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

29 cases of Endophthalmitis phacoanaphylactica were diagnosed out of a total of 1300 enucleated eyes examined histologically between 1966 and 1974. Clinically the correct diagnosis was made only once. Most frequent misdiagnoses were: phthisis, recurrent iritis, and panophthalmitis. Important factors for a correct clinical diagnosis are: 1. history of injury at least 2-3 weeks previously, 2. a cataract present at the onset of the disease, 3. an endophthalmitis, often associated with extreme i.o. hypotension. Treatment consists of an immediate and total removal of lens material, regardless of the hypotension or of inflammatory signs. The retinal architecture is usually astonishingly well preserved, even in cases with extreme destruction of the anterior segments.
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PMID:[Clinical aspects of "Endophthalmitis phacoanaphylactica" (author's transl)]. 108 Aug 18

Severe iritis which occurs within the first five days after cataract extraction may be categorized as (1) bacterial endophthalmitis, (2) toxic iritis, or (3) aseptic iritis. These entities can sometimes be distinguished because of their clinical features. If bacterial endophthalmitis is suspected, anterior chamber paracentesis should be considered and appropriate antibiotic treatment should be initiated. Acute iritis may result from the introduction of toxic agents into the eye, and may follow the use of products sterilized with ethylene oxide. Early acute aseptic iritis probably occurs more often than has previously been recognized. Response to intensive anti-inflammatory treatment is usually prompt and dramatic. The judicious use of cryoextraction and the careful manipulation of intraocular tissues may minimize the incidence and the severity of postoperative inflammation.
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PMID:Early acute aseptic iritis after cataract extraction. 108 68

A previously healthy 70-year-old white man sustained a plant injury to his left eye while gardening and was admitted here because of an ensuing perforated cornea and endophthalmitis. The lens was opaque and its anterior capsule was ruptured. Culture of fluid obtained by anterior chamber paracentesis yielded a species of the Erwinia herbicolalathyri group (Enterobacter agglomerans). Thirty-seven days after a course of cefazolin and gentamicin therapy, corneal edema necessitated a planned extracapsular cataract extraction. The aqueous humor and lens again revealed the identical Erwinia species in pure culture. The patient received another course of cefazolin and showed improvement after the lens aspiration.
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PMID:Traumatic endophthalmitis caused by an Erwinia species. 108 19

Two days after an unplanned extra-capsular cataract extraction with sector iridectomy, a patient showed typical signs of bacterial endophthalmitis. Vitreous and aqueous were aspirated for culture, and gentamicin and dexamethasone were injected. Twenty-four hours later, after isolation of Staphylococcus epidermidis, a vitrectomy to remove the central vitreous was done. Postoperatively, vision progressively improved; at the last review nine months after vitrectomy, visual acuity was 20/50.
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PMID:Intravitreal antibiotic injection and vitrectomy in acute bacterial endophthalmitis. 108 4

We performed a retrospective study on 45 patients admitted to the Rotterdam Eye Hospital and the Ophthalmic Department of the Academic Medical Center in Amsterdam with pseudophakic endophthalmitis. Vitreous loss during cataract extraction was associated with a significantly increased risk of postoperative endophthalmitis when compared with uncomplicated cataract extraction (p < 0.0001). The incidence of pseudophakic endophthalmitis in diabetic patients was not significantly higher as compared to non-diabetic patients. Vitrectomy in the treatment of postoperative endophthalmitis did not improve the final visual acuity, probably because of selection bias. Methicillin and cephazolin, used intravitreally against gram-positive organisms, failed to provide a good coverage for endophthalmitis due to Staphylococcus epidermidis.
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PMID:Pseudophakic endophthalmitis. 130 14

From 1983 to 1992, 134 patients were treated for clinically suspected endophthalmitis. 61% of this endophthalmitis population consisted of cases that were referred to our clinic. In this nine year period antibiotic treatment was carried out according to three consecutively used guidelines. These three treatment schemes differed in antibiotic spectrum and mode of antibiotic delivery. In 68 patients we performed vitrectomy on account of clinical deterioration under antibiotic treatment. We did not find significant differences in visual outcome between the three treatment groups. The incidence of endophthalmitis following cataract or vitreous surgery did not change throughout the study period. There was however a dramatic decrease in incidence of post-traumatic endophthalmitis following the introduction of a prophylactic antibiotic treatment scheme consisting of fortified gentamicin and cefazolin eyedrops, and intravenously and subconjunctivally administered gentamicin, cefazolin, and clindamycin. In 55 of 68 cases in which vitrectomy was performed in conjunction with intravitreal antibiotics, a vitreous or anterior chamber specimen was cultured. 36 patients had a positive culture result. In the group with positive culture result 42% had better visual acuity in the post-treatment period than before treatment. In the group with a sterile culture result 79% had better vision after treatment.
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PMID:Endophthalmitis: incidence, therapy and visual outcome in the period 1983-1992 in the Rotterdam Eye Hospital. 130 15

