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

We describe a triple procedure combining corneal transplantation, cataract extraction, and intraocular lens implantation in which the continuous curvilinear capsulorhexis (CCC) is performed in a closed system when corneal transparency is sufficient or using an open-sky method when corneal transparency is poor. With the closed system, the CCC is performed first followed by trephination and hydroexpulsion of the nucleus. A Caporossi coaxial forceps is used to reduce the corneal incision to 1.2 mm, preventing the need for sutures. Tunnel formation, which could limit the size of trephination, is avoided. In addition, endothelial cell loss at the periphery of the recipient cornea is reduced. This technique was performed in 10 eyes without intraoperative complications. With the open-sky method, the CCC is created while counterpressure is applied to the center of the lens with a large spatula, reducing posterior pressure and thus the risk of capsule tear. This technique was performed in 9 eyes without intraoperative complications.
J Cataract Refract Surg 2001 Jul
PMID:Closed-system and open-sky capsulorhexis for combined cataract extraction and corneal transplantation. 1148 65

Performing phacoemulsification during a triple corneal procedure has many advantages. Operating in a closed chamber makes surgery easier and safer. In some cases, however, a dense corneal opacity may prevent closed-chamber surgery, necessitating the use of an open-sky technique. In these cases, a temporary corneal graft using a corneal button not suitable for penetrating keratoplasty is proposed to allow phacoemulsification and foldable intraocular lens implantation through a corneal tunnel. The temporary corneal graft is replaced with a permanent graft after these steps are completed. This technique was effective in 3 patients with cataract and dense corneal opacity.
J Cataract Refract Surg 2001 Aug
PMID:Temporary graft for closed-system cataract surgery during corneal triple procedures. 1152 86

We report a technique in which penetrating keratoplasty is performed in conjunction with open-sky pupilloplasty in a phakic patient. The technique was used in a 27-year-old man with poor vision and severe light sensitivity in the left eye dating back to an episode of presumed herpes simplex keratouveitis 13 years previously. Examination showed a best corrected visual acuity of 20/40, a paracentral midstromal corneal scar, a fixed dilated pupil, and a clear lens. Postoperatively, the pupil was relatively round with a diameter of approximately 4.0 mm, the cosmetic result was favorable, the photophobia had resolved, and the lens and corneal transplant were clear.
J Cataract Refract Surg 2002 Mar
PMID:Open-sky pupilloplasty during phakic penetrating keratoplasty to treat a fixed, dilated pupil. 1245 45

The geographical variations in the incidence of age-related ocular changes such as presbyopia and cataracts and diseases such as pterygium and droplet keratopathies have led to theories pointing to sunlight, ultraviolet radiation (UVR) exposure and ambient temperature as potential etiological factors. Some epidemiological evidence also points to an association of age-related macular degeneration to sunlight exposure. The actual distribution of sunlight exposure and the determination of temperature variations of different tissues within the anterior segment of the eye are difficult to assess. Of greatest importance are the geometrical factors that influence selective UVR exposures to different segments of the lens, cornea and retina. Studies show that the temperature of the lens and cornea varies by several degrees depending upon climate, and that the incidence of nuclear cataract incidence is greater in areas of higher ambient temperature (i.e., in the tropics). Likewise, sunlight exposure to local areas of the cornea, lens and retina varies greatly in different environments. However, epidemiological studies of the influence of environmental UVR in the development of cataract, pterygium, droplet keratopathies and age-related macular degeneration have produced surprisingly inconsistent findings. The lack of consistent results is seen to be due largely to either incomplete or erroneous estimates of outdoor UV exposure dose. Geometrical factors dominate the determination of UVR exposure of the eye. The degree of lid opening limits ocular exposure to rays entering at angles near the horizon. Clouds redistribute overhead UVR to the horizon sky. Mountains, trees and building shield the eye from direct sky exposure. Most ground surfaces reflect little UVR. The result is that highest UVR exposure occurs during light overcast where the horizon is visible and ground surface reflection is high. By contrast, exposure in a high mountain valley (lower ambient temperature) with green foliage results in a much lower ocular dose. Other findings of these studies show that retinal exposure to light and UVR in daylight occurs largely in the superior retina.
 ...
PMID:Geometrical gradients in the distribution of temperature and absorbed ultraviolet radiation in ocular tissues. 1206 Dec 78

Corneal diseases subject to keratoplasty are often combined with a certain degree of cataract. Therefore, appropriate strategies for the management of cataract are mandatory. One strategy is a sequential procedure performing cataract surgery after keratoplasty. Though this procedure enables us to estimate IOL power accurately, there are several drawbacks including multiple procedures, slow visual rehabilitation and endothelial damage during cataract surgery. On the other hand, triple procedure, consisting of penetrating keratoplasty, extracapsular lens extraction and IOL implantation, has several advantages, such as single procedure, rapid visual rehabilitation and no additional endothelial trauma. How-ever, open sky procedure may be accompanied by uncontrollable vitreous pressure followed by posterior capsule rupture and difficulty of IOL implantation, while the worst outcome may be expulsive hemorrhage. Combined core vitrectomy preceding corneal trephination is contrived to solve this problem. This procedure is simply performed from a single sclerotomy 3.5-4.01 mm posterior to the corneal limbus with a vitreous cutter under the external pressure to the eye, and vitreous pressure is sufficiently lowered to allow the following procedures to be done very safely. Another problem with triple procedure is the calculation of IOL power. This problem is caused by unpredictable keratometer readings after keratoplasty. Several methods for calculating IOL power in triple procedure are also discussed.
 ...
PMID:Corneal triple procedure. 1551 28

