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

The effects of i.m. alfentanil and midazolam on anxiety, sedation, hemodynamics, oxygen saturation and intraocular pressure were studied in 90 patients scheduled for outpatient cataract surgery with regional anesthesia. The study was randomized, double-blind, placebo-controlled, and performed on outpatients with ASA physical status I-III and mean age 67.7 +/- 11.7 years. Alfentanil (12.5 micrograms/kg) administered into the deltoid muscle had a marked anxiolytic and short sedative effect, and was associated with stable hemodynamics. Midazolam (20 micrograms/kg) administered similarly had a more prolonged anxiolytic and sedative effect, which impaired co-operation in some patients during surgery. The regional blockade was associated with a significant reduction of oxygen saturation (SpO2), regardless of the premedication used (P less than 0.05). A slight reduction of intraocular pressure (IOP) was found after premedication, but the change was not statistically significant. We conclude that i.m. alfentanil is well tolerated, and its anxiolytic and short sedative effects make it especially suitable as premedication for day-case cataract surgery.
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PMID:Premedication for outpatient cataract surgery: a comparative study of intramuscular alfentanil, midazolam and placebo. 151 42

We describe a method for continuous control of intraocular pressure in pseudophakic retinal detachment surgery done shortly after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The system consists of a special needle inserted into the anterior chamber through the corneal limbus. The needle is attached by a regular intravenous administration set to an infusion bag. This allows fluids to exit the eye when the eyeball is compressed and to return to the eye when pressure on the eye is released. The presence of an intact posterior capsule and an intraocular lens do not impose a significant barrier to the passage of fluids between the anterior chamber and the vitreous cavity. Using this technique, intraocular pressure can be stabilized throughout the operation. The implementation of this system is demonstrated by a case report.
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PMID:Continuous control of intraocular pressure in pseudophakic retinal detachment surgery. 151 42

The one significant complication of viscoelastic materials is that they may cause postoperative intraocular pressure rise. We investigated the rate and ease of removal of various viscoelastics using the Miyake video technique. Five viscoelastics were investigated: sodium hyaluronate (Healon), Healon GV, chondroitin sulfatesodium hyaluronate (Viscoat), hydroxypropylmethylcellulose (Occucoat), and polyacrylamide (Orcolon). The viscoelastics were dyed with fluorescein and, after filling the capsular bag with a viscoelastic material, a posterior chamber intraocular lens (IOL) was implanted. The viscoelastic was then aspirated using an automated irrigation/aspiration device. Healon and Healon GV were completely removed within 20 to 25 seconds. Viscoat adhered to the lens capsule and to the posterior surface of the IOL and cooplete removal required approximately 3.5 minutes. Most Occucoat and Orcolon was aspirated within one minute; however, removal was completed only after three minutes. Removal of Healon and Healon GV was faster and more complete than removal of the other viscoelastics. Whether a small amount of viscoelastic left in the eye or trapped behind the IOL optic has any clinical significance has to be studied.
J Cataract Refract Surg 1992 Jan
PMID:Removal of viscoelastic materials after experimental cataract surgery in vitro. 153 Dec 33

We investigated the use of an infrared diode laser to perform iridotomies in 20 eyes of ten rabbits and 40 eyes of 24 patients with primary angle-closure glaucoma. We used a two-stage method with initial circular stretch burns and subsequent penetrating multiple burns. The iris was perforated in one session and remained patent through ten months in rabbits, and seven to nine months in humans. Transitory clinical complications included intraocular pressure increase of more than 10 mm Hg (20%, eight of 40 eyes), corneal endothelial changes (5%, two of 40 eyes), clouding of lens surface (60%, 24 of 40 eyes), localized cataract (5%, two of 40 eyes), and pupillary distortion (70%, 28 of 40 eyes). No retinal damage was observed. Diode laser can be used for peripheral iridotomy.
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PMID:Diode laser iridotomy in rabbit and human eyes. 154 27

In a prospective, randomized, masked study the effect of sodium hyaluronate (Healon) and timolol on the acute intraocular pressure rise after extracapsular cataract extraction with implantation of a posterior chamber lens were evaluated. Intraocular pressure was measured preoperatively and 3-6 h and 24 h postoperatively. When no timolol was used, a significant rise in intraocular pressure was observed at 3-6 h, whether or not Healon was aspirated. Timolol reduced the intraocular pressure rise, especially during the first 3-6 h after surgery. When timolol was not applied at the end of surgery, IOP exceeded 30 mmHg in 28% 3-6 h postoperatively, compared to only 4% when timolol was applied.
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PMID:The effect of Healon and timolol on early postoperative intraocular pressure after extracapsular cataract extraction with implantation of a posterior chamber lens. 155 82

Aniridia is an uncommon disorder that may be associated with glaucoma that is usually refractory to conventional medical and surgical therapy. In this study, we report our experience with the surgical management of glaucoma in aniridia in 17 eyes of 10 patients. A total of 45 surgical procedures were performed. The mean preoperative intraocular pressure was 38 mm Hg. The intraocular pressure was ultimately controlled successfully in 11 eyes (intraocular pressure range, 8 to 20 mm Hg) with a mean of 2.8 surgical procedures required in successful cases. Trabeculectomy controlled the intraocular pressure in one eye, but it was successful in only 9% of cases in which it was performed. Cyclocryotherapy was successful in five eyes (25% of cases in which it was performed), although complications of phthisis bulbi and progressive cataract occurred. We detail our experience with the Molteno implant, which was successful in five eyes (83% of cases in which it was performed). We have found this type of drainage device to be effective in controlling intraocular pressure in aniridic eyes when previous attempts at control have failed.
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PMID:The results of glaucoma surgery in aniridia. 156 57

