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

Advances in phacoemulsification and self-sealing wound construction have made topical anesthesia an effective and reliable method of obtaining ocular anesthesia. It has many advantages over the traditional retrobulbar or peribulbar technique. I have performed more than 1800 cases of phacoemulsification and posterior chamber intraocular lens implantation through a 3 mm, self-sealing, corneal tunnel incision with topical anesthesia and the use of the Bloomberg SuperNumb Anesthetic Ring. This article presents the procedure. Results show the benefits of topical anesthesia and the anesthetic ring, including elimination of the risks of globe penetration, retrobulbar hemorrhage, respiratory depression, intradural or subarachnoid injection, ptosis, and diplopia, as well as instant return of vision.
J Cataract Refract Surg 1995 Jan
PMID:Topical anesthesia using the Bloomberg SuperNumb Anesthetic Ring. 772 92

A theoretical explanation of the mechanism of iris prolapse is presented using simple flow mechanics and the Bernouille principle, which states that fluid pressure varies inversely to fluid velocity. Rapid aqueous escape into an anterior chamber perforation thus creates a relative vacuum anterior to the iris. Further analysis shows that the tendency of the iris to prolapse into an anterior chamber wound increases as an inverse function of the fourth power of the radial distance between the iris and the perforation. Anterior wound placement, clear of the iris plane, should help to prevent iris prolapse. Minimizing the irrigation velocity (and hence the fluid outflow velocity) should also help to prevent intraoperative prolapse.
J Cataract Refract Surg 1995 Mar
PMID:Mechanism of iris prolapse: a qualitative analysis and implications for surgical technique. 779 Oct 59

A prospective, randomised study was performed on 52 patients undergoing routine limbal extracapsular cataract surgery to compare the effect of 10/0 nylon and 9/0 elastic polypropylene sutures on post-operative astigmatism. Both the magnitude and the axis of the astigmatism were measured by keratometry and refraction pre-operatively and at regular intervals for 3 months post-operatively. Both groups showed an increase in the magnitude of astigmatism immediately post-operatively. The polypropylene group showed a more rapid decrease in astigmatism over the first 7 days and subsequent stabilisation, although the only significant (p < 0.05) difference in astigmatism between the two groups was at 1 week post-operatively. Both groups showed 'with-the-rule' astigmatism immediately post-operatively, although more of the polypropylene group developed 'against-the-rule' astigmatism by the end of the study. Despite an early reduction in post-operative astigmatism in the polypropylene group, early spectacle prescribing would not be recommended because of the shift in the axis of astigmatism. In addition, the polypropylene group had a 4 times greater incidence of iris prolapse compared with the nylon group.
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PMID:A prospective, controlled study of a 9/0 elastic polypropylene suture for cataract surgery: refractive results and complications. 783 49

We evaluated the centration of excimer laser myopic photorefractive keratectomy by analyzing the corneal topography in 60 eyes of 37 patients. Computer-assisted analysis of corneal topography was performed preoperatively and one week postoperatively. The distance and the direction from the center of the entrance pupil to the center of the ablation was calculated using a personal computer. Downward displacement of the ablation relative to the center of the entrance pupil was observed in 51 eyes (85%). The mean distance of the center of the ablation from the center of the entrance pupil was 0.51 +/- 0.31 mm (range 0.06 mm to 1.64 mm). To achieve more precise centration, we recommend applying an eye-movement tracking system to photorefractive keratectomy.
J Cataract Refract Surg 1994 Nov
PMID:Topographical evaluation of centration of excimer laser myopic photorefractive keratectomy. 767 51

Square scleral corneal, square clear corneal, and rectangular clear corneal incisions were constructed in six cadaver eyes that had no previous intraocular surgery. The 3.2 mm or smaller wounds had sutureless closures. To determine their relative abilities to resist leakage and iris prolapse, eyes were tested at external pressures of up to 525 pounds per square inch (psi) at one of two intraocular pressure (IOP) ranges: 10 to 15 mm Hg or 20 to 25 mm Hg. The square scleral corneal (3.2 mm x 3.2 mm) and square clear corneal wounds (3.2 mm x 3.2 mm, 2.0 mm x 2.0 mm, 1.0 mm x 1.0 mm) withstood external pressure without effect at both IOP ranges, up to the maximum 525 psi. This level of external pressure was far greater than pressures withstood by rectangular clear corneal wounds, especially the wound usually constructed in clinical practice (3.2 mm x 2.0 mm), which leaked and demonstrated iris prolapse at 13 psi at the lower IOP. The square clear corneal wounds that were stable at 525 psi, however, are either clinically impractical (visual axis encroachment from 3.2 mm x 3.2 mm wound) or not technologically feasible until the size of phacoemulsification tips and intraocular lenses can be further reduced. Thus, of the procedures for small incision cataract surgery presently in use, the square scleral corneal incision with 1.5 mm internal corneal lip appears to offer greater stability and safety than the conventional rectangular clear corneal incision (3.2 mm x 2.0 mm).
J Cataract Refract Surg 1994 Nov
PMID:Relative strength of scleral corneal and clear corneal incisions constructed in cadaver eyes. 783 73

