1/225. Combined abdominal wall paresis and incisional hernia after laparoscopic cholecystectomy.A case of combined abdominal wall paresis and incisional hernia after laparoscopic cholecystectomy is reported. The paresis possibly occurred by a lesion of the N. intercostalis when extending the incision for stone extraction. Possibly the paresis was a predisposing factor for the development of an incisional hernia. The causes of abdominal wall paresis are explored with a review of the literature. In spite of minimal trauma to the anterior abdominal wall in laparoscopic procedures, the risk of iatrogenic lesions remains.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/225. Managing a dropped nucleus during the phacoemulsification learning curve.Three patients had a pars plana vitrectomy to remove retained nuclei within 72 hours after phacoemulsification performed by a surgeon making the transition from extra-capsular cataract extraction to phacoemulsification. After vitrectomy, the nuclei were brought to the midvitreous cavity from the retinal surface with a posterior segment phacofragmenter, emulsified, and completely removed. Then, a posterior chamber intraocular lens was implanted in the sulcus through the previous cataract surgery incision and remained well centered postoperatively. postoperative complications included cystoid macular edema in 1 patient and choroidal detachment in another. No other complications were detected. Final visual acuity ranged from 20/60 to 20/30.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/225. Diffuse acute cellulitis with severe neurological sequelae. A clinical case.The incidence of head and neck odontogenic infections considerably diminished in the last decades due to appropriate antibiotic therapy. Herein we describe a case of acute diffuse facial cellulitis following tooth extraction in a patient with no apparent risk factor. During the acute process, injury was caused to the hypoglossal, vagal, glossopharyngeal and recurrent nerves of both sides. For this reason the patient currently has a nasogastric line for enteral feedings and a tracheotomy tube, which significantly affects his quality of life.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/225. Postoperative endophthalmitis caused by sequestered acinetobacter calcoaceticus.PURPOSE:To describe postoperative endophthalmitis caused by sequestered acinetobacter calcoaceticus.METHOD:Case report. A 40-year-old woman developed recurrence of inflammation after extracapsular cataract extraction with intraocular lens (IOL) implantation. At last recurrence, the capsular bag was studded with white deposits. Intraocular lens was removed along with capsular bag during pars plana vitrectomy.RESULTS:The capsular bag, when cultured, grew A calcoaceticus. The media remained clear with no evidence of recurrence of infection over a 3-month follow-up. CONCLUSION:Postoperative endophthalmitis similar to that caused by sequestered propionibacterium acnes can be caused by A calcoaceticus.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/225. Two cases of late postoperative capsular block syndrome.Two cases of late postoperative capsular block syndrome that occurred 4 and 8.5 years, respectively, were encountered. One case underwent phacoemulsification after continuous curvilinear capsulorhexis in his left eye. The other case had a can opener type capsulorhexis and underwent extracapsular cataract extraction with trabeculectomy. One-piece posterior chamber lenses were implanted in both cases. Upon slit-lamp examination, the posterior capsules were found distorted posteriorly; the capsular openings were apparently sealed by the lens optic. A whitish material existed between the intraocular lens optic and posterior capsule, with thick aggregation in a lower fifth space in case 1. After Nd:YAG laser anterior capsulotomy in case 1, the thick aggregate spread diffusely on the posterior capsule which was sunken completely for 4 weeks. After Nd:YAG capsulotomy, the distorted posterior capsule disappeared and the best corrected visual acuity was restored to 20/20 in both cases.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/225. Contact lens fitting difficulties following refractive surgery for high myopia.PURPOSE: To describe the clinical and optical problems encountered in contact lens fitting following refractive surgery for high myopia. methods: Following refractive surgery for high myopia (greater than -10.00 D) we corrected residual refractive errors with contact lenses in the four eyes of two patients. The first patient had undergone bilateral laser in situ keratomileusis (LASIK),with two subsequent LASIK retreatments in the left eye. Ten months later she was fit with rigid gas permeable (RGP) lenses in both eyes. The second patient had undergone a clear lens extraction in the right eye and radial keratotomy followed by photorefractive keratectomy(PRK) in the left eye. She was fit with toric soft lenses six years postoperatively. RESULTS: Final visual acuity obtained with contact lenses was 20/25-20/20 in all eyes. The first patient required significant minus lens power compensation. Furthermore, the RGP lens in the left eye was slightly decentered due to corneal irregularity induced by LASIK. The second patient had regular corneal surfaces and was successfully fit with daily wear toric soft lenses despite the 2.75 D of residual astigmatism in the left eye. CONCLUSIONS: Following refractive surgery for high myopia a proportion of patients will remain undercorrected. In these patients the alterations in corneal architecture that ensue make contact lens fitting more challenging. patients with regular astigmatism may be fitted successfully with toric soft lenses. patients with corneal irregularities should be fit with RGP lenses.