A personal series of 10 patients with post surgical bacterial endophthalmitis is reviewed. Clinical signs, risk factors and diagnostic modalities are analysed and compared to other reports in literature. The role of intraocular lens is discussed. While it does not seem to be a risk factor in acute endophthalmitis, it plays a major role in chronic bacterial endophthalmitis. Endophthalmitis remains a rare but serious complication after cataract surgery and prevention modalities, especially using prophylactic antibiotherapy, have still to be evaluated.
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PMID:[Risk of infection after cataract surgery with intraocular implant]. 134 Jan 6

Presented is a case of an acute gonorrhea infection of the eye with disintegration of the cornea which required a nearly immediate operation of corneal transplantation "from limbus to limbus". The patient, aged 17 years was admitted to the hospital showing bilateral acute purulent conjunctivitis and central necrosis of the left cornea with suspicion of endophthalmitis. In spite of a massive pharmacological treatment (together with intravitreal cephazolin) the cornea disintegrated from hour to hour. In atypical conditions, in an eye with acute inflammation a corneal grafting was performed together with cataract extraction and anterior vitrectomy. The grafting was "from limbus to limbus". The visual acuity of the eye with transplantation improved--with correction of +10.0 Dsph up to 1.0 in the period of 3 months.
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PMID:[Disintegration of the cornea requiring total grafting in a case of acute gonorrhea infection]. 134 11

We reviewed data from 47 patients who were treated for endophthalmitis at our hospital during the 11-year period 1980-90. The most common clinical features were hypopyon (75%), diminished vision (72%), ocular pain (68%), discharge (57%), corneal oedema (51%), conjunctival injection (49%), abnormal red reflex (34%), corneal ulcer (32%) and corneal perforation (6%). A total of 54 isolates were obtained from 41 (87%) of the 47 patients. Gram-positive bacteria were more common (72%), than Gram-negative organisms (22%). Two cases were due to fungi, and herpes simplex virus was isolated from one case. The two most common Gram-positive organisms were coagulase-negative staphylococci (25%), and Staphylococcus aureus (11%), while Pseudomonas aeruginosa predominated among the Gram-negative bacteria isolated (15%). Mixed bacterial species were obtained from 29% of the infected patients, including one from whom Vibrio fluvialis was isolated. Predisposing factors included ocular surgery (60%)--mostly for cataract extraction (47%), penetrating trauma (15%) and periocular (15%) or systemic (11%) infections. All patients received antibiotics (generally chloramphenicol and/or a beta-lactamase-stable penicillin plus an aminoglycoside) prior to culture, when treatment was adjusted according to specific aetiological agents. Seventy-nine per cent of patients received topical or systemic steroids. Vitrectomy (diagnostic and therapeutic) was performed on 21% of patients. Sixty-three per cent of culture-positive patients lost vision (no perception of light) in the affected eye, compared to 17% of culture-negative cases (P < 0.05 Fisher exact test). Similarly, a better visual outcome (acuity of 6/12 or better) was associated with coagulase-negative staphylococcal infection than with streptococcal or fungal infections.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Endophthalmitis at the Bristol Eye Hospital: an 11-year review of 47 patients. 136 6

Dacryocystorhinostomy with Jones tube placement has proven to be an effective method for correcting upper-system lacrimal drainage obstruction. The present case report illustrates the potential risk of bacterial contamination of the operative field during subsequent cataract surgery by retrograde passage of airway secretions. Temporary occlusion of the Jones tube by a silicone plug can eliminate this potential source of endophthalmitis. In addition, temporary occlusion of the Jones tube in the office can be used to determine the effectiveness of lacrimal drainage through a reconstructed canalicular system.
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PMID:Postcataract surgery endophthalmitis in a patient with a functioning Jones tube. 139 Apr 29


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