We analyzed the postoperative complications in a prospective study of 3,429 cataract operations: over 95% phacoemulsification and 4% ECCE. In more than half of the procedures, the no-stitch technique with implantation of a standard PMMA IOL was used. Postoperative wound-closure complications were more frequent in the group of corneoscleral incision with double running suture: hypotony (under 5 mmHg) in 5%, wound dehiscence with iris prolapse in 1.9%. In the series with the no-stitch technique, hypotony occurred in 1.8%. Other wound-closure complications were eliminated to a pro mille level. Intraocular inflammation with fibrin exudation was also reduced by the no-stitch technique (4.2 vs 7.4%).
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PMID:[Postoperative complications in cataract surgery. Results of a prospective study of 3,429 operations with various wound sutures]. 795 Jan 6

Eighty patients with senile cataract were subjected to a planned extracapsular cataract extraction (ECCE) with implantation of a posterior chamber intraocular lens. Retrobulbar anesthesia was administered by injection of 4 mg lidocaine 2% with adrenalin. In 40 patients 150 I.U. hyaluronidase (Kinetin) was added to the anesthesia. The hyaluronidase group had a significantly lower frequency of iris prolapse, and deeper anterior chamber, both before and after expression of the lens nucleus. Possible mechanisms explaining the beneficial effect of hyaluronidase in extracapsular cataract surgery are discussed.
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PMID:Retrobulbar anesthesia with and without hyaluronidase in extracapsular cataract surgery. A prospective, randomized, double-blind study. 815 55

Ocular trauma is one of the most important preventable causes of visual impairment. The National Eye Trauma System was developed to provide optimal clinical care for severe ocular injuries, to foster research on eye injury, and to increase awareness of ocular trauma as a public health problem. From 1985 through 1991, the National Eye Trauma System Registry collected data on 2,939 cases of penetrating eye injury reported by ophthalmologists at 48 collaborating eye trauma centers in 28 States and Washington, DC. Eighty-three percent of the cases involved men; the median age of the patients was 27 years, ranging from 1 to 92 years of age. Seventy-seven percent of the injuries were unintentional, 22 percent were the result of assault, and 1 percent were self-inflicted. In 62 percent of the cases studied, the injured person's initial best corrected visual acuity in the injured eye was the ability to perceive hand motion, or worse. The settings in which the injuries occurred included the home (28 percent), the worksite (21 percent), at recreation (11 percent), and in transportation (8 percent). At the time of the injury, 1.5 percent of the injured persons were wearing safety glasses and 2.9 percent were wearing nonsafety glasses. There was evidence of definite or possible alcohol use by at least 24 percent of the injured persons and illicit drug use by 8 percent. The most frequent types of tissue damage included corneal or scleral laceration, traumatic cataract, intraocular foreign body, vitreous hemorrhage, and prolapse of intraocular tissue. Analyses of the causes and characteristics of ocular injuries reported to the National Eye Trauma System Registry will help identify high risk settings for such injuries. Results will be used to develop and implement interventions that will reduce the incidence of eye trauma.
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PMID:Characteristics and causes of penetrating eye injuries reported to the National Eye Trauma System Registry, 1985-91. 821 Feb 60

A 12-month period was reviewed to identify the incidence of iris prolapse following cataract surgery, and any predisposing factors. Of 1408 routine manual extracapsular cataract extractions, 29 eyes (2.06%) sustained an iris prolapse. Iris prolapse was commoner in Asian patients and when less experienced surgeons were operating. Twenty-five per cent of cases occurred in patients with obstructive airways disease or post-operative cough. Thirty-four per cent of iris prolapses were identified on the first post-operative day and 86% within 2 weeks. Prolapse probably occurs because of raised intraocular pressure in association with poor wound construction or closure. More emphasis should be given to wound construction and closure during surgical training, with extra diligence when operating on patients likely to cough postoperatively. Clinicians must ensure non-English speaking patients understand about ocular aftercare following cataract surgery.
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PMID:Iris prolapse; who? When? Why? 822 9

The ophthalmologic findings associated with frontonasal dysplasia have not been defined previously in a large series of untreated children. We reviewed the ophthalmic manifestations of a series of patients with frontonasal dysplasia who were seen as part of their craniofacial evaluation. All had undergone a complete ophthalmologic examination before any manipulation of either the orbits or the soft tissues of the orbital contents. From 1986 to 1991, 23 patients with frontonasal dysplasia were seen; ophthalmologic abnormalities were found in 20 (87 percent). Abnormalities included significant refractive errors, strabismus, nystagmus, and eyelid ptosis. Three patients had amblyopia, a treatable cause of visual loss, from strabismus or anisometropia. Ten eyes in seven patients (30 percent) had severe structural anomalies, such as optic nerve hypoplasia, optic nerve colobomas, microphthalmia, cataract, corneal dermoid, or inflammatory retinopathy, that resulted in an acuity of 20/100 or worse. The high incidence of ocular abnormalities indicates that early assessment by an ophthalmologist should be part of the initial evaluation of patients with frontonasal dysplasia to detect treatable visual or ocular problems.
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PMID:Ocular manifestations of frontonasal dysplasia. 827 82


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