1/23. Pulmonary embolization of a pacing electrode fragment complicating lead extraction.We present a case that demonstrates an unusual complication of electrode extraction, namely asymptomatic embolization of a pacing electrode fragment into the pulmonary vascular bed.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/23. Visually significant calcification of hydrogel intraocular lenses necessitating explantation.PURPOSE: To report two cases of HydroviewR (Storz H60M) hydrogel intraocular lens (IOL) opacification necessitating explantation. To analyse the explanted lenses and compare them with a new lens in order to determine the cause of opacification. methods: Two cases are presented. Both patients complained of subjective decreases in vision approximately 1 year following uneventful cataract extraction and implantation of hydrogel lenses by the same experienced surgeon in the same institution. The reduced contrast sensitivity was thought to be due to failure of the hydrogel lenses which appeared opacified at the slit-lamp.They were then exchanged for acrylic lenses. Pre- and postoperative contrast sensitivity testing was performed using the VectorvisionR CSV-1000E instrument. A detailed comparative analysis of the opacified explanted lenses and a new lens was undertaken. This included surface microscopy, infrared spectral analysis, X-ray elemental analysis, scanning electron microscopy, and electron microscopy of lens slices. RESULTS: Lens exchange resulted in an improvement in subjective visual acuity (VA) and in objective contrast sensitivity testing. Analysis revealed deposits of calcium phosphate (hydroxyapatite) on the explanted lens' surfaces. CONCLUSIONS: The surface of the HydroviewR H60M intraocular lens is subject to opacification as a result of calcium phosphate (hydroxyapatite) deposition, thereby limiting the patient's visual outcome, and in some cases necessitating explantation. The reason for surface calcification requires further study.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
3/23. Removal of the retained fragment of broken solid nails by the intra-medullary route.The development of solid nails has not eliminated the risk of occasional nail failure. It has been suggested that subsequent intra-medullary removal of solid nail fragment may be virtually impossible and thus major surgery is required for their revision. We report two cases of hardware failure of a solid intra-medullary nail (Synthes solid femoral and tibial nail) and describe their successful intra-medullary removal using the Synthes extraction kit.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
4/23. Phase transformation of a zirconia ceramic head after total hip arthroplasty.We report two cases of surface deterioration of a zirconia ceramic femoral head associated with phase transformation after total hip arthroplasty. One head was retrieved at revision due to recurrent dislocation after six years and the other because of failure of the locking mechanism of the polyethylene liner after three years. The monoclinic content of the zirconia ceramics rose from 1% to about 30% on the surface of the heads. SEM revealed numerous craters indicating extraction of the zirconia ceramics at the surface. Surface roughness increased from an initial value of 0.006 microm up to 0.12 microm. This is the first report to show that phase transformation of zirconia ceramics causes deterioration of the surface roughness of the head in vivo after total hip arthroplasty.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
5/23. Corneal decompensation and graft failure secondary to a broken posterior chamber poly(methyl methacrylate) intraocular lens haptic.A 66-year-old man developed an unexplained corneal decompensation 7 years after extracapsular cataract extraction and implantation of a single-piece poly(methyl methacrylate) (PMMA) posterior chamber intraocular lens (IOL). He had penetrating keratoplasty (PKP). Two years later, he developed corneal graft failure secondary to an IOL haptic fragment in the anterior chamber angle. The patient had a repeat corneal graft and IOL exchange. The broken haptic was examined with scanning electron microscopy. The findings were consistent with late fracture of the haptic within the capsular bag, which was presumably weakened by an improper implantation technique. Fracture of a PMMA haptic should be suspected as a cause of corneal decompensation and corneal graft failure after cataract surgery. This case emphasizes the importance of safe implantation techniques.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
6/23. haemophilus parainfluenzae complicating total hip arthroplasty: a rapid failure.We present a case of rapid failure of a total hip arthroplasty caused by infection with haemophilus parainfluenzae. The septic loosening occurred over a period of 3 months and followed a dental extraction that had not been covered by prophylactic antibiotics. This failure occurred in a previously well-functioning and asymptomatic prosthetic joint.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
7/23. Luxated intraocular lens fixation using intravitreal cow hitch (girth) knot.OBJECTIVE: To describe a technique for suturing a luxated intraocular lens (IOL) in the vitreous cavity to the ciliary sulcus using intraocular cow hitch (girth) knots without IOL extraction. DESIGN: Non-comparative interventional case series. PARTICIPANTS: Five patients with a luxated IOL in the vitreous cavity. INTERVENTION: All patients underwent surgery to fixate the IOL using this technique. methods: A three-port vitrectomy was performed in all five cases. A needle with looped 10-0 polypropylene was introduced into the vitreous cavity through a sclerotomy incision, and only the needle was passed out of the eye, guided by a bent 27-gauge needle from the 3-o'clock position 1.5 mm from the limbus. A cow hitch (girth) knot at the end of the loop was made outside the globe, grasped with a straight intravitreal forceps, and introduced into the vitreous cavity. Hooking the cow hitch (girth) knot around the haptics of the IOL in the vitreous cavity, the 10-0 polypropylene was pulled so that the IOL haptic was fixated onto the sulcus. After the opposite haptic was brought into the anterior chamber, the 10-0 polypropylene was looped around the haptics of the IOL and manipulated with a push-and-pull hook in the anterior chamber through the two corneal side ports to make a cow hitch (girth) knot outside the anterior chamber. By pulling up the suture, the knot was brought back and tied in the anterior chamber. It was then fixated to the ciliary sulcus at the 9-o'clock position. MAIN OUTCOME MEASURES: patients were evaluated for visual acuity, refraction, and surgical complications associated with the procedure. RESULTS: In all five cases, the IOL fixated stably and remained well positioned. No significant intraoperative or postoperative complications occurred. CONCLUSIONS: This technique enables secure fixation of the luxated IOL in the vitreous without extracting it.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
8/23. Progressive opacification of hydrophilic acrylic intraocular lenses in diabetic patients.Four patients with diabetes mellitus had cataract extraction with implantation of a hydrophilic acrylic intraocular lens (IOL) (ACRL-C160, Ophthalmed). The IOLs showed progressive and generalized opacification 10 to 20 months after implantation, decreasing visual acuity. All 4 IOLs were removed. By light microscopic examination, the IOL surfaces were wrinkled and encrusted with microspheres. Electron microscopy revealed the material to be crystalline in nature. Energy dispersive x-ray spectrum analysis showed that the deposits were mainly composed of calcium and phosphate.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
9/23. Bilateral spontaneous subluxation of scleral-fixated intraocular lenses.Two young men with primary ectopic lenses had intracapsular cataract extraction and scleral fixation of posterior chamber intraocular lenses (PC IOLs) using 10-0 polypropylene sutures tied to the IOL eyelets. Three to 9 years after implantation, spontaneous IOL vertical subluxation occurred in all 4 eyes (5 IOL loops), probably because of suture breakage. Late subluxation of a sutured IOL may occur several years after implantation. Double fixation and thicker sutures should be considered, especially in young patients.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
10/23. Periocular migration of an intraocular lens.A woman presented with a painful eye 6 weeks after cataract extraction and intraocular lens implantation. In the past she had had a sector iridectomy for iris bombe caused by chronic anterior uveitis. On examination the three central corneal sutures were absent, whilst the medial and lateral sutures had broken and were protruding from the section. The eye was quiet and the section intact. Combined clinical and ultrasound examination failed to locate the intraocular lens. Four months postoperatively, while being fitted for contact lenses for the correction of aphakia, the intraocular lens appeared from the superior fornix.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
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