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

The authors analysed and compared three groups of patients who had undergone surgery. In the first group of 72 patients with diabetes and cataract, intraocular lens implantation was carried out. In the second group of 96 patients with diabetes and cataract, cataract surgery was not followed by intraocular lens implantation. The third group of 100 nondiabetic patients, selected by random choice, had intraocular lens implanted after the cataract surgery. Retinal status, postoperative complications and visual acuity were the parameters analysed in correlation with the intraocular lens implantation. In the authors' opinion, the prognosis following cataract surgery and intraocular lens implantation in diabetic patients is good, if diabetic complications do not occur, particularly retinopathy and vitreal hemorrhage which impair the vision considerably. Intraocular lens can be implanted even in cases of maculopathy and preproliferative diabetic retinopathy, provided a thorough diagnostic evaluation has been performed (echography, fluorescein angiography). Laser photocoagulation procedure should also be carried out before surgery and repeated as long as the transparence of the lens enables it. The treatment should be resumed two weeks after the cataract surgery and intraocular lens implantation at the latest. Intraocular lens implantation is contraindicated in proliferative diabetic retinopathy, and especially iridal rubeosis, as the risk of neovascular glaucoma development is considerable.
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PMID:[Implantation of intraocular lenses in patients with diabetes]. 203 42

Combined extracapsular cataract extraction, pars plana vitrectomy, and posterior chamber intraocular lens implantation was performed in six eyes with proliferative diabetic retinopathy. These eyes all had minimal iris vascular changes and were at reasonably low risk for developing intraoperative and postoperative complications. The surgery must be relatively brief and the endophotocoagulation accurate. Initial visual acuities ranged from light perception to 4/200. With an average follow-up of 9.7 months, final acuities ranged from 4/200 to 20/40.
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PMID:Combined vitrectomy, cataract extraction, and posterior chamber intraocular lens implantation in diabetic patients. 203 77

We report on our results of transscleral Nd-YAG-cyclophotocoagulation on 27 eyes with refractory glaucoma. Cyclophotocoagulation was performed with similar parameters according to our findings of morphological investigation in normal human donor eyes. 9 eyes had hemorrhagic glaucoma, 10 eyes had secondary glaucoma after intraocular silicone oil tamponade because of proliferative diabetic retinopathy or because of complicated retinal detachment with proliferative vitreoretinopathy. None of the patients in this group had silicone oil in the anterior chamber, silicone oil emulsification and only one eye had rubeosis iridis. The third group of 8 eyes had glaucoma with aniridia, post-traumatic or postinflammatory glaucoma, glaucoma after extraction of a congenital cataract and one eye with an absolute painful pseudoexfoliation glaucoma. The effects were applied coaxially through the conjunctiva at 1 to 1.5 mm distance from the limbus. The energy was between 3.8 and 4.2 Joules, the exposure time was 10 ms. The focus of the laser beam was placed 3.6 mm posteriorly with a focus adjustment of 9 at the LASAG Microruptur 2. The mean postoperative observation period was 7.5 months. Among the group of hemorrhagic glaucomas the intraocular pressure could in 78% be lowered below 22 mmHg, in 60% among the secondary glaucomas after intraocular silicone oil application and in 50% among the heterogenous third group. In eyes with preceding cyclocryocoagulation 82% fulfilled this criterion. The intraocular pressure stayed stable after 4 weeks at a mean level of 40% below the preoperative values. In all cases the intraocular pressure was at least lowered by 14 mmHg. Vision was reduced in three eyes by the underlying disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical use and results of trans-scleral Nd-YAG cyclophotocoagulation in therapy-refractory glaucoma]. 205 34

The authors analyze the results of treatment of 30 eyes of 28 patients suffering from various forms of diabetes mellitus for 1 to 15 years; no cases with neovascularization or proliferative diabetic retinopathy were included in the study. Extracapsular cataract extraction with intraocular lens (IOL) intracapsular implantation was carried out according to the method developed by B. N. Alexeyev. Polymethylmethacrylate lens with a 5 mm diameter of the optic section with polymethylmethacrylate supporting elements was implanted into the capsular sac. In 4 cases lenses with 7 mm optic section diameter and with polypropylene supporting arches were implanted. IOLs were implanted in both eyes to 2 patients. The methods of examination included visometry, biomicroscopy, measurements of the blood sugar before and after surgery, tonometry, tonography, echography, ophthalmometry, gonioscopy, fluorescent angiography. The findings permit a conclusion that IOL intracapsular implantation to diabetics was effective in all 30 cases analyzed. High visual acuity was achieved in more than 80 percent of patients. No grave complications of the ocular or general condition due to diabetes mellitus were recorded. Therefore IOL intracapsular implantation is safe and possible in type I and II diabetes mellitus patients.
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PMID:[Intracapsular implantation of intraocular lenses in patients with diabetes mellitus]. 207 49

We evaluated the use of a heavier-than-water fluorinated silicone oil in the treatment of 30 selected cases of complicated retinal detachment from January 1988 to July 1989. Proliferative vitreoretinopathy grade C-2 or greater accounted for 19 cases, proliferative diabetic retinopathy with traction detachment for two cases, giant retinal tears five, ruptured globe with retinal detachment two, massive choroidal effusion with retinal detachment one, and acute retinal necrosis with retinal detachment one. Initial retinal reattachment was achieved in all cases. Complications included redetachment seven (23%), cataract six (75% of phakic patients), raised intraocular pressure four (13%), hypotony four (13%), keratopathy three (10%), uveitis-synechia formation three (10%), phthisis two (3%), choroidal haemorrhage one (3%), and vitreous haemorrhage one (3%). Postoperative visual acuities with at least six months' follow-up range from no light perception to 20/50, with seven patients (23%) 20/400 or better.
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PMID:Fluorosilicone oil in the treatment of retinal detachment. 222 98

