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

Phakoanaphylactic endophthalmitis is a rare but deleterious complication of surgical, traumatic, or spontaneous lens capsule perforation. The authors describe a 79-year-old patient who developed severe endophthalmitis four days after extracapsular cataract extraction and implantation of a posterior chamber lens. The inflammation, which led to phthisis and eventually necessitated enucleation, was characterized by an atypical hypopyon in the form of a conglomerate of fibrin and cellular elements originating at pupillary level. The laboratory workup revealed a chronic lympho-granulomatous inflammation with epitheloid cells and polynuclear giant cells near the lens capsule, confirming the clinical diagnosis of a phakoanaphylactic endophthalmitis. Ten weeks after the cataract extraction a persistent iridocyclitis developed in the fellow eye, which had been free of inflammation up to that point. Hypotonia of the globe, a previous opacification of the first eye, the close chronological relationship with the phakogenic inflammation of the first eye, and clues from the literature suggest a sympathizing phakoanaphylactic endophthalmitis in the fellow eye. Differential diagnosis to rule out other postoperative inflammatory reactions, e.g., bacterial endophthalmitis, toxic lens syndrome, pseudo-phakoanaphylactic endophthalmitis, and sympathetic ophthalmia is described.
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PMID:[Endophthalmitis phakoanaphylactica with anterior uveitis of the partner eye]. 258 2

Sixteen cases of previously reported culture-proven Propionibacterium-associated endophthalmitis after extracapsular cataract extraction (ECCE) are reviewed. The inflammation was observed 2 to 10 months after surgery and occurred after laser posterior capsulotomy in four cases. Clinically, it appeared as a chronic iridocyclitis characterized by granulomatous-appearing keratic precipitates (5 cases), hypopyon (10 cases), and a white plaque on the posterior capsule or intraocular lens (IOL) implant (8 cases). Response to corticosteroid treatment was transient. Surgical intervention was required between 1 and 16 months after the inflammation began and included removal of the IOL and capsular bag via the limbus in 7 cases and pars plana vitrectomy in 11. Intravitreal antibiotics were administered in 12 cases. Postoperative visual acuity ranged from 20/20 to count fingers, with 11 of 16 patients recovering visual acuity of 20/40 or better. Propionibacterium-associated endophthalmitis should be suspected if chronic indolent intraocular inflammation develops after ECCE. Intraocular specimens should be obtained and submitted for aerobic and anaerobic culture and cytologic/histopathologic studies. Based on the clinical courses of these patients, recommendations for management are discussed.
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PMID:Propionibacterium-associated endophthalmitis after extracapsular cataract extraction. Review of reported cases. 278 95

One hundred and seventeen consecutively detected Chinese patients, 100 males and 17 females, with HLA-B27-Positive acute anterior uveitis (AAU) were studied in the uveitis clinic at the National Yang-Ming Medical College and Veterans General Hospital during a 3-year period from January 1984 to December 1986. The ages of onset of uveitis ranged from 8 to 76 years and averaged 38.2, with most of them (63.8%) distributed between 30 and 59 years and a peak incidence in the thirties. Of the 137 uveitis attacks observed during the follow-up, 60.6% manifested as serous iridocyclitis and 39.4% highly fibrinous. Mutton-fat keratic precipitates were never noted. Of the 117 patients, 78 (66.7%) had recurrent uveitis attacks. The average interval between successive attacks was longer than 1.5 years in 50 (64.1%) of the 78 patients. All patients were unilaterally involved in an AAU attack. Of the 78 patients with recurrent uveitis attacks, 25.6% had an ipsilateral eye suffering from uveitis attacks and 74.4% had uveitis attacks involving either eye. In viewing the distribution of AAU attacks, a significant monthly variation was found (p less than 0.0001) with the highest incidence from December to March. Posterior synechiae and cataract were the most common two persistent ocular complications, which were present in 31.4% and 14.3% of the diseased eyes respectively. The visual prognosis was generally good with 90.3% of the diseased eyes having a visual acuity better than 0.5.2+ Among the 117 patients, 75.2% had an association with seronegative spondylarthropathies, which included ankylosing spondylitis (50.4%), probable ankylosing spondylitis (6.8%), Reiter's disease (12.0%), juvenile rheumatoid arthritis (4.3%) and psoriatic arthropathy (1.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical manifestations of HLA-B27-positive acute anterior uveitis in Chinese. 278 86

We noticed a tenfold higher incidence of zonular rupture during planned extracapsular cataract extraction (e.c.c.e.) in patients with exfoliation syndrome compared to patients without this disease. The exfoliation glaucoma is an especially bad precondition for e.c.c.e. The postoperative complication rate (toxic lens syndrome, iridocyclitis) is remarkably high when there is an increased fluorescein leakage of the iris vessels before the operation. Also changes of the vitreous as shown by biomicroscopy or ultrasonography in the case of hazy optical media of the eye are a bad precondition. An intracapsular cataract extraction without lens implantation should be considered in cases of two or more worsening preoperative conditions.
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PMID:Our experiences in planned extracapsular cataract extraction in the exfoliation syndrome. 285 10

