Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to reduce the incidence of postoperative complications in silicone-filled eyes, many authors recommend that silicone oil should be removed from the eye as soon as a stable retinal situation is achieved. Even in the eyes with completely attached retina and a clinically stable situation there is a risk of retinal redetachment and other complications after silicone oil removal. In a retrospective study we analyzed 324 cases after silicone oil removal regarding the postoperative redetachment rate and risk of complications from this procedure. The indication for primary surgery was retinal detachment with PVR in 167 (51.5%) cases, proliferative diabetic retinopathy in 87 cases (26.8%), complications of penetrating ocular injuries in 48 cases (14.8%), giant tear retinal detachment in 9 cases (2.7%) and retinal detachment with a central hole in 13 cases (4%). At the time of silicone oil removal retina was completely attached in 277 eyes. Local retinal redetachment central to the encircling band existed in 47 eyes at the time of silicone removal. Follow-up time ranged from 6-63 months. Silicone oil removal was combined with a cataract operation in 42 cases (12.9%), penetrating keratoplasty in 9 cases (2.8%) and membrane peeling in 54 eyes (16.7). In the postoperative period the retina detached in 39 (12%) eyes. In the eyes with preoperatively completely attached retinas, redetachment occurred in 23 eyes (8%), whereas in the group of eyes with an unstable preoperative retinal situation, the retina redetached in 16 eyes (34%). The duration of the silicone oil tamponade had no effect on the redetachment rate. In the group of eyes with an unstable preoperative retinal situation, preoperative laser photocoagulation at the cerelage buckle, as well as central to the local detachment, reduced the incidence of redetachment after silicone oil removal significantly (25% vs. 53%). In the group of eyes with a preoperatively stable retinal situation, this effect was not significant. Our results show that in eyes with completely attached retinas, the risk of complications and redetachment after silicone oil removal is relatively low. In selected cases, even in eyes with incompletely attached retinas, silicone oil could be removed. Nevertheless, a relatively high risk of postoperative complications has to be taken into consideration. In eyes with an incompletely attached retina, preoperative laser photocoagulation at the cerclage buckle, as well as central to the local redetachment significantly reduced the incidence of redetachment after silicone oil removal.
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PMID:[Long-term outcome after silicone oil removal]. 875 Sep 94

There has been recent interest in the progression of diabetic retinopathy following extracapsular cataract extraction (ECCE) especially with vitreous loss. It is well known that diabetic retinopathy progresses after intracapsular cataract extraction (ICCE) but was thought to be less common after ECCE. We present 7 patients with symmetrical non-proliferative diabetic retinopathy who underwent ECCE with intraocular lens (IOL) implantation. These patients ranged in age from 56 to 69 years; 2 were insulin-dependent diabetics (IDDM) and 5 non-IDDMs. Rubeosis iridis developed quickly between post-operative outpatient visits despite good diabetic control and a static retinal picture in the fellow eye. Visual loss following the onset of rubeosis was severe, with 3 patients needing cyclocryotherapy and eventually having no perception of light. The rapid onset of rubeosis between post-operative outpatient visits leads us to suggest much shorter periods between reviews than is current practice and the consideration of routine panretinal photocoagulation in the immediate post-operative period in diabetics with worsening retinopathy after ECCE and IOL. Possible causes of the increase in neovascularisation and rubeosis are discussed. The most important message highlighted by these case histories is that the surgery and follow-up of diabetic patients undergoing surgery should be undertaken by an ophthalmologist with an interest in diabetes. Where there is no recognised diabetic retinal specialist in a unit, then early referral to such an ophthalmologist is recommended when complications arise.
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PMID:Progression of diabetic retinopathy and rubeotic glaucoma following cataract surgery. 884 40

The present study proposes itself to display the behaviour of eyes proposed for operation of cataract in case of the existence of diabetes. Therefore on a lot of 868 operated eyes for cataract using the EEC +/- IOL method has been found that 28 eyes of having diabetes required antidiabetic treatment. From these, 9 didn't present diabetic retinopathy, 15 had diabetic background retinopathy and 4 presented proliferative diabetic retinopathy without rubeosis iridis or neovascular glaucoma. From these, 9 were operated through EEC and 19 through EEC +/- IOL. The intra- and postoperative complications were more frequent at the patients having diabetes. There weren't marked differences regarding the implant of the artificial crystalline. The operation of cataract brings to the appearance or to the increasing of the gravity of ocular phenomena of the diabetes. Thus, the diabetes retinopathy grows progressively worse after the surgical intervention, inflammatory phenomena of the anterior segment of the eye are more frequent, endophthalmitis appears more frequently due to the low immunity of the sufferings of diabetes. The method to be elected for solving the cataract of the sufferings with diabetes mellitus remains EEC +/- IOL.
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PMID:[Diabetes and extracapsular extraction of the crystalline lens]. 896 69