The purpose of the present study was to design and test a new soft contact lens with 2 holes for improvement of both visibility and the rate of lens cortex aspiration during cataract surgery using the penetrating keratoplasty triple procedure. Two groups of 9 age-matched patients underwent the penetrating keratoplasty triple procedure with or without the newly designed contact lens. The use of the new soft contact lens reduced the time required for irrigation and aspiration of the lens cortex from 183.8 +/- 92.2 to 121.2 +/- 27.9 seconds (P<.05); the total operative and open-sky times also significantly decreased. In addition, use of the lens greatly improved visibility of the surgical field during cataract extraction. The newly designed soft contact lens thus improves management of the lens cortex during the penetrating keratoplasty triple procedure.
 ...
PMID:Modification of a soft contact lens for use during irrigation and aspiration in the penetrating keratoplasty triple procedure. 1660 83

We report a surgical technique for managing bullous keratopathy secondary to anterior chamber intraocular lens (AC IOL). The technique comprises femtosecond laser-assisted penetrating keratoplasty and AC IOL exchange with fibrin glue-assisted sutureless posterior chamber intraocular lens (PC IOL) implantation ("glued IOL"). This new triple procedure combines the unique benefits of the femtosecond laser and the glued IOL, leading to stable wound configuration, decreased open-sky time, and less pseudophacodonesis, and there is less risk for the suture-related complications of transscleral suture fixation.
J Cataract Refract Surg 2009 Jun
PMID:Femtosecond-assisted keratoplasty with fibrin glue-assisted sutureless posterior chamber lens implantation: new triple procedure. 1946 79

The authors report using double-needle cataract extraction in the course of triple surgery and describe the usefulness of a double-needle technique. Before penetrating preparation of the recipient cornea, two straight double-arm 10-0 Prolene needles (Ethicon, Edinburgh, Scotland) were inserted in parallel on the recipient corneal bed transcorneally immediately anterior to the iris. The use of two needles stabilized the iris plane and offset positive vitreous pressure during triple surgery, continuous curvilinear capsulorrhexis, phacoemulsification, irrigation, and aspiration, allowing the safe implantation of an intraocular lens in the bag in an open-sky state. There were no procedural difficulties and no complications. This simple technique using double needles in triple surgery can be used effectively and may prevent forward movement of the lens-iris diaphragm, anterior capsular tearing, and rapid expulsion of the lens caused by positive vitreous pressure in the open-sky state.
 ...
PMID:The usefulness of the "double-needle" technique for combined cataract extraction and corneal transplantation. 2115 76

Corneal pathologies leading to keratoplasty are often associated with cataract and combined surgery is therefore mandatory. Triple procedure with penetrating keratoplasty and concurrent cataract extraction followed by intra ocular lens (IOL) implantation is usually the preferential choice because visual rehabilitation is theoretically more rapid. Surgeons have to be aware of surgical conditions during open-sky surgery because vitreous pressure is not counterbalanced by anterior chamber pressure. Today, many surgeons prefer non-simultaneous procedures with cataract surgery performed months after grafting because of the improvement in spherical refractive error. More recently, new triple procedures, Descemet's stripping automated keratoplasty and concurrent cataract surgery have gained popularity, especially in patients with Fuchs dystrophy associated with cataract. Surgery starts with phacoemulsification, followed by endothelium exchange through a 3 to 5 mm incision. Advantages against classic triple procedure are quick visual rehabilitation, fewer induced refractive errors, minimal postoperative discomfort and corneal integrity. Surgeons have to consider an eventual postoperative hyperopic shift secondary to corneal lenticule shape when choosing adequate intraocular lens.
 ...
PMID:[Keratoplasty combined with cataract surgery]. 2292 Oct 23

The authors describe "iris-assisted," open-sky, continuous curvilinear capsulorhexis (CCC) in a triple procedure combining corneal transplantation, cataract extraction, and intraocular lens implantation. They do not use miotics or mydriatics. Patients receive oral acetazolamide (250 mg), intravenous mannitol (5 mL/kg), and Honan balloon at 30 mm Hg for 20 to 30 minutes before surgery. After trephination and excision of recipient cornea, the pupil assumes a mid-dilated position. After injection of 2.3% hyaluronic acid into the anterior chamber, a central linear incision is made in the anterior capsule using a cystotome needle and a CCC is made (approximately 5.5 mm) along the pupillary margin with CCC forceps. The mid-dilated iris can "assist" by resisting posterior pressure to reduce the risk of capsular extension. The nucleus passes through the capsulorhexis following hydrodissection. The keratoplasty is completed followed by cortex removal and in-the-bag intraocular lens implantation, which are facilitated by the CCC in a closed system.
 ...
PMID:"Iris-assisted," open-sky, continuous curvilinear capsulorhexis technique for combined cataract extraction and corneal transplantation. 2335 21


<< Previous 1 2 3 Next >>