1/28. vitreous hemorrhage following phakic anterior chamber intraocular lens implantation in severe myopia.PURPOSE: To describe two cases of vitreous hemorrhage following phakic anterior chamber lens (AC-IOL) implantation in high myopia. CASE REPORT: In case 1, hemorrhage developed one month after surgery, without retinal involvement, and visual acuity (VA) resulted 20/200 after pars-plana vitrectomy (PPV). In Case 2, vitreous hemorrhage was complicated by retinal detachment (RD). PPV and silicone oil injection were performed, with AC-IOL removal and cristalline lens extraction. After 2 years the retina was attached and VA was 20/80. DISCUSSION: Only few cases of RD, posterior uveitis and endophthalmitis are reported following phakic AC-IOL implant. vitreous hemorrhage could represent an additional posterior segment complication. Intraoperative manoeuvres, hypotony-induced posterior vitreous detachment and/or peripheral retina traction could play a role in engendering this complication in highly myopic eyes.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/28. Bilateral acute postoperative retinal detachment after cataract extraction: case report and review of the literature.A 57-year-old white man had extracapsular cataract extraction complicated by vitreous loss. On postoperative day 1, he was noted to have a total retinal detachment (RD) with vitreous hemorrhage. No predisposing anatomic risk factors were present except for the vitreous loss. During the RD repair, 2 small superior tears were discovered. Eleven months later, the patient had uneventful phacoemulsification in the fellow eye. On postoperative day 1, he again had a total RD with a superior retinal tear. Meticulous retinal evaluation had been performed preoperatively, and no holes or tears were discovered. The RD was repaired, and the best corrected visual acuity at the last examination was 20/40 in both eyes.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
3/28. Posterior vitreous detachment after cataract extraction in non-myopic eyes and the resulting retinal lesions.A series of 54 non-myopic aphakic eyes with no signs of posterior vitreous detachment and 63 non-myopic aphakic eyes with various stages of posterior vitreous detachment was followed-up for a period of 6 months to 6 years. Over half of the eyes with no vitreous detachment when first examined developed various stages of posterior vitreous detachment during the follow-up period; in 10 eyes this was accompanied by entopsies with or without photopsies and three eyes developed five new retinal tears. In over half of the eyes with partial vitreous detachment when first examined, the vitreous detachment continued to progress causing retinal detachment in one eye. Late vitreous detachment in non-myopic aphakia or the completion of a partially-detached vitreous could account for the higher incidence of retinal tears in this group of eyes.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |
4/28. Vitreous surgery for bilateral bullous retinal detachment in Vogt-Koyanagi-Harada syndrome.A successful surgical treatment (vitrectomy) for bilateral bullous retinal detachment in a patient with Vogt-Koyanagi-Harada (VKH) disease is reported. A 78-year-old woman had severe reduction of visual acuity in both eyes because of an extremely bullous nonrhegmatogenous retinal detachment accompanied by VKH disease. We performed lens extraction and vitrectomy on both eyes combined with systemic and topical corticosteroid therapy. The retina was reattached immediately after the surgery and her visual acuity promptly improved in both eyes. She had no recurrence of retinal detachment even after tapering the dose of corticosteroid. We suggest that vitrectomy may be an effective therapeutic option in the treatment for severe bullous retinal detachment associated with VKH disease.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/28. The management of glaucoma in nanophthalmos.patients with nanophthalmos are prone to develop a chronic painless type of glaucoma in middle age, probably due to the natural increase in the size of the lens which is already relatively too large for the small eye. Although the underlying mechanism is obscure, a slowly progressive "creeping" chronic angle-closure is postulated, but gonioscopic evaluation is difficult due to the shallow anterior chamber, with grade I and slit angles. Response to medical treatment is poor and miotics may even make the condition worse by producing relative pupillary block and by relaxing the lens zonule. Ordinary glaucoma surgery is to be avoided in nanophthalmos because of the fear of postoperative ciliary-block malignant glaucoma. Periopheral iridectomy performed in five eyes at an advanced stage of the chronic angle-closure did not facilitate glaucoma control in three eyes, and in two eyes in which the operation was combined with posterior sclerotomy, the eyes became blind from vitreous hemorrhage. Lenx extraction in five eyes controlled the glaucoma but was followed by choroidal effusion and nonrhegmatogenous retinal detachements in two eyes and blindness in another eye when combined with a posterior sclerotomy. No firm therapeutic recommendations can be made on the basis of the author's experience in the six reported cases. Conventional medical therapy seems ineffectual even when begun early in the glaucoma. Conventional glaucoma surgery must be performed early, before permanent damage to the outflow mechanism occurs but removal of the lens must be anticipated. The surgeon must also remain aware of the high incidence of serious posterior-segment complications which inexplicably follow glaucoma or lens surgery in nanophthalmos, as described by Brockhurst.