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/225. Early acute aseptic iritis after cataract extraction.Severe iritis which occurs within the first five days after cataract extraction may be categorized as (1) bacterial endophthalmitis, (2) toxic iritis, or (3) aseptic iritis. These entities can sometimes be distinguished because of their clinical features. If bacterial endophthalmitis is suspected, anterior chamber paracentesis should be considered and appropriate antibiotic treatment should be initiated. Acute iritis may result from the introduction of toxic agents into the eye, and may follow the use of products sterilized with ethylene oxide. Early acute aseptic iritis probably occurs more often than has previously been recognized. Response to intensive anti-inflammatory treatment is usually prompt and dramatic. The judicious use of cryoextraction and the careful manipulation of intraocular tissues may minimize the incidence and the severity of postoperative inflammation.- - - - - - - - - - ranking = 6keywords = extraction (Clic here for more details about this article) |
8/225. alcaligenes xylosoxidans and propionibacterium acnes postoperative endophthalmitis in a pseudophakic eye.PURPOSE: To report a case of persistent polymicrobial postoperative endophthalmitis caused by alcaligenes xylosoxidans and propionibacterium acnes in a pseudophakic eye. A. xylosoxidans is a gram-negative bacteria resistant to most antibiotics. methods: Case report. RESULTS: A 72-year-old man presented with clinical signs of endophthalmitis on the first postoperative day after a phacoemulsification procedure with posterior chamber intraocular lens, left eye. Initial treatment included topical, subconjunctival, and oral antibiotics. After initial clearing, there was recrudescence of infection on postoperative day 37 that prompted referral of the patient to the Cullen eye Institute. Treatment at that time included anterior chamber and vitreous taps with intravitreal antibiotic injections. Complete pars plana vitrectomy and intraocular lens explantation were eventually required because of persistent infection with a resistant organism. Cultures from the first procedure grew A. xylosoxidans and P. acnes. Cultures from the vitrectomy grew only A. xylosoxidans. At the final follow-up visit 6 months after the initial procedure. The eye was without inflammation with best-corrected visual acuity of 20/40. CONCLUSION: Both A. xylosoxidans and P. acnes can cause chronic progressive endophthalmitis after cataract extraction often resistant to corrective antibiotic therapy. Successful intervention may require complete vitrectomy with intraocular lens and capsule removal.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/225. Posterior subcapsular cataracts: posttransplantation in children.Posterior subcapsular cataracts (PSC) were noted in 41 of 69 (60%) recipients of renal allografts. The PSC were noted during the first posttransplant year (Group 1) in 21 (30%) recipients and after the first posttransplant (Group 2) year in 20 (30%) recipients. The dosage of prednisone during the first posttransplant year corrected for patient weight showed a significant correlation with the development of PSC during the first posttransplant year. The severity of the PSC were correlated with time of onset and prednisone dosage. Four recipients in Group 1 required cataract extraction to obtain sufficient vision to facilitate school work.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
10/225. Penetrating keratoplasty in eyes treated with conjunctival flaps.PURPOSE: To analyze the results of corneal transplants in severely inflamed eyes previously treated with conjunctival flaps. methods: In the period 1984-1996, seven homoplastic penetrating keratoplasties (PKs) and one rotating autokeratoplasty were performed on a series of 47 eyes of 46 patients treated with partial or total conjunctival flaps. Two of these PKs were combined with an extracapsular cataract extraction, and the rotating autograft was combined with an extracapsular cataract extraction and intraocular lens implantation. Patient ages ranged between 25 and 52 years (three men and five women), and the follow-up period was 3 to 15 years. The recipient corneal buttons were studied histopathologically. RESULTS: The eight graftings remained transparent; two cases developed glaucoma that was controlled with medication, and one had a rejection episode, which disappeared with medical treatment. All patients reached a postoperative vision between 20/70 and 20/30. CONCLUSION: Therapeutic conjunctival flaps improve the conditions of the recipient bed for transplant in severely inflamed eyes.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
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