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

We performed either a combined cataract extraction and trabeculectomy or a combined cataract extraction and thermal sclerostomy on 43 eyes. All eyes had chronic open angle glaucoma or chronic angle closure glaucoma, or a combination of the two. In our cataract/trabeculectomy group, 74% had improvement in visual acuity, 91% had normalized intraocular pressure without anti-glaucoma medications, 31% had transient postoperative hyphemas. In our cataract/thermal sclerostomy group, 61% had improvement in visual acuity, 61% had normalization of intraocular pressures without antiglaucoma medications, 17% had transient postoperative hyphemas. We could not correlate any of the complications of surgery with poor intraocular pressure results in either groups. The mechanism for the higher success rate with a combined cataract extraction and trabeculectomy as compared with a combined cataract extraction and thermal sclerostomy was not obvious after analyzing these patients.
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PMID:Combined cataract extraction and thermal sclerostomy versus combined cataract extraction and trabeculectomy. 98 Mar 83

1300 enucleated globes were examined from 1966-1974: Among these 20 eyes (1.5%) revealed a "phacolytic glaucoma" histologically. The clinical diagnosis before enucleation were "secondary glaucoma" or "absolute glaucoma" (19) and once "uveitis dolorosa". "Phakolysis" was considered in only 3 eyes. 15 cases revealed surprisingly well preserved retinal structure - indicating probable good function. The only therapy possible consists of immediate cataract extraction - inspite of high intraocular pressure. Phacolytic glaucoma must be considered in the differential diagnosis of unilateral "acute glaucoma"; also in young patients with traumatic and complicated cataract.
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PMID:[Clinical findings in phakolytic glaucoma (author's transl)]. 117 90

In a series of 3,222 cataract operations where enzymatic zonulolysis with Alphachymotrypsin was employed, the authors describe two complications which are thought to be due to the effects of the enzyme. They are the persistent iridoplegia in 18 cases (0.05) and the filamentary keratitis in 34 patients (1.05%). The clinical picture of an acute enzymatic intraocular pressure increase and the appearance of a persistent iridoplegia are discussed. Furthermore, these complications are brought together in tables and associated with other which are also thought to be caused by Chymotrypsin.
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PMID:[Persistent iridoplegia and filamentary keratitis complications following cataract extraction (author's transl)]. 120 24

In a combined trabeculectomy and cataract extraction procedure on 17 eyes of 16 patients, there was a 50% average decrease in intraocular pressure. Visual acuity improved in 14 eyes, remained unchanged in two eyes, and declined in one eye. The postoperative complications were few and appreciable in only two cases. According to our follow-up findings, the combined technique is no more traumatic than an ordinary cataract extraction.
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PMID:Trabeculectomy combined with cataract extraction. 125 81

This report describes a new combined cataract extraction-glaucoma procedure. The technique is a modification of a standard filtration type of operation. The essential step is the development of a shelved posterior scleral lip, 4 mm of which is excised; full thickness sclera is not removed. This permits tight incisional closure, but with the presence of a "valve" permitting exit of aqueous under a prepared conjunctival flap should intraocular pressure rise significantly in the postoperative period. In 15 cases there were no serious complications, no flat anterior chamber, good pressure control in 14 cases, and filtering blebs in nine.
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PMID:The partial-punch: a new combined cataract-glaucoma operation. 126 19

A 52-year-old Caucasian woman with pigmentary glaucoma underwent a left cyclodiathermy procedure for raised intraocular pressure (IOP) in 1962 and right sclerectomy the following year. Over 25 years later a low IOP was still maintained though pilocarpine was needed in the left eye. After a left cataract extraction with insertion of a posterior chamber lens, field loss had not progressed very much in either eye though the visual acuity was reduced in the more affected eye. Both drainage operation and a cyclodestructive procedure controlled IOP over a long period of time in this patient and were associated with only a very gradual progression of field loss.
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PMID:Preservation of residual field after surgical lowering of intraocular pressure. 129 31