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/28. Pars plana suture fixation for intraocular lenses dislocated into the vitreous cavity using a closed-eye cow-hitch technique.We describe a modified intraocular cow-hitch technique for pars plana suture fixation of intraocular lenses (IOLs) that dislocated into the vitreous cavity in 3 patients who had a 3-port vitrectomy and IOL implantation because of retinal disease. To reposition the dislocated IOL after the residual vitreous was removed, 2 additional sclerotomies for suture fixation were made 3.0 mm posterior to the limbus. A loop (cow-hitch knot) was made with 10-0 polypropylene for suture fixation. After the neck of the cow-hitch loop was grasped with an intraocular forceps, the loop was used to lasso a haptic of the dislocated IOL, which was then pulled forward to the sclerotomy. The same procedure was used for the other haptic, and both sutures were secured to the sclera under scleral flaps. In all patients, the dislocated IOLs were repositioned without the need for extraction. The procedures were uneventful. Pars plana suture fixation with the intraocular cow-hitch technique can be used to reposition an IOL that has dislocated into the vitreous cavity.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/28. Continuous control of intraocular pressure in pseudophakic retinal detachment surgery.We describe a method for continuous control of intraocular pressure in pseudophakic retinal detachment surgery done shortly after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The system consists of a special needle inserted into the anterior chamber through the corneal limbus. The needle is attached by a regular intravenous administration set to an infusion bag. This allows fluids to exit the eye when the eyeball is compressed and to return to the eye when pressure on the eye is released. The presence of an intact posterior capsule and an intraocular lens do not impose a significant barrier to the passage of fluids between the anterior chamber and the vitreous cavity. Using this technique, intraocular pressure can be stabilized throughout the operation. The implementation of this system is demonstrated by a case report.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/28. Bilateral intraocular foreign bodies simulating crystalline lens.PURPOSE: To report a case of large bilateral intraocular foreign bodies mistaken for crystalline lens on computed tomography (CT). DESIGN: Case report. methods: A 24-year-old man was referred after bilateral open globe repair following a motor vehicle accident. Preoperatively, the CT scan had been read as "Right eye posteriorly dislocated lens. No evidence of foreign bodies." RESULTS: The patient underwent left eye cataract extraction with removal of a 7 x 5 x 5 mm piece of glass buried in the crystalline lens. The patient subsequently underwent right eye pars plana vitrectomy, removal of another piece of glass measuring 6 x 5 x 5 mm, retinal detachment surgery, and corneal grafting. CONCLUSIONS: Current safety standards require auto glass to fracture into pieces of a specific size to minimize laceration and missile injury. These pieces of glass may have a shape and size similar to the crystalline lens but have higher radiodensity on CT scan.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/28. Recurrent corneal oedema following late migration of intraocular glass.This is a report of very late complications following intraocular penetration of numerous fragments of glass as a result of a test tube explosion. Fifteen years after the initial injury glass splinters began to migrate from the vitreous into the anterior chamber, causing acute episodes of corneal oedema. Four such episodes occurred over the past nine years, the corneal oedema each time disappearing within a few days following surgical extraction of the glass splinters. The literature on intraocular glass and its movement within the eye is reviewed.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
10/28. retinal detachment adherent to posterior chamber IOL after Molteno implant surgery.A patient with refractory glaucoma 1 year after cataract extraction and trabeculectomy had Molteno implant surgery. Three days after surgery a kissing choroidal effusion and retinal detachment adherent to the posterior chamber IOL were detected. Repeated choroidal taps were unsuccessful. Removal of the Molteno implant, vitrectomy, and silicone oil injection were required to reattach the retina.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
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