1/11. Combined cataract extraction and submacular blood clot evacuation for globe perforation caused by retrobulbar injection.A 45-year-old woman, originally scheduled for cataract surgery in the left eye, was referred for management of a globe perforation noticed after the retrobulbar injection of an anesthetic solution. There was a moderate degree of vitreous hemorrhage, and initial visual acuity was hand movement. A submacular blood clot of about 4-disc diameter was detected when the vitreous hemorrhage gradually cleared. One week after the incident, combined phacoemulsification, intraocular lens implantation, pars plana vitrectomy, and submacular clot removal using tissue plasminogen activator (tPA) as an adjunct were performed. Recovery was uneventful. At the last follow-up 6 months after surgery, best corrected visual acuity was 20/30.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/11. Long-term posterior and anterior segment complications of immune recovery uveitis associated with cytomegalovirus retinitis.PURPOSE: To identify and describe long-term posterior and anterior segment complications of immune recovery uveitis in patients with inactive cytomegalovirus retinitis who are undergoing highly active antiretroviral therapy-mediated recovery of immune function.methods: A prospective cohort study at a university medical center. Twenty-nine eyes of 21 patients with immune recovery uveitis and inactive cytomegalovirus retinitis were followed for 14.5 to 116 weeks (median, 43 weeks) after diagnosis of immune recovery uveitis. RESULTS: Nine eyes of nine patients developed visually important complications involving the posterior segment, anterior segment, or a combination of both. Posterior segment complications included severe proliferative vitreoretinopathy in three eyes and spontaneous vitreous hemorrhage from avulsion of a blood vessel secondary to contraction of the inflamed vitreous in one eye. Proliferative vitreoretinopathy recurred in all cases after surgery, severely compromising the visual outcome. Anterior segment complications included posterior subcapsular cataracts with vision decrease in five eyes and persistent anterior chamber inflammation after cataract extraction, resulting in posterior synechiae and large visually important lens deposits in three eyes.CONCLUSION: Persistent inflammation in immune recovery uveitis may lead to vision-threatening complications, such as proliferative vitreoretinopathy, posterior subcapsular cataracts, and severe postoperative inflammation. Immune recovery uveitis is a chronic inflammatory syndrome that may result in complications months to years after the onset of inflammation.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
3/11. 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 = 0.25keywords = extraction (Clic here for more details about this article) |
4/11. 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 = 1.25keywords = extraction (Clic here for more details about this article) |
5/11. vitreous hemorrhage as the initial presentation of postoperative endophthalmitis.PURPOSE: To describe a patient with postoperative endophthalmitis whose only abnormal finding at presentation was a vitreous hemorrhage. DESIGN: Interventional case report. methods: A 68-year-old diabetic woman underwent cataract extraction with intraocular lens implantation in the left eye. Three days after surgery, she had painless loss of vision, minimal anterior chamber inflammation, and dense vitreous hemorrhage in the left eye. RESULTS: On the fourth postoperative day, significant anterior chamber inflammation developed with fibrin and a hypopyon. During vitrectomy with intravitreal antibiotic injection, an area of retinitis surrounding an eroded retinal blood vessel was found. Cultures of undiluted vitreous fluid grew coagulase-negative staphylococcus organisms. The endophthalmitis resolved and 20 months later, her best-corrected visual acuity had improved to 20/40. CONCLUSION: Postoperative endophthalmitis may present as a vitreous hemorrhage, secondary to retinitis and erosion of a retinal blood vessel.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
