrowth several decades after intraocular surgery.PURPOSE: To report the management of a patient with the longest reported interval between intraocular surgery and the development of epithelial downgrowth. methods: A 53-year-old man who underwent right eye penetrating keratoplasty in 1970 for keratoconus and removal of an iris cyst in 1977 developed epithelial downgrowth 25 years after cyst removal. RESULTS: The area of epithelial downgrowth was initially treated with cryotherapy. Two weeks postoperatively, the patient had no resolution of epithelial downgrowth and developed diffuse corneal edema. Penetrating keratoplasty was performed along with extracapsular cataract extraction. At 6 months of follow-up, the patient's graft was clear, without evidence of recurrence of epithelial downgrowth, and he had 20/50 visual acuity. CONCLUSION: Epithelial downgrowth is an uncommon yet serious complication of intraocular surgery, making early detection of this condition important. This case illustrates that epithelial downgrowth can occur several decades after intraocular surgery.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/19. Bullous keratopathy and corneal decompensation secondary to iridoschisis: a clinicopathological report.PURPOSE: To report a case of localized bullous keratopathy and total corneal decompensation secondary to iridocorneal touch in iridoschisis. DESIGN: Single interventional case report with pathologic correlation. methods: An 80-year-old man with bilateral iridoschisis presented with loss of vision in the left eye (OS). Examination of the OS showed shallow anterior chamber (AC), cortical cataract, and free-floating iris fibers causing iridocorneal touch, leading to localized bullous keratopathy and total corneal decompensation. Ultrasound biomicroscopy (UBM) confirmed the area of iridocorneal contact. RESULTS: Penetrating keratoplasty combined with cataract extraction and posterior chamber lens implantation was performed in the OS. Histopathology of the corneal button showed features of corneal edema and endothelial cell loss with evidence of iridocorneal contact. CONCLUSIONS: Iridoschisis is an uncommon cause of bullous keratopathy and corneal decompensation. patients with iridoschisis may need specular microscopy to determine the status of the corneal endothelium.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/19. iris reconstruction with a multipiece endocapsular prosthesis in iridocorneal endothelial syndrome.iris reconstruction in cases of iridocorneal endothelial (ice) syndrome is extremely challenging because of the nature of the iris tissue, which is typically friable and poorly suited to suture repair. Reconstruction in such cases often requires artificial iris implantation. This report illustrates cataract extraction and iris reconstruction with a multipiece endocapsular iris prosthesis that can be inserted through a small incision. maintenance of a small incision size is a distinct advantage when glaucoma is coexistent in patients with ice syndrome. It also demonstrates the presence of an ice membrane over the anterior capsule and the importance of recognizing this membrane rather than confusing it with the anterior capsule when performing the capsulorhexis.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/19. Traumatic aniridia after small incision cataract extraction.INTRODUCTION: phacoemulsification and falls are both common in the elderly population. We present a case of acquired total aniridia and vitreous haemorrhage occurring as a result of trauma in a pseudophakic eye. methods: Interventional case report with history, clinical photograph and discussion with literature review. RESULTS: A previously healthy 74-year-old Caucasian female was referred with a painful left eye and poor vision following a fall and trauma to the left side of her face. Initial examination confirmed visual acuity of perception of light with total hyphaema and vitreous haemorrhage. Subsequent examination revealed complete aniridia with an intact capsular bag and well-centred posterior chamber intraocular lens and attached retina. Final visual acuity after treatment was 6/9. CONCLUSIONS: Blunt trauma may cause total iris disinsertion in and expulsion from pseudophakic eyes. This relatively novel injury may present increasingly commonly to casualty departments and ophthalmologists.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |
10/19. Massive pseudophakic pigment dispersion associated with an iris nevus.A 67-year-old woman examined 12 months following extracapsular cataract extraction had a massive pseudophakic pigment dispersion associated with diffuse corneal epithelial edema, mild uveitis, and secondary glaucoma. She underwent penetrating keratoplasty following removal of a posterior chamber intraocular lens (IOL), anterior vitrectomy, capsulectomy, and iris biopsy. Histopathologic examination revealed a pigmented iris nevus and signs of iris erosion by the IOL loop. Because 3 months later the eye developed streptococcal endophthalmitis and had to be eviscerated, we had the opportunity to examine the eye contents; we found no evidence of phakoanaphylactic uveitis.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
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