We evaluated visual prognosis in 50 eyes of 47 patients which underwent successful vitrectomy for proliferative diabetic retinopathy and were followed for more than five years. It was found that the latest visual acuity was worse than the best visual acuity by more than three lines after vitrectomy in 14 eyes (28%) except for the eyes with decreased vision due to cataract. The causes of decrease in visual acuity were optic atrophy in seven eyes, macular degeneration in five eyes, branch retinal vein occlusion in one eye, and submacular hemorrhage in one eye. Risk factors for postoperative decrease in visual acuity were thought to be preoperative macular detachment, subretinal proliferation, and postoperative high intraocular pressure. Therefore, even after successful vitrectomy, there is some risk that the best postoperative visual acuity may deteriorate in cases with severe preoperative retinopathy with these risk factors. This finding suggests that the vitrectomy should be performed before the development of these risk factors for the maintenance of good postoperative visual acuity.
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PMID:[Long-term visual prognosis after successful vitrectomy for proliferative diabetic retinopathy]. 948 73

Lens capsules become fibrotic after the extraction of a cataract. To understand this phenomenon, we evaluated the immunolocalization of prolyl 4-hydroxylase (an enzyme involved in procollagen hydroxylation), and extracellular matrix components and cytoskeletal components in a normal human lens capsule and in others with intraocular lenses. Lens capsules containing intraocular lenses were removed from a patient with proliferative vitreoretinopathy and three with proliferative diabetic retinopathy during vitreous surgery. Two circular sections of the anterior capsules with lens epithelial cells were obtained by anterior capsulotomy during cataract surgery. In addition, a lens capsular bag was obtained immediately after phacoemulsification. The lens capsules were processed for light microscopic immunohistochemical detection of the alpha and beta subunits of prolyl 4-hydroxylase, extracellular matrix components (including collagen types, laminin and cellular fibronectin) or cytoskeletal components (such as cytokeratin, vimentin and alpha-smooth muscle actin). Monolayer lens epithelial cells were seen on the inner surface of the normal anterior capsules. Each intraocular lens was found to be fixed in the capsular bag. Light microscopic immunohistochemistry showed that these proliferating cells expressed vimentin and alpha-smooth muscle actin; in contrast, quiescent lens epithelial cells did not stain for alpha-smooth muscle actin. Marked immunostaining for subunits of prolyl 4-hydroxylase was detected in lens epithelial cells proliferating on the capsules, while no or only faint prolyl 4-hydroxylase immunoreactivity was detected in quiescent lens epithelial cells immediately after phacoemulsification. Collagen types I, III and VI and cellular fibronectin were observed diffusely in accumulated connective tissue on a capsule with an intraocular lens. Type IV collagen immunoreactivity was seen both in the capsules and in the connective tissue accumulation on the capsules. Collagen V and laminin were detected in association with cellular proliferation. Collagen VII and VIII and laminin 5 were not seen. We concluded that during wound healing of the lens capsule after cataract extraction, the lens epithelial cells that proliferate on the inner surface of the capsule transform it into a myofibroblastic phenotype, expressing prolyl 4-hydroxylase and alpha-smooth muscle actin. These proliferating cells are involved in the production of collagen on the lens capsule. This results in a postoperative fibrotic process and contraction of the lens capsule.
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PMID:Immunolocalization of prolyl 4-hydroxylase subunits, alpha-smooth muscle actin, and extracellular matrix components in human lens capsules with lens implants. 953 56

At the University Eye Clinic Bratislava we performed a retrospective study on the occurrence of endophthalmitis after lens operations. Over the years 1993-1995 we performed 2374 lens operations. Endophthalmitis occurred in 20 eyes (0.84%). Endophthalmitis occurred after uncomplicated as well as after surgical procedures with various perioperative complications. All patients were treated with antibiotics locally and parenterally. Nine patients were treated with steroids. In these patients we did not performed pars plana vitrectomy. Owing to endophthalmitis one eye was eviscerated. In one eye after previous vitrectomy for proliferative diabetic retinopathy developed later inoperable retinal detachment. In one eye was present an old retinal detachment before the cosmetic cataract extraction was performed. Without any complications were cured nine eyes. In eight eyes are remained iris synechiae and vitreous opacities. Two eyes lost light perception and one eye was without light perception already before cataract extraction. The final visual acuity was better than 2/60 in 70% of the eyes and better than 6/36 in 50% of the eyes.
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PMID:[Endophthalmitis after lens surgery]. 972 75