6/11. Pars plana vitrectomy in eyes containing a treated posterior uveal melanoma.PURPOSE: To determine the safety of pars plana vitrectomy in eyes containing a treated posterior uveal melanoma. DESIGN: Interventional case series. methods: Retrospective case series of patients with posterior uveal melanoma who underwent pars plana vitrectomy. Complications, vitreous cytology, local tumor control, and metastasis were assessed. RESULTS: Nine patients met study criteria. Tumors were treated with (125)I plaque radiotherapy (seven patients) or transpupillary thermotherapy (two patients). vitrectomy was performed for vitreous hemorrhage (five patients), macular pucker (two patients), macular hole (one patient), and rhegmatogenous retinal detachment (one patient). vitrectomy was performed at a mean of 24.7 months (range, 7-47 months) after melanoma treatment. Dispersion of tumor cells at vitrectomy was not observed in any patients. melanoma cells were detected in the vitreous aspirate in one of seven cases examined cytologically. This patient had intratumoral and vitreous hemorrhage before plaque radiotherapy, underwent combined vitrectomy/cataract extraction, and developed intraocular tumor dissemination 56 months after vitrectomy. No other patients developed intraocular tumor dissemination. At mean follow-up of 24 months (range, 3-63 months) after vitrectomy, none of the nine patients developed systemic metastasis. CONCLUSIONS: Pars plana vitrectomy rarely may lead to intraocular tumor dissemination, although the risk of this complication is probably low if the tumor has been treated and has responded to therapy before vitrectomy. vitrectomy should be approached with caution if a vitreous hemorrhage is present, especially if the hemorrhage occurred before tumor treatment, as this may seed tumor cells into the vitreous cavity.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
7/11. Pars plana vitrectomy foreign body extraction assisted with a 24-gauge needle tunnel.A 54-year-old man presented with corneal laceration, traumatized iris, small vitreous hemorrhage, lens opacity, and a 13-mm intraocular foreign body embedded in the retina. Pars plana vitrectomy and argon laser photocoagulation were performed. Using intraocular forceps, the object was forced into a 24-gauge needle that was inserted through the sclerotomy. The foreign body and the needle were removed from the eye. phacoemulsification with foldable intraocular lens implantation in the ciliary sulcus was performed. Seven days after the surgery, the patient's visual acuity was 20/20 with spectacle correction of -3.5 diopters. The use of a needle tunnel during pars plana vitrectomy should be considered in similar cases of large, irregular intraocular foreign bodies to avoid severe and irreversible damage to the adjoining tissues.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/11. 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 = 1keywords = extraction (Clic here for more details about this article) |
9/11. Intraocular hemorrhage from wound neovascularization years after anterior segment surgery (Swan syndrome).At the Mayo Clinic from 1972 to 1986, 15 patients (17 eyes) had intraocular hemorrhage due to neovascularization of the stromal wound years after anterior segment surgery (Swan syndrome). Months to years after surgery patients complained of low-grade blurring that was painless and transient. The hemorrhage was seen after intracapsular cataract extraction, and one third of the patients had had an intraocular lens implant. Of the 15 patients 14 were referred, 6 for vitreous hemorrhage, 5 for recurrent hyphema, 2 for amaurosis fugax and 1 for recurrent uveitis. The average time between surgery and presentation was 4 years. The initial visual acuity was better than 20/40 in 15 eyes (extremes 20/20 and hand movement), and intraocular pressure was elevated above 30 mm Hg in 2 eyes. Treatment included periodic observation (in 10 eyes), goniophotocoagulation (in 7) and limbal cryopexy (in 3). After a mean follow-up period of 3 years all 17 eyes showed normal acuity and intraocular pressure. No patient had intractable glaucoma or phthisis.- - - - - - - - - - ranking = 0.25keywords = extraction (Clic here for more details about this article) |
10/11. Pars plana vitrectomy for retinal detachment due to internal posterior ophthalmomyiasis after cataract extraction.BACKGROUND: The authors report a case of posterior internal ophthalmomyiasis causing vitreous haemorrhage and retinal detachment after uncomplicated cataract extraction. CASE REPORT: The patient suffered an abrupt vitreous haemorrhage 9 days after ECCE and posterior chamber IOL implantation. After 2 months the haemorrhage did not clear up and a retinal detachment arose. The patient underwent encircling scleral buckle, pars plana vitrectomy and fluid-gas exchange. In course of intervention the surgeon removed from the vitreous chamber a 14-mm-long round worm subsequently identified as a dipterous larva of the sarcophagidae family. DISCUSSION: The patient showed no sign of subretinal tracking or retinal breaks or holes. The sclerocorneal surgical wound seems the most likely site of entrance of the parasite, and this would then be the first reported case of myiasis with no RPE tracking.- - - - - - - - - - ranking = 1.25keywords = extraction (Clic here for more details about this article) |
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