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

A postsurgical flare was evaluated with a flare-cell meter and the effect of residual viscoelastic substances on the blood aqueous barrier function was studied. The materials consisted of 100 eyes undergoing extracapsular cataract extraction and posterior chamber lens implantation using sodium hyaluronate products (Healon:Pharmacia and Opegan:Santen). The molecular weight is 1.9-3.6 million daltons in Healon and 0.9-1.2 million daltons in Opegan. According to the aqueous warm current on the 1st postoperative day, the eyes were divided into two groups; the poor current group and the normal current group. The poor current group consisted of 13 eyes had static aqueous current, probably due to residual viscoelastic substances from the clinical findings, namely a little pain, foggy general corneal edema and spontaneous recovery of the warm current without specific administrations of antibiotics. Eyes with poor current were recognized in 18% (11/62) among cases with Healon and 5% (2/38) in case with Opegan. Flare values of the poor current group were higher in 7 eyes than the highest of the normal current group on the 1st postoperative day. After the 2nd postoperative day, the median flare value of the poor current group was higher than that of the normal current group. The difference was statistically significant throughout the first week (p less than 0.02). The cell number was also higher in the poor current group on the 1st and 2nd postoperative day (p less than 0.02). These findings suggest that the residual viscoelastic materials may increase the breakdown of blood-aqueous barrier and/or interfere the barrier recovery.
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PMID:[The effect of viscoelastic substances on postsurgical blood aqueous barrier]. 189 57

A randomised, placebo controlled, double-masked study was undertaken in 115 patients undergoing cataract surgery to assess the efficacy of the anaesthetic cream EMLA (eutetic mixture of local anaesthetic, lignocaine-prilocaine) in alleviating the pain of retrobulbar injection. Sixty three patients received the EMLA cream and 52 the placebo cream. The pain was assessed objectively by the anaesthetist, who observed the reaction of the patient on needle insertion, and subjectively by the patient. Significantly lower pain scores were recorded in patients treated with EMLA cream (anaesthetist's observation: p less than 0.01, patient's assessment: p less than 0.006). No patients experienced serious side effects in either treatment group.
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PMID:A double-masked evaluation of lignocaine-prilocaine cream (EMLA) used to alleviate the pain of retrobulbar injection. 201 76

We sought to determine whether, given the decreasing rate of complications associated with cataract surgery and IOL implantation, postoperative restrictions placed on patients undergoing these procedures could be significantly and safely relaxed. We reviewed the charts of 216 patients who had undergone capsulorhexis or "can-opener" capsulotomy, phacoemulsification, and insertion of an oval IOL over a 3-year period, noting any operative or postoperative complications. All of these patients had been examined the day after surgery and, if no complications were noted, had been instructed only to refrain from activities that produced pain. No shield was required, and no instructions were given to restrict showering, hair washing, or any other normal physical activity. We found no complications related to any postoperative activity. These results suggest that current postoperative instructions typically restricting such patients' activities should be reevaluated.
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PMID:A new look at postoperative instructions following cataract extraction. 192 1

Postoperative inflammation is one of the oldest complications of cataract surgery. It was described by the Indian Susruta as early as 500 BC. Following the introduction of cataract extraction by Daviel in 1745, these operations attracted increasing interest. In 1786 de Wenzel distinguished two types of postoperative inflammation. In the dangerous type there was involvement of the entire eye and severe pain; in the benign type, which began in the first few postoperative days, the conjunctiva and lids were not involved, and even if hypopyon developed there was no severe pain. During the 19th century, the possible causes of the benign type of iritis were discussed, including infection, phacoanaphylaxis, trauma, toxicity of irrigation solutions etc. In the early days of implantation of intraocular lenses, from 1949 onward, postoperative inflammation was common. However, it was not until 1980 that the term "toxic lens syndrome" was introduced. The clinical descriptions do not differ much from other descriptions of benign iritis published during the last 200 years. Therefore, it does not seem that there is any great advantage to be gained by using this new term.
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PMID:[Iritis following cataract operations. Historical retrospective with critical comments on a so-called "toxic lens" syndrome]. 219 76

Six days after suture-fixation of a posterior chamber lens to the sclera, a suprachoroidal hemorrhage occurred causing pain and intraocular lens dislocation. Placing the sutures at the 3 o'clock and 9 o'clock positions and having the needles exit 2 mm posterior to the limbus may have inadvertently increased the possibility of the hemorrhage. Suprachoroidal hemorrhage after suture-fixating lenses to the sclera and ciliary body area is a potential complication that patients should be advised of preoperatively.
J Cataract Refract Surg 1990 Jul
PMID:Suprachoroidal hemorrhage after placement of a scleral-fixated lens. 219 68