Ninety-two nonglaucomatous patients undergoing extracapsular cataract extraction with implantation of a posterior chamber intraocular lens by residents at a Veterans hospital were randomized in double-masked fashion to receive either a topical nonsteroidal antiinflammatory agent, diclofenac sodium 0.1%, or a placebo consisting of vehicle only. One drop of placebo or diclofenac sodium 0.1% was administered on an inpatient basis by trained staff every 6 hours for three doses, starting the afternoon prior to surgery. A further drop was given at 90, 60, 30, and 15 minutes before the operation. Starting 24 hours after surgery, all patients received diclofenac sodium 0.1%. All patients remained hospitalized for 72 hours postoperatively. Mean baseline intraocular pressure (IOP) was 14.0 and 14.1 mm Hg in the diclofenac and placebo groups, respectively. IOP rose 8.6 mm Hg in both groups at 6 hours after surgery. At 24 hours, the mean IOP elevation from baseline was 11.3 mm Hg in the diclofenac group and 9.6 mm Hg in the placebo group (P = .47). Within the first 24 hours, IOP spiked more than 10 mm Hg in 57% (26/46) of the diclofenac patients and in 54% (25/46) of the placebo patients. These results suggest that diclofenac sodium 0.1% drops affect neither the incidence nor the height of IOP elevation following cataract surgery.
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PMID:The effect of diclofenac sodium ophthalmic solution on intraocular pressure following cataract extraction. 157 84

In the Fluorouracil Filtering Surgery Study, ten of 162 eyes (6.2%) that had undergone previous cataract extraction developed a nonexpulsive suprachoroidal hemorrhage after filtering surgery. Of the previously reported risk factors, including age, myopia, history of vitrectomy, history of 5-fluorouracil injections, postoperative hypotony, and high preoperative intraocular pressure, only high preoperative intraocular pressure was statistically significant (P = .002). The risk of suprachoroidal hemorrhage was strongly associated with the level of the preoperative intraocular pressure. None of the 63 patients with a preoperative intraocular pressure less than 30 mm Hg, three of the 47 patients (6%) with a preoperative intraocular pressure between 30 and 39 mm Hg, four of the 36 patients (11%) with a preoperative intraocular pressure between 40 and 49 mm Hg, two of the 12 patients (17%) with a preoperative intraocular pressure between 50 and 59 mm Hg, and one of four patients with an intraocular pressure more than 60 mm Hg developed a suprachoroidal hemorrhage. Because the preoperative intraocular pressure was highly correlated with the difference between the preoperative and the postoperative intraocular pressure, it was not possible to distinguish which factor was clinically more important.
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PMID:Risk factors for suprachoroidal hemorrhage after filtering surgery. The Fluorouracil Filtering Surgery Study Group. 157 23

Long-term intraocular pressure (IOP) was evaluated in 41 glaucoma patients after extracapsular cataract extraction (ECCE) with posterior chamber lens (PC-IOL) implantation. All patients were initially monitored for a mean of 19 days. Eight failed to return for reexamination, but follow up of the other 33 continued for a mean of 12 months. IOP dropped significantly and the need for medication was reduced in all patients (particularly in those with open-angle glaucoma and prior iridotomy and iris suturing). The reduction in pressure remained significant in patients with simple or exfoliation glaucoma even after long-term observation. Pressure also significantly dropped in patients who had undergone previous ophthalmic surgery. The pressure drop was possibly due to a surgical deepening of the chamber angle. (Using the laser tomographic scanner, we found the same phenomenon in 50 patients without glaucoma: following ECCE/PC-IOL, the anterior chamber angle widened 9.3 +/- 4.3 degrees.)
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PMID:Intraocular pressure and anterior chamber depth before and after extracapsular cataract extraction with posterior chamber lens implantation. 158 91

The safety and efficacy of phacoemulsification and posterior chamber lens insertion combined with the Pearce trabeculectomy (PE/PCL/P-TRX) in patients with coexistent cataract and glaucoma was evaluated retrospectively. The Pearce trabeculectomy is a form of nonfiltration glaucoma surgery in which an inner block containing trabecular meshwork is excised under a scleral-pocket incision which is closed tightly. Thirty consecutive eyes sustained a reduction of mean intraocular pressure from 21.0 +/- 4.4 mm Hg to 16.6 +/- 3.3 mm Hg after PE/PCL/P-TRX at one year (P less than .001). The average number of glaucoma medications used was reduced from 1.9 to 0.8 postoperatively. At one year, 60% (18 of 30) of eyes treated with PE/PCL/P-TRX had intraocular pressures less than 21 mm Hg without medications.
J Cataract Refract Surg 1992 May
PMID:Surgical outcome of phacoemulsification combined with the Pearce trabeculectomy in patients with glaucoma. 159 37


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