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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a group of 2,281 eyes after extraction of a cataract and implantation of an iris clip lens (1,362 eyes after intracapsular extraction and 927 eyes after extracapsular extraction) motion of the retina occurred in 36 eyes (1.67%), incl. 27 after intracapsular extractions (1.98%) and 9 after extracapsular extractions (0.97%). In patients with pseudophakic retinal detachment after implantation of an iris clip lens the frequency of factors which might interfere with the development of this complication was investigated. The latter proved to be the following: prolapse of the vitreous body, luxation of the implanted lens, posterior uveitis and myopia. Detachment of the retina was preceded by: peroperative prolapse of the vitreous body in 34.21%, luxation of the implanted lens in 28.95%, posterior uveitis in 36.85% and myopia (up to -4.0 Ds) in 21.05%. Anatomical and functional results after operation of pseudophakic motion were evaluated in 38 eyes (36 eyes operated on account of cataract in the authors' department, two in other departments). The minimal follow up period after operation of retinal detachment was six months. Anatomical restoration of the retina was achieved in 23 eyes (60.53%), in 9 eyes a residual motion remained (23.68%) and in four eyes total motion (10.53%). In two eyes keratopathy developed (5.26%). Central vision 6/6-6/12 was achieved in 18.42%, 6/15-6/36 in 21.05%, 6/60-3/60 in 28.95% and less than 3/60 in 31.58%. In the poorer anatomical and functional results after operation of pseudophakic motions participate in addition to the above mentioned ones difficult visualization of the retinal periphery and the extent of surgical trauma during surgery of detached retinas.
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PMID:[Retinal detachment in pseudophakia]. 191 4

We evaluated the strength of various incisions used in cataract surgery in cadaver eyes. Fluid was forced into the eye through a paracentesis incision and measured via a second paracentesis incision connected to a pressure transducer. In four eyes with the limbal, two-step procedure and radial sutures, leakage from the wound was seen at 100 mm Hg to 120 mm Hg, and iris prolapse through the wound occurred at 160 mm Hg to 400 mm Hg. In three eyes with the scleral tunnel two-step procedure, no prolapse was observed at pressures up to 400 mm Hg, although leakage was observed in two eyes at 400 mm Hg. In two eyes with the three-step procedure with an internal corneal lip, no leakage or prolapse was observed at pressures up to 400 mm Hg or upon manipulation of the wound at various pressures. In an additional evaluation of four eyes with the three-step procedure, no leakage or prolapse was observed with compressed air at pressures over 2,000 mm Hg. A three-step incision with an internal corneal lip may provide a more pressure resistant wound than a two-step limbal or scleral tunnel incision.
J Cataract Refract Surg 1991
PMID:Relative strength of cataract incisions in cadaver eyes. 195 83

Preservation of the intact ("true") capsular bag, with no tears to the periphery, is essential to assure permanent in-the-bag fixation of the intraocular lens. Removal of a large nucleus using the open-system planned extracapsular cataract extraction (ECCE) technique is often associated with tearing of the capsulectomy or serious complications such as zonular rupture, vitreous loss, unintended intracapsular cataract extraction, or posterior lens prolapse. A closed-system planned ECCE technique which allows a safe removal of the lens while maintaining the integrity of the capsular bag is presented. Hydrodissection of the lens nucleus to an epinucleus and a central hard nucleus allows hydroextraction of the small hard core while pushing the posterior capsule backward. The positive pressure in the anterior chamber, provided by the anterior chamber maintainer, keeps the position of the lens steady in its natural location, and minimizes the stress on the zonular apparatus during nucleus delivery. The remaining epinucleus can be either hydroexpressed or aspirated. Fracturing the central core, when possible, enables removal of the lens material through a small limbal incision. Viscoelastic material can be combined with a low-flow, anterior chamber maintainer in a closed-system and provides a useful surgical tool.
J Cataract Refract Surg 1991 Mar
PMID:Lens anatomical principles and their technical implications in cataract surgery. Part II: The lens nucleus. 204 Sep 79

The effectiveness of periocular anaesthesia and its complications were examined in 100 successive cataract operations. The patients were divided into 3 groups according to the duration of ocular compression with an Autopressor device after administration of periocular anaesthesia. In the control group, no compression was used (C-O, n = 36 patients). In the other two groups, compression was used for 10 (C-10, n = 32) and for 20 (C-20, n = 32) min. No differences in globe or orbicular akinesia were found between the groups. At 10 min, immobilisation of the globe in different directions was attained in 60.1-84.5% of the patients. Compression for an additional 10 min did not significantly improve the akinesia. In contrast, the hitherto undescribed loss of light perception increased with time: 15 patients at 10 min and 22 at 20 min were unable to see light. Chemosis and haematomas in the upper eyelid occurred more often in C-0 than in the other 2 groups. One day postoperatively the average palpebral aperture was smaller in C-0 than in the other two groups. The frequent postoperative ptosis (74.3% on the 1st day) decreased rapidly, but on postoperative day 7, 9 patients still had ptosis. In only one patient was ptosis still recognizable at 6 weeks postoperatively. No serious complications occurred. This study demonstrates that periocular anaesthesia with ocular compression is a suitable method for cataract surgery.
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PMID:Periocular anaesthesia: technique, effectiveness and complications with special reference to postoperative ptosis. 208 Jul 7