Surgical solutions and drugs are important in ocular surgery. These include irrigating solutions, viscoelastic substances, mydriatics and miotics, and a growing number of other agents designed to enhance intraocular surgery and its outcome. Potential for damage to the corneal endothelium and other tissues is related to the chemical composition, pH, and osmolality of the irrigating solutions that bathe tissues. Quality balanced salt solutions (BSS) are usually safe for use as an intraocular solution in patients with normal corneal endothelium. If prolonged irrigation times are expected, or the patient already has decompensated endothelium, i.e., primary or secondary endotheliopathy, the use of a "complete" BSS solution is indicated to minimize damage. Intraocular sulfite-containing epinephrine may cause severe corneal edema and should be avoided, or if used, be well diluted. Sulfite-free epinephrine solution is now available and does not cause the endothelial toxicity that one may see with sulfite-containing epinephrine solutions. Current formulations of acetylcholine and carbachol used as miotics in surgery have been evaluated in humans and caution is recommended in using acetylcholine solutions intracamerally in patients with already decompensated endothelium. Chondroitin sulfate, hydroxypropyl methylcellulose, and sodium hyaluronate are non-toxic to animal endothelial cells under conditions analogous to cataract extraction in humans but can be toxic to endothelium if there is continued contact with endothelium for hours. Chondroitin sulfate has been shown to have more of a protective effect in mechanical pseudophakos trauma probably because of its cohesiveness and tendency to coat the endothelium. Viscoelastics cause a significant rise in intraocular pressure of > 30 mm Hg in 3-10% of patients. Very high intraocular pressures are often seen postoperatively after viscoelastic use surgically in patients who preoperatively have a history of ocular hypertension or glaucoma.
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PMID:Overview of the corneal toxicity of surgical solutions and drugs: and clinical concepts in corneal edema. 130 90

Twenty-one eyes of 18 patients with uncontrolled glaucoma and intraocular inflammatory disease had glaucoma filtering surgery with postoperative subconjunctival 5-fluorouracil (5-FU). Follow-up for eyes in which intraocular pressure was controlled ranged from 6 to 53 months (mean, 34 months; median, 35 months). Fifteen of 21 eyes (71%) had controlled intraocular pressure (21 mmHg or less). Control was achieved in 9 of 10 (90%) phakic eyes and in 6 of 11 (55%) aphakic or pseudophakic eyes with or without glaucoma medication. Four of six filter failures had a second filtering procedure with 5-FU, and of these four procedures, three were successful. Cataract progression occurred in 9 of 10 phakic eyes, leading to cataract surgery in 7 eyes. Other complications included corneal epithelial defects in 13 eyes, bleb leaks in 3 eyes, choroidal effusions in 13 eyes, 1 choroidal hemorrhage, 1 serous retinal detachment and macular retinal pigment epithelial disturbance associated with hypotony and choroidal effusion. Filtering surgery with postoperative subconjunctival 5-FU can successfully control intraocular pressure in eyes with ocular inflammatory disease.
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PMID:Glaucoma filtering surgery with postoperative 5-fluorouracil in patients with intraocular inflammatory disease. 843 21

The Neodymium (Nd):YAG laser is commonly used in ophthalmology mainly for the posterior capsulotomy in patients with secondary cataract after extracapsular cataract extraction. A frequent side-effect following different kinds of YAG laser treatments is an acute increase in the intraocular pressure (IOP). The present study addresses the role of calcitonin gene-related peptide (CGRP) in the ocular irritative response following YAG laser anterior capsulotomy in rabbits. The YAG laser anterior capsulotomy caused an irritative response in the eye, which consisted of an increase in the IOP, miosis and breakdown of the blood-aqueous barrier. Following YAG laser capsulotomy, CGRP-immunoreactivity was found in the aqueous humour in different molecular weight forms as revealed by gel-permeation chromatography. One of the peaks coeluted with synthetic human CGRP. Methysergide attenuated the increase in the IOP and disruption of the blood-aqueous barrier, but not the miosis, following YAG laser anterior capsulotomy. The present study demonstrates the release of CGRP into the aqueous humour following YAG laser capsulotomy, and suggests that CGRP is partly causing the increase in IOP and disruption of the blood-aqueous barrier in this irritative response.
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PMID:Ocular irritative response to YAG laser capsulotomy in rabbits: release of calcitonin gene-related peptide and effects of methysergide. 132 26

A randomized, masked study measuring postoperative intraocular pressure at 4, 8, and 24 hours, two to seven days, and one month after planned extracapsular cataract extraction with posterior chamber lens implantation was conducted. Seven commonly used ocular hypotensive agents and a control, given at the completion of surgery, were compared: timolol maleate (Timoptic), levobunolol hydrochloride (Betagan), betaxolol hydrochloride (Betoptic), pilocarpine hydrochloride (Pilopine Gel), carbachol (Miostat), apraclonidine hydrochloride (Iopidine), acetazolamide (Diamox). There were significant differences between agents. Miostat was the most effective in controlling postoperative IOP, followed by Timoptic. Diamox, Pilopine Gel, and Betagan were equally effective. Betoptic was somewhat less effective and Iopidine was not significantly better than the control.
J Cataract Refract Surg 1992 Jan
PMID:Comparison of the postoperative intraocular pressure with Betagan, Betoptic, Timoptic, Iopidine, Diamox, Pilopine Gel, and Miostat. 173 53


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