A consecutive series of 100 vitrectomies for tractional retinal detachment involving the macula in proliferative diabetic retinopathy was analyzed to determine the influence of preoperative iris rubeosis (NVI) and active neovascularization at the fundus (NVF) on surgical results. The minimum follow-up was 12 months. Preoperatively, iris rubeosis was present in 52% and active neovascularization at the fundus in 85%. Surgery was performed under Spitznas wide-angle observation, using a stereoscopic diagonal inverter, either with the panfundoscope or binocular ophthalmoscopy through the operating microscope. Most of the eyes were phakic (94%). No lensectomy was performed. Anatomical success was achieved in 81%, ambulatory vision in 77%. Anatomical success was reduced to 63% in cases with preoperative NVI and to 78% in cases with preoperative NVF. Including 5 cases of re-vitrectomy, silicone oil was used for internal tamponade in 9%, SF 6/air 50:50 in 39% and air in 26%. In 26%, no internal tamponade was applied. Postoperative complications consisted of vitreous hemorrhage (25%), increased rubeosis (22%), neovascular glaucoma (2%), and redetachment (7%). The final causes of failure in 19% of eyes were: neovascular glaucoma (1%), rubeosis/hypotony/cataract (14%), and phthisis bulbi (4%).
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PMID:Factors influencing the results of vitreous surgery in diabetic retinopathy. I. Iris rubeosis and/or active neovascularization at the fundus. 246 37

One hundred eyes of 95 patients were operated with vitrectomy and silicone oil injection. The patients were divided into 3 groups: Penetrating trauma (PT)-22 eyes, proliferative diabetic retinopathy (PDR)-14 eyes, and proliferative vitreoretinopathy (PVR)-64 eyes. All of the eyes had retinal detachment including the macula. Final attachment of the retina was achieved in 40% of PT, 50% of PDR, and 60% of PVR. Improvement of visual acuity following the operation was noted in 54% of PT, 43% of PDR, and 67% of PDR. Postoperative complications included band keratopathy, elevation of IOP, hypotony, and cataract. Neovascularization of the iris, either preoperative or postoperative, is associated with very poor prognosis.
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PMID:Management of complicated retinal detachment by vitrectomy and silicone oil injection. 247 41

The authors describe the technique of extracapsular cataract extraction and posterior chamber lens implantation in conjunction with pars plana vitrectomy. In persons with the sequelae of proliferative diabetic retinopathy and retinal branch vein obstruction, as well as those with rhegmatogenous retinal detachment, the procedure enables visual rehabilitation with one operation and seemingly no increase in morbidity.
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PMID:Combined extracapsular cataract extraction, posterior chamber lens implantation and pars plana vitrectomy. 263 3

Combined cataract removal, posterior chamber intraocular lens (PC IOL) implantation, and pars plana vitrectomy were performed in 15 diabetic patients who presented with coexisting cataract and vitreoretinal complications from proliferative diabetic retinopathy (PDR). Posterior chamber IOLs were placed anterior to the anterior lens capsule after pars plana lensectomy and vitrectomy in nine eyes, whereas extracapsular cataract extraction (ECCE) with PC IOL placement was performed before vitrectomy in six eyes. Panretinal laser endophotocoagulation was applied in 13 of the 15 eyes as an important part of the operative procedure. Because of inactive diabetic retinopathy or satisfactory preoperative panretinal photocoagulation, 2 of the 15 eyes did not receive laser endophotocoagulation. Visual acuity was improved in 12 eyes and was similar to preoperative vision in 3 eyes. After a minimum of 6 months and a maximum of 28 months of follow-up, the visual results are the following: 20/40 or better (4 eyes), 20/50 to 20/200 (5 eyes), 20/400 to 5/200 (5 eyes), and hand motions (1 eye). Although 5 of the 15 eyes required secondary vitreoretinal procedures, neovascular glaucoma and complications attributable to the IOL did not occur. A recurrent postoperative retinal detachment (RD) developed with subsequent hypotony and rubeosis iridis in 1 of the 15 eyes.
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PMID:Posterior chamber intraocular lens implantation during diabetic pars plana vitrectomy. 261 53

A phacoemulsification procedure, combined with an "in-the-bag" lens implantation, was performed on ten eyes that once had proliferative diabetic retinopathy (PDR). The ten eyes were in eight patients who had a 20-plus year history of either type I or type II diabetes mellitus. All eyes had reached the "quiescent" state of diabetic retinopathy 2-13 years before the cataract surgery through either argon laser pan retinal photocoagulation and/or pars plana vitrectomy. Nine of ten eyes remained completely free of retinal neovascularization and rubeosis iridis, with follow-up periods between 1.5 and 5 years. One eye has been lost to recurrent vitreous hemorrhages and an inoperable retinal detachment.
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PMID:Phacoemulsification and implantation of posterior chamber intraocular lens in eyes with quiescent proliferative diabetic retinopathy. 365 17


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