A 79-year-old female patient presented with recurrent severe iridocyclitis after extracapsular cataract extraction and implantation of a PMMA posterior chamber lens in 1983: In April, June, July, September, October and December 1984 as well as April and August 1985 and January and April 1987, the uveitis appeared without a hypopyon and was diagnosed as a "toxic lens syndrome". Consequently, IOL explantation followed by anti-inflammatory and - intermittently - immunosuppressive therapy was performed in October 1984 with a resulting improvement in vision. In June 1987, the patient presented with a full-blown bacterial endophthalmitis, which required immediate pars plana vitrectomy. Lens cortex material and capsule residues were removed. Staphylococcus epidermidis was cultured from the vitreous aspirate using enrichment techniques. Antibiotic topical and systemic therapy was performed according to the antibiotic sensitivity test and resulted in a complete cure of the intraocular inflammation.
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PMID:[Pseudo- "toxic lens" syndrome over the course of 4 years caused by staphylococcus epidermidis endophthalmitis]. 318 47

All patients who had cataract surgery at the Schieffelin Leprosy Research and Training Centre, Karigiri, India, between January 1979 and April 1985 were studied to find out the outcome of that surgery. These patients included 291 leprosy cases and 89 nonleprosy cases. Postoperative complications were slightly higher among leprosy patients compared to the nonleprosy cases. Visual recovery was marred by preoperative corneal opacities in some of the leprosy patients. Eyes with chronic insidious type of iridocyclitis did not produce any devastating results postoperatively. Patients whose skin smears were still positive for leprosy bacilli did not show any major complication. All leprosy patients should be offered the benefit of cataract surgery for restoring sight because blindness in leprosy would mean a double handicap if they are already suffering from insensitive, deformed hands and feet.
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PMID:Cataract surgery on leprosy patients. 341 Nov 66

An irregular proteinaceous film populated by sessile macrophages and large giant cells was found on the surface of a posterior chamber lens implant. This had to be removed from a position with its haptics in the capsular bag 8 months after surgery because of increased uveitis. The implant had been placed at the time of extracapsular cataract extraction in a patient with pre-existing active bilateral chronic iridocyclitis of a non-granulomatous type. An anterior chamber lens implant placed after intracapsular cataract extraction in the other eye of the same patient was tolerated, and the same type of implant was used to replace the removed posterior chamber lens implant.
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PMID:Failed PC-IOL implantation in one eye and successful AC-IOL implantation in the other eye in a patient with pre-existing bilateral uveitis. 341 58

We studied six cases of chronic, indolent intraocular inflammation that occurred after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The inflammation was characterized by a delayed onset, and in three cases had the clinical appearance of a granulomatous iridocyclitis. Cultures of intraocular specimens obtained from six eyes yielded Propionibacterium; five yielded P. acnes. Pleomorphic gram-positive bacilli consistent with Propionibacterium were identified in cytologic or histopathologic studies in four of the six culture-positive cases. After surgical and medical therapy, the inflammation resolved. Postoperative Propionibacterium endophthalmitis may masquerade as a chronic iridocyclitis.
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PMID:Chronic Propionibacterium endophthalmitis after extracapsular cataract extraction and intraocular lens implantation. 349 43

Risk factors for significant visual loss were investigated in 51 patients with iridocyclitis associated with juvenile rheumatoid arthritis (JRA). Average follow-up was 12.7 years. Of 89 eyes with uveitis, 22% had visual loss to 20/200 or worse, 46% had cataracts, 30% had band keratopathy, and 27% had glaucoma. Severity of visual loss and complications correlated with the degree of inflammation found on initial ocular examination. Of 58 eyes that were initially normal or had signs of mild inflammation (cells, flare, keratitic precipitates), 3% had final vision of 20/200 or worse, 28% had cataracts, 5% had band keratopathy, and 17% had glaucoma. Of 31 eyes with posterior synechiae on initial examination, 58% had final vision of 20/200 or worse, 81% had cataracts, 77% had band keratopathy, and 45% had glaucoma. When arthritis clearly preceded uveitis, 6% of patients had a poor visual outcome compared to 67% of patients whose initial manifestation of JRA was uveitis. Systemic corticosteroid administration used primarily for arthritis correlated with cataract formation.
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PMID:Prognostic factors in the uveitis of juvenile rheumatoid arthritis. 368 2

RGH-6201 (4-diethylaminoethoxy-alpha-ethyl-benzhydrol) in the first dose-range finding study on rats produced severe, irreversible ophthalmic damage. The underlying mechanism was studied in a series of experiments with daily doses of 50, 100 and 200 mg/kg in rats by gavage. Lenticular damage appeared as a moderate nuclear degeneration during Week 4 of treatment with 50 mg/kg RGH-6201. This could be detected in the isolated eye and in histological examination but not by ophthalmoscopy. Keratitis and iridocyclitis developed about the 2nd week of treatment followed by epithelial proliferation in the lens under the anterior capsule in the higher dose groups. Nuclear and total cataract developed from the 2nd week on in the 200 mg/kg group and from the 3rd week on in the 100 mg/kg group. Further gross pathological changes in the high dose group were characterized by marked hairloss, desquamation in the cardiac region of the stomach and diarrhoea. It has to be emphasized that fine lenticular changes were unrelated to keratitis and iridocyclitis. Since other benzhydrol derivatives such as 2,5-dimethyl-alpha-ethylbenzhydrol and 3-trifluoro-methyl-alpha-ethyl-benzhydrol do not induce similar changes, the diethyl-amino-ethoxy group was assumed to be the toxic part of the molecule. Intravenous studies with equimolar doses of diethyl-aminoethanol revealed no similar symptoms.
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PMID:Analysis of cataract and keratotic damage induced by 4-diethylaminoethoxy-alpha-ethyl-benzhydrol (RGH-6201) in rats. 386 78


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