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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The potential complications of cataract surgery in the general population are well known. In addition, cataract extraction in the patient with diabetes mellitus is associated with other potential complications common to this disease: neovascular glaucoma and acceleration of proliferative diabetic retinopathy with or without vitreous hemorrhage. We analyzed the records of 154 patients with diabetes mellitus who had undergone standard intracapsular cataract extraction in one eye only with the other eye serving as the unoperated control eye. We were able to determine the status of the diabetic retinopathy before the operation and to note the development of vitreous hemorrhage and rubeosis iridis/neovascular glaucoma after the operation. If either event occurred within six weeks of the surgery, it was considered to be a complication of the cataract extraction. Intracapsular cataract extraction in this diabetic population, without regard of the preoperative status of the retinopathy, was associated with a statistically significant incidence of postoperative rubeosis iridis/neovascular glaucoma (7.8% vs 0%). In patients with preoperative active proliferative diabetic retinopathy, the risk of developing postoperative rubeosis iridis/neovascular glaucoma was even higher (40% vs 0%). There was also a statistically significant incidence of vitreous hemorrhage after surgery in eyes with no diabetic retinopathy or background diabetic retinopathy (6.5% vs 0%). In patients with active proliferative diabetic retinopathy, there was an increased incidence of vitreous hemorrhage after surgery (20% vs 6.5%), but this was not statistically significant due to the small number of patients studied. Possible explanations for these findings are explored and therapeutic and prophylactic measures recommended.
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PMID:Neovascular glaucoma and vitreous hemorrhage following cataract surgery in patients with diabetes mellitus. 619 91

I performed a one-port pars plana vitrectomy during phacoemulsification to manage vitreous loss with and without posterior dislocation of lens fragments in nine consecutive cases. I used a 1 mm vitrectomy instrument with an infusion sleeve for the vitrectomy; the coaxial light of the microscope and an infusion contact lens held on the cornea provided intraocular illumination. Eight of the nine cases achieved a visual acuity equal to or better than 20/25 after a mean follow-up of 5.7 months. One patient's visual acuity was 20/70 because of severe background diabetic retinopathy.
J Cataract Refract Surg 1994 May
PMID:New approach to managing vitreous loss and dislocated lens fragments during phacoemulsification. 806 14

We retrospectively compared the visual acuity and degree of background diabetic retinopathy in 32 consecutive patients with diabetes who had cataract surgery in one eye (study group) and compared them with the visual acuity and degree of diabetic retinopathy in 32 patients with diabetes who had not had cataract surgery (control group) to determine if the retinopathy was asymmetric and worse in the operated-on eye. Twenty-three (72%) of the 32 study patients had asymmetric retinopathy (with the more severe retinopathy in the eye that underwent cataract surgery in each case) compared with three (9%) of the control group (P < .0005). The eyes that had cataract surgery did poorly in terms of visual acuity with no eyes achieving 20/20 or 20/25, only three eyes achieving 20/30 or 20/40, and 16 achieving 20/100 or worse.
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PMID:Severe diabetic retinopathy after cataract surgery. 797 91

To ascertain the ophthalmic complications after heart transplantation, the authors reviewed 59 patients who had been referred to the ophthalmology department during a 4-year period and were subsequently followed for at least 1 year. Twenty-five patients (43%) were found to have lens changes in one or both eyes, which is typical of prolonged oral corticosteroid therapy. In three patients (5.2%) posterior subcapsular cataract formation progressed to a level where cataract surgery was required. In two patients (3.4%) cytomegalovirus retinitis developed within 6 months of the transplantation, and significant irreversible visual loss occurred. Retinal vascular changes were found in 22 patients (37.3%), including 18 patients with hypertensive retinopathy and one patient with background diabetic retinopathy. During the period of observation, a central retinal vein occlusion developed in one patient, an anterior ischemic optic neuropathy developed in one patient, and bilateral occipital lobe infarctions developed in one patient. Older patients and those with a longer survival time after transplantation were more likely to have ophthalmic complications (p = 0.04). Although these results indicate a low incidence of sight-threatening complications after heart transplantation, early referral of patients with visual symptoms is important. Those involved with the care of heart transplant patients should be aware of ocular complications secondary to immune suppression and underlying cardiovascular disease.
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PMID:Ophthalmic complications after heart transplantation. 847 98

India is amidst a demographic transition showing an ageing trend. This will increase non-communicable diseases including diabetes which is already showing an increasing trend. With scanty literature existing on elderly diabetics (> 60 years of age), it was decided to study the clinico-laboratory and complication profile of this group of patients. Fifty consecutive elderly diabetics were studied and evaluated for ECG, chest x-ray, blood sugar, urea, creatinine, lipid profile, proteinuria, motor nerve conduction velocity and autonomic neuropathy. Duration of diabetes varied from one month to 28 years. Fifty-six per cent of the patients presented with classical symptoms of polyuria, polyphagia and polydipsia. Hypertension was present in 40% and cataract in 54% of the patients. Eighteen per cent were obese, 52% had evidence of peripheral neuropathy while 56% had autonomic neuropathy. Background diabetic retinopathy was present in 56%, pre-proliferative retinopathy and maculopathy in 4% each; hypertensive retinopathy in 10% of patients; 44% had microproteinuria and 8% had chronic renal failure. Hypercholesterolaemia was present in 64% and hypertriglyceridaemia in 42% of the patients with 26% having coronary artery disease. Sixty per cent were harbouring infections--20% had foot infections, 14% had tuberculosis and 10% had urinary tract infections. Ninety-two per cent of the patients were aware of their disease but 62% were not aware of the complications and of the need for strict dietary and drug compliance. There was a high prevalence of associated diseases viz, osteoarthritis, cataract, hypertension, hepatitis and parkinsonism. Therefore, this study brings out the need to have a holistic and multidisciplinary approach for management of elderly diabetics who constitute a heterogeneous group with distinct health care problems.
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PMID:Clinical and laboratory profile of diabetes in elderly. 1065 95

A 50 year old man presented to Eye clinic University clinical centre Tuzla with bilateral visual impairment. Clinical examination revealed low visual acuity and keratoconus in both eyes, white cataract in right eye and diabetic retinopathy in left eye. Ultrasonography examination was normal. The patient underwent Trypan blue capsule staining, phacoemulsification and implantation of intraocular lens Alcon AcrySof SN60T9 16 D spherical and 6.0 D cylinder power. Phacoemulsification went uneventful and early postoperative recovery was successful. Visual acuity improved to 0,8 and fundus examination revealed background diabetic retinopathy. Postoperative follow up two years after surgery showed no signs of keratoconus progression and visual acuity maintained the same.
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PMID:Use of the toric intraocular lens for keratoconus treatment. 2482 42