Lens capsules become fibrotic after cataract extraction. A variety of extracellular matrix (ECM) components accumulate on these capsules in association with the proliferation of lens epithelial cells. To provide a better understanding of the process of capsular fibrosis, we assessed the types of proteoglycans (PG) in human lens capsules with intraocular lenses (IOL). Lens capsules containing IOLs were removed from 1 patient with proliferative vitreoretinopathy and 1 patient with proliferative diabetic retinopathy. After treatment with chondroitinase ABC, tissue sections were processed for immunohistochemical detection of the proteoglycans including chondroitin, large PG, chondroitin 4-sulfate PG, chondroitin 6-sulfate PG, dermatan sulfate PG, and keratan sulfate PG. Extracellular matrix was found on the inner surface of the capsular bag. In association with what appeared to be proliferating lens epithelial cells, each of the six types of PG was present in the ECM on the capsules. All six types of PG might be involved in the fibrosis and opacification of lens capsules after extraction of the cataract and implantation of the IOL.
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PMID:Immunohistochemical identification of proteoglycan types in fibrotic human capsules with intraocular lens implants. 982 64

In the past three decades, a great improvement has occurred in microsurgical techniques used in the management of various eye diseases involving retina and vitreous. Advances in instrumentation has made the surgery easier and refined. The instruments used are narrated widely in this article. Various vitreous substitutes have been developed and are required in vitreoretinal surgery. These are gases, silicone oil, perfluorocarbon liquids and fluorosilicone oil. Anterior segment indications for vitreous surgery are: Vitreous loss during cataract surgery, thick after cataracts that can't be managed with Nd: YAG capsulotomy, vitreocorneal touch, updrawn pupils, incarcerated vitreous in the wound causing cystoid macular oedema, malignant glaucoma, penetrating keratoplasty in aphakic patients, congenital cataracts and filtering procedures in aphakic eyes. In posterior segment indications, vitrectomy is useful in penetrating trauma, haemorrhage, retinal deetachment, intra-ocular foreign bodies and infection endophthalmitis Macular surgery involves peeling of epimacular membrane or proliferation, treating vitreomacular traction syndrome, idiopathic macular holes, retinal detachment associated with optic pit, evacuation of submacular haemorrhage and excision of choroidal neovascular membranes. Available options to treat retinal detachments are pneumatic retinopexy, scleral buckling and vitreous surgery. Proliferative vitreoretinopathy remains the important cause of failure and occurs in about 8-10% cases after retinal detachment. Vitreous surgery for ocular trauma, vitrectomy for proliferative diabetic retinopathy, macular hole surgery, submacular surgery are also discussed in detail.
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PMID:Recent developments in vitreoretinal surgery. 1139 74

Diabetic retinopathy remains a major cause of blindness and vision loss in France. Around 2% of diabetic patients become legally blind and 10% have a severe visual handicap. Systematic screening, careful follow-up and treatment of diabetic retinopathy should allow to avoid severe ocular complications. ETDRS (Early Treatment Diabetic Retinopathy Study) brought major information concerning the natural history of diabetic retinopathy and allowed to establish a convenient classification. Laser photocoagulation improves the prognosis of proliferative diabetic retinopathy, and decreases the rate of vision loss due to macular oedema. Diabetic retinopathy may worsen after cataract extraction; therefore close ophthalmological follow-up after surgery is necessary. It has not been proven that glaucoma is more frequent in diabetic patients than in the general population.
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PMID:[Ocular complications in diabetes: towards standardizing screening and care]. 1179 21

Though several studies have shown that the biochemical function of nitric oxide (NO) in the eye might play an important role in the regulation of intraocular pressure (IOP), local control of ocular blood flow and loss of retinal ganglion cells by apoptosis, it is unclear whether the role of NO is similar in the pathogenesis of different kinds of glaucoma: primary open-angle glaucoma (POAG), chronic closed-angle glaucoma (CCAG) and neovascular glaucoma (NVG). To further explore this issue, we measured the concentrations of NO in aqueous humor and plasma samples from patients with POAG (n = 31), CCAG (n = 76), NVG (n = 8) and cataract (n = 30). All of the NVG patients suffered from severe proliferative diabetic retinopathy, while other patients were free of any other systemic disease. The NO levels in both aqueous humor and plasma samples were assessed by chemiluminescence assay. We found that the NO levels in aqueous humor samples were greatly varied in patients with POAG (36.2 +/- 3.3 microM), CCAG (47.7 +/- 3.4 microM) and NVG (65.8 +/- 5.4 microM), and all of them were significantly higher than in cataract patients (27.0 +/- 2.9 microM p < 0.05). Except NVG patients whose NO levels in plasma samples were highest (24.1 +/- 3.5 microM) among all groups, the plasma NO levels were not significantly different between the other glaucoma patients and the cataract patients. We therefore concluded that significant variation of the elevated NO levels in aqueous humor samples from the patients with different types of glaucoma may reflect their differences in the pathogenesis.
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PMID:Significant variation of the elevated nitric oxide levels in aqueous humor from patients with different types of glaucoma. 1242 1


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