A prospective clinical trial comparing peribulbar with retrobulbar anaesthesia is reported. Ninety-nine consecutive patients for cataract extraction under local anaesthesia were randomly allocated to a peribulbar or retrobulbar technique. The effectiveness of the anaesthetic, the operative conditions, and the degree of patient discomfort were recorded. Pain scores (as assessed separately by the patient, surgeon, and attendant nurse) demonstrated that anaesthetic administration and surgery were less painful with the peribulbar method. This technique gave more reliable ocular akinesia and orbicularis oculi paralysis in addition to a lower operative complication rate.
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PMID:Peribulbar versus retrobulbar anaesthesia. 220 7

Fibrous membrane formation on the anterior surface of an intraocular lens with occlusion of the pupil was noted in five patients having phacoemulsification and one patient having planned extracapsular cataract extraction. Initial onset of pain and decreased vision ranged from eight to 36 postoperative days. Since these patients did not respond fully to steroid therapy, the neodymium:YAG laser was used to disrupt the fibrinous membrane which occluded the pupil. In all but one case, the fibrinous reaction responded to laser therapy. Generally, less energy was required when laser therapy was initiated early in the treatment plan.
J Cataract Refract Surg 1990 Sep
PMID:Severe fibrinous reaction after cataract and intraocular lens implantation surgery requiring neodymium:YAG laser therapy. 223 83

Comparatively little attention has been paid to the conjunctival toxicity of antibiotics administered at the time of cataract surgery. We have observed the effect of subconjunctival gentamicin and cefuroxime injection, using colour photography in a randomised single blind trial of 121 patients undergoing routine cataract surgery. Our results suggest that a hyperaemic eye is likely to occur about twice as often in patients injected with gentamicin (p less than 0.001). Gentamicin is associated with more pain postoperatively (p less than 0.05). Significant manifestations of gentamicin toxicity are conjunctival oedema and capillary closure. Cefuroxime has some theoretical advantages over gentamicin in its antibacterial spectrum.
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PMID:Randomised single blind trial to compare the toxicity of subconjunctival gentamicin and cefuroxime in cataract surgery. 227 36

Radial keratotomy for myopia and transverse keratotomy for astigmatism are the most commonly performed refractive surgical procedures. A decade of experience with modern techniques has produced considerable literature on the complications of keratotomy. Vision-threatening complications (bacterial keratitis, traumatic rupture of the globe through weakened keratotomy scars, endophthalmitis, cataract formation from surgical trauma to the lens) are quite rare, occurring in less than 1% of eyes in published series. The most common side effects affect most patients in the first few months after surgery: pain for 24 to 48 hours, transient glare and light sensitivity, and fluctuating visual acuity. The most common persistent complications are overcorrection and undercorrection. Persistent irregular astigmatism occurs in almost all cases in the region of the incision scars, but it is rarely severe enough to reduce spectacle acuity. Most individuals have mild glare, but this is rarely disabling. Diurnal variation of refraction in visual acuity occurs commonly, but the magnitude of the fluctuation is seldom enough to require multiple pairs of spectacles. Longterm refractive stability occurs in approximately half of eyes by six months, but approximately one in four eyes will experience continued change over six months to four years. Complications, such as scarring from intersecting keratotomy incisions, irregular astigmatism resulting from multiple reoperations, and overcorrections with the attendant early onset of symptomatic presbyopia are becoming much less frequent.
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PMID:Complications of radial and transverse keratotomy. 268 58

Transscleral neodymium (Nd):YAG cyclophotocoagulation, a new cyclodestructive procedure for controlling intraocular pressure in patients with refractory glaucoma, is designed to penetrate the sclera and selectively destroy the ciliary body and processes without damaging the overlying tissue. Complications include conjunctival edema, corneal edema, iritis, gas in the anterior chamber, pain, hyphema, hypopyon, vitreous hemorrhage, and cataract. We present a case in which a patient developed focal areas of scleral thinning 6 weeks after transscleral Nd:YAG cyclophotocoagulation. The possibility of scleral damage or thinning should be kept in mind when performing the procedure.
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PMID:Focal scleral thinning after transscleral Nd:YAG cyclophotocoagulation. 271 Apr 91


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