1/19. Malignant glaucoma following laser iridotomy.BACKGROUND: A 69-year-old man presented with malignant glaucoma 10 days after an iridotomy for acute angle-closure glaucoma. methods: The case notes are reviewed, describing his presentation and treatment, including the technique of extracapsular cataract extraction with anterior vitrectomy. RESULTS: An excellent visual outcome was achieved with no recurrence of the malignant glaucoma. CONCLUSIONS: This case illustrates the recently established link between laser iridotomy and malignant glaucoma. miotics and other possible causes are excluded, a surgical option is described and the importance of assessing central anterior chamber depth in cases of angle closure is emphasised.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/19. Expulsive hemorrhage before phacoemulsification.A 65-year-old white man who was scheduled for cataract extraction experienced a sudden increase in intraocular pressure (IOP) with flattening of the anterior chamber immediately after the anterior capsule incision. The eye was sutured, and because no decrease in pressure was noted, surgery was postponed. The presence of the cataract prevented ophthalmoscopic examination. Echographic examination revealed a hemorrhagic choroidal detachment with involvement of the ciliary body. The patient was examined regularly until the choroidal detachment disappeared 4 weeks later. He then had uneventful phacoemulsification and intraocular lens implantation.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/19. Episcleral pseudomelanoma: late complication of scleral tunnel incision.PURPOSE: To describe two patients who developed scleral thinning as a late complication of scleral tunnel incision for cataract extraction. DESIGN: Observational case report and interventional case report. methods: A 75-year-old man had an asymptomatic gray-brown subconjunctival nodule in the location of the healed scleral tunnel incision for cataract surgery. A 62-year-old man had a biopsy of a brown conjunctival nodule at the site of a scleral tunnel incision for cataract surgery. RESULTS: The 75-year-old patient with prolapsed uveal tissue was followed up for 4 years without change in the wound defect. The 62-year-old patient had a biopsy because the exposed ciliary body mimicked a melanoma. CONCLUSIONS: Scleral defects with herniated uveal tissue as a late sequela of scleral tunnel incision for cataract surgery should be differentiated from melanoma and can be safely observed for years when covered by conjunctiva.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/19. Complicated extracapsular cataract surgery in pseudoexfoliation syndrome: a case report.Crystalline lens dislocation and zonular dialysis during intraocular surgery are recognised features of the pseudoexfoliation syndrome (PES). A case is reported in which zonular dialysis occurred in both eyes during extracapsular cataract extraction. In particular surgery was complicated by difficulty in performing anterior capsulotomy. Careful preoperative assessment and peroperative technique may help to reduce the risk of surgical complication in PES.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/19. Delayed ciliochoroidal detachment following intraocular lens implantation.Three patients who had extracapsular cataract extractions with intraocular lens implants developed delayed ciliochoroidal detachments, which responded to systemic steroid therapy. This rare complication may have been due to ciliary sulcus fixation of the implant. The possible mechanism and treatment are discussed.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/19. Management of the hypotonous cyclodialysis cleft.Authoritative experience in the management of hypotonous cyclodialysis clefts is difficult to obtain because of their rarity. In this study, the authors describe nine patients with hypotonous cyclodialyses clefts: six patients were treated successfully with argon laser photocoagulation to the cleft surfaces; in one patient, cleft diathermy was used to seal an incompletely closed cleft after a single argon laser treatment; one patient responded to conservative management; another patient did not require treatment. Four cases followed ocular trauma and five occurred after extracapsular cataract extraction and posterior chamber intraocular lens implantation. In three patients, the anterior chamber was too shallow to permit gonioscopy; sodium hyaluronate (Healon) was used to reform the anterior chamber, to delineate the extent of the cyclodialysis cleft, and to provide maximal access for the argon laser treatment. In another patient, laser cleft consolidation was successful only after fully opening the cleft with sodium hyaluronate. The evolution of the laser photocoagulation technique used by the authors is described. Laser cyclodialysis cleft consolidation can be repeated easily and safely. The authors recommend argon laser photocoagulation as the primary management approach. Intracameral viscoelastic agents are useful adjuncts. The complications of cleft lasering are minor, although a hypertensive episode commonly occurs in the early postoperative period as the cleft closes. Major intraocular surgeries usually can be avoided.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/19. Management of traumatic rupture of the globe in aphakic patients.We report the successful treatment of three cases of traumatic ruptures of the globe complicated by massive choroidal hemorrhage, uveal prolapse and retinal detachment. All three of the eyes were aphakic prior to injury and all patients were age 64 or older. The presenting visual acuity in all patients was light perception. The blunt injury in each case caused a wound dehiscence at the site of previous cataract extraction. All injuries were associated with uveal prolapse. Secondary surgical intervention was performed when the hemorrhagic choroidal detachments had decreased as demonstrated by echography in the suprachoroidal space, occurring at an average of 14 days after injury. The management consisted of surgical drainage of the choroidal hemorrhage combined with vitrectomy and silicone oil injection. Successful reattachment of the retina was achieved in all cases. Postoperative epiretinal membranes formed in two cases but all were anatomically successful at six months. Final visual acuities varied from 20/70 to 1/200, visual acuity being a function of secondary contusive damage to the retina and choroid. We believe that in eyes sustaining severe blunt injuries resulting in rupture of the globe complicated by massive choroidal hemorrhage and retinal detachment, properly timed external drainage of the choroidal hemorrhage combined with pars plana vitrectomy and silicone oil injection is a useful approach.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/19. Cataract surgery in nanophthalmic eyes.Cataract surgery in nanophthalmic eyes may be complicated by postoperative uveal effusion. Evidence is presented that prophylactic lamellar scleral resection with decompression of the vortex veins, performed 2 months or more prior to cataract extraction, may reduce the incidence of this severe complication. A randomized study to determine the benefit of such prophylaxis is advocated.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/19. Pseudophakic choroidal detachment with cyclodialysis cyst.Two cases of spontaneous pseudophakic ciliochoroidal detachment, associated with extracapsular cataract extraction, posterior chamber intraocular lens implantation with intact posterior capsules, and small cyclodialysis clefts are documented. In both patients, the choroidal detachments occurred in a delayed fashion following uncomplicated cataract surgery and both presented with characteristic ocular hypotony. Although one patient required surgical management, both patients regained excellent vision after closure of the clefts and resolution of the ciliochoroidal detachments.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
10/19. Expulsive hemorrhage: its incidence in cataract surgery and a report of four bilateral cases.Between 1978 and 1983, 13,890 cataract extractions were performed in baltimore at JHH and the GBMC with 14 expulsive hemorrhages for an incidence of 0.10%. In the years 1963 through 1983, 180,690 cataract extractions were performed in Taxila, pakistan with 87 expulsive hemorrhages for an incidence of 0.05%. Reasons for the significant differences in incidence are presented. The six reported cases of bilateral expulsive hemorrhage are reviewed. Four more cases are added. A classification of choroidal hemorrhage is presented.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
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