In 1978 at the beginning of the modern lens implantation era, 6160 posterior chamber lenses (PCL) were implanted in the USA; 1,110,000 PCL were implanted in 1986. With reference to the total number of lenses implanted, PCL implantations amounted to 4% in 1978 and to 89% in 1986. The increasing use of PCL has mainly been due to the fact that patients with these lenses had significantly better visual acuity and fewer complications after surgery than patients with anterior chamber lenses (ACL). As an example, an FDH study in 1983 should be mentioned: more vision in an otherwise normal eye was more than 0.5: 90% (ACL) versus 94% (PLC); ablatio: 0.9% versus 0.5%; secondary glaucoma: 1.2% versus 0.5%; cystoid edema of the macula: 2.2% versus 0.8%. The considerable advantage in extracapsular extraction of a cataract lies in the fact that the anatomical and physiological conditions of the eye structure may be nearly completely maintained, and this is because the intact posterior capsule--similar to the lens with zonular fibers in the normal eye--forms a diaphragm between the vitreous and aqueous humor. Thus the stability of the eye will be maintained and prolapse of the vitreous with possible traction at the retina cannot occur. Phacoemulsification and ECCE are well-established methods. The clinical results of both methods are practically identical, except for a significantly lower rate of astigmatism with phacoemulsification, which was examined 8 to 10 weeks following surgery (phaco: 1.0 +/- 0.49; expression: 3.3 +/- 1.7).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparative evaluation of intracapsular cataract extraction, extracapsular cataract extraction and phacoemulsification]. 208 93

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.
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PMID:Management of traumatic rupture of the globe in aphakic patients. 219 84

Postcataract extraction ptosis is a common complication of cataract surgery. While many factors have been implicated in its etiology, trauma to the superior rectus/levator complex is considered the most important factor. We prospectively evaluated the effect of two superior rectus bridling techniques on the degree and severity of ptosis present three months after cataract surgery. All other potential variables were controlled for. Bridling the tendon of the superior rectus muscle using the direct, subconjunctival (open) approach results in significantly less severe ptosis than the standard technique of indirect transconjunctival (closed) bridling.
J Cataract Refract Surg 1990 Jul
PMID:Postcataract extraction ptosis: effect of the bridle suture. 200 51

Vitreous prolapse into the anterior chamber after cataract extraction is a severe complication in cases in which there is a contact between the vitreous and the cornea. The present paper discusses the result of treatment by vitrectomy in 15 patients with this complication. Anatomical and functional improvement was attained in 12 cases (89 p.c.) and in 5 among them--full visual acuity was obtained.
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PMID:[Vitrectomy in the treatment of vitreous body prolapse after cataract extraction]. 226

Ptosis may develop after cataract surgery because of a dehiscence of the levator aponeurosis. A series of patients undergoing entropion repair was examined in order to determine the mechanism of entropion and the correlation with cataract surgery. It is suggested that involutional senile entropion may develop related to cataract surgery, on the same basis as ptosis, due to disinsertion of the capsulopalpebral fascia. It is suggested that the cataract surgeon should examine the patient closely for preoperative entropion to prevent or anticipate the development of frank entropion after the cataract surgery.
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PMID:Association of entropion with cataract surgery. 226 96

A retrospective study of cataract surgery performed between January 1983 and December 31, 1989, disclosed 48 eyes in which the posterior capsule was torn. The overall incidence of this complication was approximately 1% but was further reduced when the technique of capsulorhexis was mastered. Our review of the video tapes of these surgical procedures revealed that the tear occurred most frequently during nucleus removal (41%) and posterior capsular vacuuming (28%). The anatomy of each tear was classified and related to the event responsible for the torn capsule, as well as to the likelihood of vitreous involvement. Vitreous presented through the tear in 32% of the 48 cases, entered the wound in 6%, and remained posterior to the torn capsule in 62%. Intraocular lenses were implanted in every case; only posterior chamber lenses were used during the last four years of the study. Vitreous-related complications included vitreous prolapse, peaked pupils, and vitreous-induced pupillary block. Acute postoperative intraocular pressure elevation was a frequent finding and was managed by conservative therapy. Transient cystoid macular edema developed in one case which had a rotating anterior chamber intraocular lens. No retinal detachments occurred in this series. Final visual acuity of 20/40 or better was achieved in 89% of the 48 cases. When properly managed, a torn posterior capsule is compatible with an excellent visual outcome.
J Cataract Refract Surg 1990 Jul
PMID:The torn posterior capsule: its intraoperative behavior, surgical management, and long-term consequences. 238 Sep 32


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